Senescence rates in patients with end‐stage renal disease: a critical appraisal of the Gompertz model

Aging Cell

J. J. E. Koopman⁸  M. P. Rozing⁸  A. Kramer⁴  D. J. de Jager⁷  D. Ansell⁹  J. M. J. De Meester¹  K. G. Prütz¹⁰  P. Finne²  J. G. Heaf³  R. Palsson⁶  R. Kramar^5,8  K. J. Jager⁴  F. W. Dekker⁷ 

[1] AZ Nikolaas, Department of Nephrology, Dialysis and Hypertension, Sint-Niklaas, Belgium;Finnish Registry for Kidney Diseases, Helsinki, Finland;Department of Nephrology B, Herlev Hospital, University of Copenhagen, Herlev, Denmark;ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands;Austrian Dialysis and Transplant Registry, Kematen/Krems, Austria;Division of Nephrology, Landspitali University Hospital and Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland;Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands;Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands;UK Renal Registry, Southmead Hospital, Bristol, UK;Swedish Renal Registry, Department of Nephrology and Transplantation, Skåne University Hospital, Malmö, Sweden

关键词: dialysis;    end‐stage renal disease;    Gompertz model;    kidney transplantation;    senescence rate;   

DOI  :  10.1111/j.1474-9726.2010.00659.x

来源: Wiley

【 摘 要 】

Summary

The most frequently used model to describe the exponential increase in mortality rate over age is the Gompertz equation. Logarithmically transformed, the equation conforms to a straight line, of which the slope has been interpreted as the rate of senescence. Earlier, we proposed the derivative function of the Gompertz equation as a superior descriptor of senescence rate. Here, we tested both measures of the rate of senescence in a population of patients with end-stage renal disease. It is clinical dogma that patients on dialysis experience accelerated senescence, whereas those with a functional kidney transplant have mortality rates comparable to the general population. Therefore, we calculated the age-specific mortality rates for European patients on dialysis (n = 274 221; follow-up = 594 767 person-years), for European patients with a functioning kidney transplant (n = 61 286; follow-up = 345 024 person-years), and for the general European population. We found higher mortality rates, but a smaller slope of logarithmic mortality curve for patients on dialysis compared with both patients with a functioning kidney transplant and the general population (P < 0.001). A classical interpretation of the Gompertz model would imply that the rate of senescence in patients on dialysis is lower than in patients with a functioning transplant and lower than in the general population. In contrast, the derivative function of the Gompertz equation yielded the highest senescence rates for patients on dialysis, whereas the rate was similar in patients with a functioning transplant and the general population. We conclude that the rate of senescence is better described by the derivative function of the Gompertz equation.

【 授权许可】

Unknown   
© 2010 The Authors. Aging Cell © 2010 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland