Leeftijdsafhankelijke afkapwaarde voor eGFR is niet nodig

A study of adults with chronic kidney disease (CKD) suggests that the current criteria for CKD may result in overestimation of the CKD burden in an aging population with age-related loss of kidney function. Therefore, an age-adjusted formula for GFR (glomerular filtration rate) should be implemented in clinical practice. We agree that in older patients physiological loss of kidney function should be taken into account, however an age-adjusted formula would not be superior. Even in older patients with mild chronic kidney disease (eGFR < 60 ml/min/1.73m2) dose adjustments are necessary for renally excreted drugs. So far, an age-adjusted formula for older patients does not better predict clinically relevant renal outcomes. Based on the current Dutch guideline older patients with mildly impaired GFR without albuminuria will not be referred to specialized nephrology care, unless there is rapid deterioration. Finally, an age-adjusted formula may unnecessarily complicate the current categories of CKD.

Conflict of interest and financial support: none declared. ICMJE forms provided by the authors are available online along with the full text of this article.