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. Author manuscript; available in PMC: 2015 Oct 5.
Published in final edited form as: Am J Kidney Dis. 2015 Jul;66(1):172. doi: 10.1053/j.ajkd.2015.05.003

In Reply to ‘The Myth of the Future Burden of CKD in United States’

Thomas J Hoerger 1, Nilka Ríos Burrows 2, Meda E Pavkov 2
PMCID: PMC4593483  NIHMSID: NIHMS725329  PMID: 26111907

In our AJKD article, we reported estimates of the future prevalence of CKD using existing definitions of the disease.1 In their letter, Drs Delanaye, El Nahas, and Glassock state that the high prevalence of CKD in persons aged 65 and older is primarily due to aging and does not represent an added mortality risk.2 A few studies have indeed found that estimated GFR values between 45 and 59 mL/min/1.73 m2 are not associated with increased mortality.3 However, other large epidemiologic studies have found that the relative and absolute risks of mortality are higher for the elderly with estimated GFR in this range than for the elderly with greater estimated GFR levels, even after controlling for albuminuria.4,5 Thus, we believe that CKD staging does provide prognostic information for persons aged 65 and older. We agree with Delanaye et al that not all persons who reach CKD stage 3a will progress to more advanced CKD stages; however, we disagree with their statement that “clearly stage 3a neither progresses to more severe stages nor shortens life expectancy” in persons aged 65 and older.

Acknowledgments

Financial Disclosure: The authors declare that they have no relevant financial interests.

References

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