In the United States, chronic kidney disease (CKD)—defined by reduced GFR <60 mL/min per 1.73 m2, or presence of kidney damage—is very common in the elderly population. The prevalence of CKD is estimated to be 46.8 percent in those older than 70 years (1). However, the significance of reduced GFR in the elderly has been debated, and some suggest that reduced GFR is secondary to (expected) age-related changes in kidney function and is not evidence of true kidney disease. Regardless of the label, elderly patients with reduced levels of GFR are at higher risk for adverse outcomes and complications, and they require modification of drug dosages. Issues related to the accuracy and interpretation of GFR estimates in the kidney are discussed here.
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