Older adults: Kidney disease or senescent aging? HUGE vs. CKD-EPI scale. The approach to the elderly.

Abstract

Introduction: The approach to the renal condition of the elderly requires diagnostic tools for this age group, which allow discerning its renal condition between chronicity and senescence. The objective of this research was to analyze whether the HUGE scale is a companion tool to determine the existence of chronic kidney disease in older adult patients seen in outpatient clinics. Methods: This observational, analytical and cross-sectional study was carried out in the nephrology outpatient clinic of the Specialty Hospital of the Armed Forces No. 1 in 2015-2018. Results: We included 285 patients. The prevalence of chronic kidney disease was higher in people older than 75 years (60.7%). With the HUGE formula, a lower proportion of chronic kidney disease was established in 37% of men and 60% of women (P = 0.002) than in the CKD-EPI formula (83% and 89%, respectively). The specificity achieved by the HUGE formula was higher than the CKD-EPI and MDRD formulas (97% vs. 80% vs. 79%, respectively), having the highest discriminative capacity (NPV 70%). Hyperuricemia and diabetes mellitus are associated with the development of chronic kidney disease. Conclusions: In this research, it was shown that the HUGE formula helps discern those older adults with decreased glomerular filtration due to senescent aging in those with kidney disease In addition, The use of the HUGE formula is recommended as a complementary tool in the approach to chronic kidney disease in older adults.