The association between age and nephrosclerosis on renal biopsy among healthy adults
AD Rule, H Amer, LD Cornell, SJ Taler… - Annals of internal …, 2010 - acpjournals.org
AD Rule, H Amer, LD Cornell, SJ Taler, FG Cosio, WK Kremers, SC Textor, MD Stegall
Annals of internal medicine, 2010•acpjournals.orgBackground: Chronic kidney disease is common with older age and is characterized on
renal biopsy by global glomerulosclerosis, tubular atrophy, interstitial fibrosis, and
arteriosclerosis. Objective: To see whether the prevalence of these histologic abnormalities
in the kidney increases with age in healthy adults and whether histologic findings are
explained by age-related differences in kidney function or chronic kidney disease risk
factors. Design: Cross-sectional study. Setting: Mayo Clinic, Rochester, Minnesota, from …
renal biopsy by global glomerulosclerosis, tubular atrophy, interstitial fibrosis, and
arteriosclerosis. Objective: To see whether the prevalence of these histologic abnormalities
in the kidney increases with age in healthy adults and whether histologic findings are
explained by age-related differences in kidney function or chronic kidney disease risk
factors. Design: Cross-sectional study. Setting: Mayo Clinic, Rochester, Minnesota, from …
Background
Chronic kidney disease is common with older age and is characterized on renal biopsy by global glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arteriosclerosis.
Objective
To see whether the prevalence of these histologic abnormalities in the kidney increases with age in healthy adults and whether histologic findings are explained by age-related differences in kidney function or chronic kidney disease risk factors.
Design
Cross-sectional study.
Setting
Mayo Clinic, Rochester, Minnesota, from 1999 to 2009.
Patients
1203 adult living kidney donors.
Measurements
Core-needle biopsy of the renal cortex obtained during surgical implantation of the kidney, and medical record data of kidney function and risk factors obtained before donation.
Results
The prevalence of nephrosclerosis (≥2 chronic histologic abnormalities) was 2.7% (95% CI, 1.1% to 6.7%) for patients aged 18 to 29 years, 16% (CI, 12% to 20%) for patients aged 30 to 39 years, 28% (CI, 24% to 32%) for patients aged 40 to 49 years, 44% (CI, 38% to 50%) for patients aged 50 to 59 years, 58% (CI, 47% to 67%) for patients aged 60 to 69 years, and 73% (CI, 43% to 90%) for patients aged 70 to 77 years. Adjustment for kidney function and risk factor covariates did not explain the age-related increase in the prevalence of nephrosclerosis.
Limitation
Kidney donors are selected for health and lack the spectrum or severity of renal pathologic findings in the general population.
Conclusion
Kidney function and chronic kidney disease risk factors do not explain the strong association between age and nephrosclerosis in healthy adults.
Primary Funding Source
National Institutes of Health, U.S. Public Health Service.
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