Chronic kidney disease (CKD) is defined as the presence of lasting functional abnormalities in the renal structure and function that can worsen over time. Kidneys are vital for the whole body to work properly. Therefore, when a person has CKD, they may also have problems with the functioning of the rest of their body. Some of the common complications of CKD include anemia, bone disease, heart disease, high potassium, high calcium and fluid accumulation.

CKD是全球重要的公共卫生问题，尤其是在老年人中，它与巨大的经济负担有关。高收入国家通常将其年度预算的2-3％用于治疗终末期肾脏疾病，尽管接受此类治疗的人占总人口的0.03％。https://www.kidney-international.org/article/s0085-2538(15)55004-7/fulltext

尽管CKD的患病率正在增加，并且早期诊断对预防终末期肾脏疾病（ESRD）等并发症的重要性已经确定，但欧洲的筛查计划是高度异质和分散的。卫生系统计划需要仔细评估CKD的流行病学，但是在许多国家，有关该疾病的发病率和死亡率的数据是稀缺或不存在的。https://www.thelancet.com/article/s0140 30 - 6736 (20)045-3/fulltext

The SCOPE (Screening for CKD among older people across Europe) H2020 project implemented in seven European Countries plus Israel includes an observational prospective study with a 2-year follow up, recruiting 2426 older people aged 75+, to investigate whether and to which extent currently available screening methods may identify older people at risk of worsening kidney function.

范围项目的基线数据库的初步结果已在BMC老年人Special Issueby Dr Fabrizia Lattanzio et al.

CKD和生活质量

Quality of life (QoL) refers to the physical, psychological, social, and medical aspects of life that are influenced by health status and functions. The SCOPE team investigated the QoL among older in early stage of CKD, to identify the factors that influence this relationship.The studyresults showed that CKD and its severity may be significantly associated with impaired QoL among community-dwelling older people.

Is kidney function associated with cognition and mood in late life?

CKD和认知障碍的患病率由于人口衰老而增长。CKD，认知障碍和情绪障碍具有共同的危险因素。肾功能降低是否与最古老的老年人的认知和情绪障碍有关。因此，范围团队首次调查了肾功能，认知和情绪之间的可能关联。The study结果表明，在CKD的更高级阶段，老年人的认知障碍和抑郁症状的患病率不会增加。

CKD是瀑布的预测因子吗？

Falls are a serious negative health outcome in older persons. In facts, the fall rate rises with increasing age. However, the impact of CKD on falls in older community-dwelling persons is not well investigated yet, especially in relation to the urinary tract symptoms (LUTS). The SCOPE team studied the impact of CKD and LUTS on falls as well as on injurious falls.The study结果表明，较低的尿路症状是跌倒和有害跌倒的预测指标，而CKD和Falls之间的关联需要前瞻性研究。

CKD和肌肉减少症

在患有CKD的老年人中，肌肉质量和功能（肌肉减少症）的损失可能更为明显，其中蛋白白蛋白异常存在于尿液中（蛋白尿）。范围小组根据肾脏功能和蛋白尿水平调查了社区居民老年人中肌肉减少症的流行。The studyresults showed that sarcopenia is common among older adults, especially those in more advanced CKD stages, even if the estimated prevalence slightly differs depending on the equation used to assess estimated Glomerular Filtration Rate (eGFR); likewise, sarcopenia seems to be widespread among older people with higher albuminuria levels.

肾功能与营养状况之间的关联

不同的机制将营养状况与CKD的发生和过程联系起来。现有文献表明，尤其是在末期肾脏疾病期间，会导致营养不良（营养不良）。但是，范围团队进一步研究了肾功能与营养状况之间的这种关系。The studyresults showed that population of community-dwelling 75+ with CKD show general features of overweight and obesity with a small prevalence of malnutrition.

CKD在多发性模式中

CKD is known to be associated with several co-occurring conditions. The SCOPE team has explored multimorbidity patterns, as well as the impact of physical performance and CKD severity among an older community-dwelling people.The studyresults showed that CKD contributes significantly to multimorbidity patterns in a population of older outpatients and it was rarely observed without any co-occurring diseases. Moreover, CKD may cluster with hypertension and sensory impairments, but its contribution to multimorbidity pattern may be affected by CKD severity.

这些科学结果促使人们通过纵向研究进一步改善了老年人群中CKD的筛查方法以及援助和护理模型。CKD的早期诊断代表了一个优先问题，以防止 /减缓老年患者的进展，同时减少对长期护理的需求和医疗保健系统的相关成本。