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The Berlin initiative study: the methodology of exploring kidney function in the elderly by combining a longitudinal and cross-sectional approach

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Abstract

Epidemiologic data on incidence, prevalence and risk factors for chronic kidney disease (CKD) and its progression to kidney failure in people ≥70 years are scarce. This lack may have two reasons: First, the issue has only recently gained importance by the changing demographics characterized by an aging society. Secondly, a validated method for estimating kidney function in terms of glomerular filtration rate (GFR) in the elderly is still lacking. In this paper we describe the methodology of a combined longitudinal and cross-sectional approach of a population based study which will start in January 2010. The aims of the study are to identify prevalent and incident cases of CKD as well as co-morbidities and associated risk factors for progression of disease in this specific age-group. To assess prevalence, a new GFR estimation equation is to be developed. In a longitudinal approach a population based, age stratified sample of 2,000 subjects ≥70 years will be randomly drawn from a data base of a large health insurance company. Interview, physical examination, and preliminary estimation of GFR, based on serum creatinine will be performed. The entire cohort will be followed over the course of 2 years. In a cross-sectional approach a subsample of 600 subjects will be defined based on preliminary GFR values. Kidney function will be determined by measuring plasma clearance of an exogenous filtration marker (Iohexol). A new GFR-equation will be developed and validated using Iohexol clearance as gold standard to estimate GFR accurately and precisely. Data of 2,000 subjects will be used to estimate prevalence of CKD.

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Acknowledgments

The authors thank Andrej Woehrmann for his assistance in the quality assurance process and the manuscript preparation. Grant support: This work was supported by the KfH Foundation of Preventive Medicine (www.kfh-stiftung-praeventivmedizin.de), a non-profit organization supporting science and research in the field of prevention. Address: KfH-Stiftung Praeventivmedizin, Martin-Behaim-Strasse 20, 63263 Neu-Isenburg.

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Correspondence to Elke S. Schaeffner.

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Schaeffner, E.S., van der Giet, M., Gaedeke, J. et al. The Berlin initiative study: the methodology of exploring kidney function in the elderly by combining a longitudinal and cross-sectional approach. Eur J Epidemiol 25, 203–210 (2010). https://doi.org/10.1007/s10654-010-9424-x

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