• Lesley A Inker, Aghogho Okparavero, Hocine Tighiouart, Thor Aspelund, Margret B Andresdottir, Gudny Eiriksdottir, Tamara Harris, Lenore Launer, Hjalmfridur Nikulasdottir, Johanna Eyrun Sverrisdottir, Hrefna Gudmundsdottir, Farzad Noubary, Gary Mitchell, Runolfur Palsson, Olafur S Indridason, Vilmundur Gudnason, and Andrew S Levey.
• Tufts Medical Center, Boston, MA. Electronic address: linker@tuftsmedicalcenter.org.
• Am. J. Kidney Dis. 2015 Aug 1;66(2):240-8.

BackgroundChronic kidney disease (CKD) is common in the elderly, but the cause is often not identifiable. Some posit that age-related reductions in glomerular filtration rate (GFR) and increases in albuminuria are normal, whereas others suggest that they are a consequence of vascular disease.Study DesignCross-sectional analysis of a substudy of a prospective cohort.Setting & ParticipantsAGES (Age, Gene/Environment Susceptibility)-Reykjavik Study.PredictorExposure to higher blood pressure in midlife.Outcomes & MeasurementsMeasured GFR using plasma clearance of iohexol and urine albumin-creatinine ratio.ResultsGFR was measured in 805 participants with mean age in midlife and late life of 51.0±5.8 and 80.8±4.0 (SD) years, respectively. Mean measured GFR was 62.4±16.5 mL/min/1.73 m(2) and median albuminuria was 8.0 (IQR, 5.4-16.5) mg/g. Higher midlife systolic and diastolic blood pressures were associated with lower later-life GFRs. Associations persisted after adjustment. Higher midlife systolic and diastolic blood pressures were also associated with higher albumin-creatinine ratios, and associations remained significant even after adjustment.LimitationsThis is a study of survivors, and people who agreed to participate in this study were healthier than those who refused. Blood pressure may encompass effects of the other risk factors. Results may not be generalizable to populations of other races. We were not able to adjust for measured GFR or albuminuria at the midlife visit.ConclusionsFactors other than advanced age may account for the high prevalence of CKD in the elderly. Midlife factors are potential contributing factors to late-life kidney disease. Further studies are needed to identify and treat midlife modifiable factors to prevent the development of CKD.Copyright © 2015 National Kidney Foundation, Inc. All rights reserved.

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