NYMC Faculty Publications

Prevalence of Moderate and Severe Renal Insufficiency in Older Persons With Hypertension, Diabetes mellitus, Coronary Artery Disease, Peripheral Arterial Disease, Ischemic Stroke, or Congestive Heart Failure in an Academic Nursing Home

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Journal of the American Medical Directors Association

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OBJECTIVE: To determine the prevalence of moderate and severe renal insufficiency in older persons in an academic nursing home.

DESIGN: The prevalence of an estimated glomerular filtration rate (GFR) determined by the Modification of Diet in Renal Disease equation less than 60 mL/min/1.73 m(2) was investigated in older persons in an academic nursing home with either hypertension, diabetes mellitus, coronary artery disease (CAD), peripheral arterial disease (PAD), ischemic stroke, or congestive heart failure (CHF).

SETTING: An academic nursing home.

PARTICIPANTS: Two hundred and two persons (104 women and 98 men), mean age 73 years (range 50 to 98 years) residing in an academic nursing home.

MEASUREMENTS: Prevalence of a GFR less than 60 mL/min/1.73 m(2).

RESULTS: A GFR less than 60 mL/min/1.73 m(2) was present in 60 (42%) of 143 persons with hypertension, in 30 (48%) of 62 persons with diabetes mellitus, in 28 (52%) of 52 persons with CAD, in 13 (50%) of 26 persons with PAD, in 10 (44%) of 23 persons with ischemic stroke, and in 15 (63%) of 24 persons with CHF.

CONCLUSION: Older persons with hypertension, diabetes mellitus, CAD, PAD, ischemic stroke, or CHF have a high prevalence of moderate or severe renal insufficiency and should be treated optimally to reduce the increased risk of cardiovascular events and mortality in this high-risk population.