Chronic kidney disease (CKD) can affect people of all ages, but it is particularly prevalent in older people. While around 13 % of the adult population has CKD, that number jumps to more than 50 % in those over the age of 75. That should alarm European nations, where 23 % of the population is aged 65 and over, a figure that is set to grow rapidly. “Ageing populations in industrialised countries will probably lead to an increase in CKD and CKD-related complications,” says Fabrizia Lattanzio, scientific director at INRCA, an Italian institute dedicated to research on ageing. “Against this backdrop, we must work to ensure proper care for older people and improve their quality of life – and that begins with screening.” According to Lattanzio, the current method of screening for CKD is heterogeneous, fragmented, inaccurate and, overall, ineffective. Addressing this was the focus of the EU-funded SCOPE project. “Our goal was to determine what works better for older populations and, based on these findings, propose new recommendations to improve screening programmes for those at risk of developing CKD,” adds Lattanzio, who served as the project coordinator.
Building a comprehensive data set
At the heart of the project was an evaluation of the predictive value and cost-effectiveness of several different CKD screening measures, with a particular focus on older people. “We hoped to pave the way towards more accurate identification of CKD and, ultimately, better treatment for this fragile population,” explains Lattanzio. The project started by enrolling a real-world population without stringent inclusion or exclusion criteria. “One of our main challenges was recruiting a cohort of 2 435 often very old and frail patients,” notes Lattanzio. “However, through the use of various mitigation and personalised measures, we were able to successfully achieve this ambitious sample size.” Next, researchers used clinical and laboratory evaluations to collect a comprehensive data set that included both baseline measurements and a two-year follow-up. The project has made this data set, which includes nearly 200 000 bio-samples, available for use by other researchers. “What makes the SCOPE project interesting is the use of comprehensive geriatric assessment (CGA) in CKD screening,” remarks Lattanzio. “CGA is an assessment technology that can indicate how such characteristics as multimorbidity, polypharmacy, frailty and disability can impact a patient’s overall health.”
Opening the door to new methods
SCOPE’s findings have played an important role in the development of new clinical guidelines for CKD screening and treatment, which now recommend using CGA as a means of reducing CKD-related healthcare costs. Beyond these guidelines, the project has also increased awareness about the importance of screening for CKD. “Our research has conclusively shown how CKD screening helps improve disease management and the well-being of older people,” concludes Lattanzio. “This opens the door to developing new methods for using biomarkers to assess kidney function in older populations.”
SCOPE, chronic kidney disease, screening, comprehensive geriatric assessment, kidney