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D'Annunzio Chieti Pescara","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005874","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urol Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) is increasingly prevalent among the elderly, yet current diagnostic criteria often fail to distinguish between true CKD and age-related physiological decline in glomerular filtration rate (GFR). This overestimation can lead to overdiagnosis, overtreatment, and psychological distress. Frailty, a common condition in older adults, further complicates the clinical picture. This study aimed to reclassify CKD in the elderly by integrating age-adjusted GFR estimation and frailty assessment in a regional Italian population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective, population-based study involving 325,622 individuals aged\u2009\u2265\u200965\u00a0years residing in the Abruzzo region. Data included serum creatinine, eGFR (CKD-EPI), urine tests, renal imaging, and frailty measures using the Clinical Frailty Scale (CFS) and Fried Frailty Criteria (FFC). The Keller formula (GFR\u2009=\u2009130\u2009\u2212\u2009age) was applied to distinguish between physiological renal aging and pathological CKD. Patients were categorized into four groups: Robust CKD, Senescent Nephropathy, Robust Aged Kidney, and Frailty Aged Kidney.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 58,611 elderly patients classified with CKD stages G3\u2013G5 based on CKD-EPI, only 27.9% (65\u201374\u00a0years), 56.0% (75\u201384\u00a0years), and 54.0% (\u2265\u200985\u00a0years) had eGFR values below age-adjusted expectations. More than 40% of patients met criteria for renal senescence rather than true CKD. Over 50% of CKD patients fell into frail phenotypes (Senescent Nephropathy or Frailty Aged Kidney), emphasizing the need for a multidimensional clinical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reclassifying CKD using age-adjusted GFR and frailty assessment improves diagnostic accuracy in the elderly, preventing misdiagnosis and guiding personalized care. This approach supports a shift from static staging to a more nuanced, patient-centered nephrological model that integrates renal physiology and geriatric assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11255-025-04698-6","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T19:26:10Z","timestamp":1753989970000},"page":"319-328","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Reclassification of chronic kidney disease in the elderly: integrating age-adjusted GFR and frailty assessment in a regional Italian population (Abruzzo)"],"prefix":"10.1007","volume":"58","author":[{"given":"Fabrizio","family":"Cristiano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Guido","family":"Musso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"4698_CR1","unstructured":"https:\/\/demo.istat.it\/"},{"key":"4698_CR2","unstructured":"https:\/\/www.osservatoriosullasalute.it\/osservasalute\/rapporto-osservasalute-2016"},{"key":"4698_CR3","unstructured":"https:\/\/www.istat.it\/comunicato-stampa\/la-demografia-delle-aree-interne-dinamiche-recenti-e-prospettive-future\/"},{"issue":"11","key":"4698_CR4","doi-asserted-by":"publisher","first-page":"825","DOI":"10.7326\/0003-4819-158-11-201306040-00007","volume":"158","author":"PE Stevens","year":"2013","unstructured":"Stevens PE, Levin A (2013) Kidney disease: improving global outcomes chronic kidney disease guideline development work group members. 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