A recent meal of cooked meat can increase the measurement of serum creatinine and falsely lower the eGFR. As creatinine levels are inluenced by muscle mass eGFR may be an unreliable indicator of kidney function in those with muscle mass that varies greatly from the average adult, e. Warning Don't risk using unapproved coronavirus test kits More Info. Find an explanation of your pathology test Keyword:.
Test name Tests All Tests and synonyms Test not listed? Health check Screening On This Page At a glance What is being tested? The test Common questions Related information. At a glance Why get tested? When to get tested? Sample required? A blood sample drawn from a vein in your arm. Hemoglobin A and creatinine clearance B according to age in male participants. To convert creatinine clearance to milliliters per second, multiply by 0.
Hemoglobin A and creatinine clearance B according to age in female participants. Prevalence of anemia according to sex and creatinine clearance in unadjusted A and age-adjusted B models. Serum erythropoietin EPO levels according to creatinine clearance in participants affected by anemia.
The number of subjects in each group is reported within the bars. Values are given as geometric means, adjusted for age and hemoglobin.
Arch Intern Med. Background In the older population, anemia has been associated with poor outcomes including disability and mortality. Understanding the mechanisms leading to anemia is essential to plan better treatment and prevention strategies. We tested the hypothesis that the age-related decline in kidney function is associated with an increased prevalence of anemia and that such an increase is accompanied by a concomitant decrement in erythropoietin levels.
This analysis included participants with complete data on hemoglobin and erythropoietin levels and markers of renal function. Conclusions Severe age-related decline in renal function is associated with a reduced erythropoietin secretion and anemia.
Whether moderate kidney impairment in older persons is associated with a progressively increasing risk of anemia remains to be determined. Anemia is an extremely prevalent condition in older age.
It has been estimated that individuals older than 85 years have a 2-fold to 3-fold greater prevalence of anemia compared with individuals aged 65 to 69 years. In older persons, anemia has important clinical consequences.
Recent studies have demonstrated an inverse correlation between hemoglobin Hb concentration and muscle strength, physical performance, disability, and mortality. It has been suggested that the ability of the kidney to secrete erythropoietin EPO in response to tissue hypoxia declines with aging 11 in parallel with the decline of renal function. At present, controversial data are available on the EPO response to anemia in the older population compared with the younger population, 12 , 13 and scant data are available on the relationship between renal function and risk of anemia in samples of community-dwelling older persons representative of the general population.
The objective of this study was to determine whether the age-associated progressive reduction in renal function is also accompanied by an increased risk of anemia and whether an identifiable threshold of renal function exists below which the risk of anemia markedly increases. Our study may contribute to the understanding of whether the high prevalence of anemia in the older population is due to an age-related reduction of renal function and EPO secretion. The study was designed to identify risk factors for late-life disability.
Participants were selected from the city registries of Greve in Chianti and Bagno a Ripoli using a multistage sampling method. Of these, participants with complete data for the analysis presented herein were considered. Participants consented to participate and agreed to have their blood samples analyzed for scientific purposes. For those unable to fully consent, surrogate consents were obtained from close relatives.
Blood samples were obtained from participants after a hour fasting and after the participants had been resting for at least 15 minutes. At the time of the home interview, participants were provided a plastic container and received detailed instructions for hour urine collection. Erythropoietin serum levels were measured in duplicate using the Advantage EPO chemiluminescence immunoassay Nichols Institute Diagnostic, San Clemente, Calif , which has a sensitivity of 1. Serum creatinine and urinary creatinine from the hour urine collection were measured using a modified Jaffe method and used to calculate creatinine clearance CrCL as a measure of glomerular filtration rate GFR.
Commercial enzymatic tests were used for determining iron concentrations Roche Diagnostics, Mannheim, Germany. The presence of specific medical conditions was established using standardized criteria that combined information from self-reported history, medical records, and a clinical medical examination.
Because the distribution of EPO levels was highly skewed, log-transformed EPO values were used in the analysis and subsequently back-transformed and reported as geometric means and interquartile ranges. The relationship between Hb and CrCl according to age in both sexes was explored using scatterplots and summarized by linear regression models. Age-adjusted prevalence of anemia according to CrCl was calculated and compared between sexes using a generalized linear model.
All analyses were performed using the SAS statistical package, version 8. The novelty of this study is in the analysis of the interplay between low ABI and the rapid renal function deterioration in a population affected by AF. This would suggest that low ABI, in addition to being a marker of systemic atherosclerosis, represents a marker of vascular damage occurring not only in the coronary or cerebral tree, but also in the circulation of other organs such as the kidney.
However, our data are in keeping with other methods exploring atherosclerosis disease, such as pulse wave velocity, which have been shown to be predictive of renal function decline in different clinical settings.
This is in contrast to Foster et al , 8 who found only a trend between low ABI and incident CKD, but their small sample size may perhaps account for the different findings. This study has implications and limitations. Patients with AF have a relatively high prevalence and incidence of renal impairment which is related to ABI, a marker of systemic atherosclerosis.
This finding may turn useful particularly in the era of NOACs which are excreted, even if to a different degree by the kidney, and whose dosage requires to be tailored in case of patients with AF with moderate renal function.
In this context, ABI measurement could be particularly useful in identifying patients who are at high risk of renal function deterioration, and will eventually require serum creatinine monitoring. Furthermore, identification of patients at high risk of renal disease progression may be of use to identify patients who are at higher risk of cardiovascular events.
Our analysis performed only in a Caucasian population is a study limitation, as it cannot be translated to other race or ethnic groups. Contributors: FV is responsible for the study concept and design, drafting of the manuscript and critical revision of the manuscript.
DP and PP are responsible for the study concept and design, acquisition, analysis and interpretation of data and drafting of the manuscript. AS, SB and MP are responsible for the acquisition, analysis and interpretation of data and critical revision of the manuscript. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests: None declared. Patient consent: Obtained. Provenance and peer review: Not commissioned; externally peer reviewed. Data sharing statement: No additional data are available. National Center for Biotechnology Information , U. BMJ Open. Published online May Author information Article notes Copyright and License information Disclaimer.
Correspondence to Professor Francesco Violi; ti. This article has been cited by other articles in PMC. Design Observational prospective multicentre cohort study. Participants AF patients on treatment with vitamin K antagonists. Results Mean age was Strengths and limitations of this study. Introduction Atrial fibrillation AF is the most common arrhythmia encountered in daily clinical practice, accounting for approximately one-third of all hospitalisations for a cardiac rhythm abnormality.
Statistical analyses Categorical variables are reported as counts percentage. Results Clinical characteristics of patients with AF included in the study are described in table 1.
Open in a separate window. Figure 1. Rapid decline in renal function Analysis of rapid deterioration in renal function showed that References 1. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke ; 22 —8. Severe renal impairment and stroke prevention in atrial fibrillation: implications for thromboprophylaxis and bleeding risk.
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