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The Association Between Age and Nephrosclerosis on Renal Biopsy Among Healthy Adults

2010; American College of Physicians; Volume: 152; Issue: 9 Linguagem: Inglês

10.7326/0003-4819-152-9-201005040-00006

1539-3704

Andrew D. Rule, Hatem Amer, Lynn D. Cornell, Sandra J. Taler, Fernando G. Cosio, Walter K. Kremers, Stephen C. Textor, Mark D. Stegall,

Renal and Vascular Pathologies

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.