Over the past decade, chronic kidney disease (CKD), defined as impaired glomerular filtration rate (GFR) or elevated urine albumin excretion, has been increasingly recognized as an important risk factor contributing to cardiovascular disease and death.1- 3 Moreover, the prevalence of CKD has increased, with CKD now affecting approximately 13.1% of Americans.4 This increase has been driven by the increasing prevalence of the most common risk factors for CKD, including diabetes, hypertension, and—perhaps most important—older age.4,5 Among US adults aged 70 years or older, the prevalence of CKD has been estimated to be more than 45%.4 However, the clinical implications of CKD in elderly persons remain uncertain. In particular, substantial controversy exists regarding whether CKD represents a true disease or whether loss of GFR is simply part of the natural aging process.
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