{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:22:14Z","timestamp":1791433334408,"version":"4.3.3"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The debate over whether to use age-adapted or age-independent estimated glomerular filtration rate (eGFR) cut-offs for diagnosing chronic kidney disease (CKD) reflects a fundamental tension between physiological understanding and clinical pragmatism. Age-adapted proponents highlight robust evidence that GFR declines naturally with age, with many healthy older adults falling below the traditional 60\u00a0ml\/min\/1.73\u00a0m2 threshold. They argue that fixed cut-offs risk overdiagnosing CKD in the elderly, potentially leading to unnecessary anxiety and treatment, while underrecognizing risk in younger individuals whose GFRs are abnormal for their age. Physiological and longitudinal studies support this view, suggesting age-specific percentiles may better reflect true pathology. Conversely, advocates for age-independent thresholds emphasize that age-related GFR decline is not benign. Large epidemiological studies show that older adults with an eGFR of 45\u201359\u00a0ml\/min\/1.73\u00a0m2 are at increased risk of kidney failure, cardiovascular events and mortality, even in the absence of albuminuria. They caution that redefining CKD based on age could exclude high-risk older adults from beneficial therapies and research and that \u2018healthy\u2019 reference populations may harbour undiagnosed disease. A balanced approach recognizes the physiological realities of aging while not ignoring the clinical risks associated with reduced kidney function in older adults. Individualized risk prediction tools and shared decision-making can help tailor diagnosis and management. Ultimately, moving beyond arbitrary thresholds toward a patient-centred, risk-based strategy may best serve individuals across their lifespans, ensuring that CKD diagnosis and care are both scientifically sound and clinically meaningful.<\/jats:p>","DOI":"10.1093\/ckj\/sfaf328","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T12:23:17Z","timestamp":1761222197000},"source":"Crossref","is-referenced-by-count":6,"title":["Age-adapted versus age-independent eGFR thresholds to diagnose CKD: integrating the debate and charting a balanced path forward"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1480-5761","authenticated-orcid":false,"given":"Pierre","family":"Delanaye","sequence":"first","affiliation":[{"name":"University of Li\u00e8ge, CHU Sart Tilman Department of Nephrology-Dialysis-Transplantation, , Li\u00e8ge ,","place":["Belgium"]},{"name":"H\u00f4pital Universitaire Car\u00e9meau, Universit\u00e9 de Montpellier Department of Nephrology-Dialysis-Apheresis, , N\u00eemes ,","place":["France"]},{"name":"GIGA Metabolism and Cardiovascular Biology, University of Li\u00e8ge , Li\u00e8ge ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5576-820X","authenticated-orcid":false,"given":"Priya","family":"Vart","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, University of Groningen Department of Clinical Pharmacy and Pharmacology, , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Floege","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Hospital, Rheinisch-Westf\u00e4lische Technische Hochschule (RWTH) Aachen , Aachen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Zoccali","sequence":"additional","affiliation":[{"name":"Renal Research Institute , New York, NY ,","place":["USA"]},{"name":"Institute of Molecular Biology and Genetics (Biogem) , Ariano Irpino ,","place":["Italy"]},{"name":"Associazione Ipertensione Nefrologia Trapianto Renale (IPNET), c\/o Nefrologia, Grande Ospedale Metropolitano , Reggio Calabria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"2025111304363102700_bib1","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1681\/ASN.2019030238","article-title":"CKD: a call for an age-adapted definition","volume":"30","author":"Delanaye","year":"2019","journal-title":"J Am Soc 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