J Korean Med Assoc.  2004 Mar;47(3):258-267. 10.5124/jkma.2004.47.3.258.

Renal Disease in the Elderly

Affiliations
  • 1Division of Nephrology and kidney Center, Inha University College of Medicine and Hospital, Korea. nhkimj@inha.ac.kr

Abstract

Aging is a normal degenerative biologic process that affects many organs, of which the kidney is one of the most prominently affected. Physicians who treat elderly patients must be aware of the decline in renal function that accompanies the aging process. The findings of urinary abnormalities or a decreased glomerular filtration rate (GFR) in elderly patients should alert clinicians to fully evaluate the renal function. GFR decreases steadily, starting in the middle age. Evaluation of elderly patients should include careful consideration of possible fluid and electrolyte disturbances. Acute renal failure is most frequent among the aged, mainly due to the comorbidities and the intervention they require. Diabetes and renovascular diseases including hypertension now ac count for most of the cases ofchronic kidney disease. The elderly are the fastest growing population of patients requiringenal replacement therapy in this aging society. This represents one of the great public health issues. A ging is a normal degenerative biologic process that affects many organs, of which the kidney is one of the most prominently affected. Physicians who treat elderly patients must be aware of the decline in renal function that accompanies the aging process. The findings of urinary abnormalities or a decreased glomerular filtration rate (GFR) in elderly patients should alert clinicians to fully evaluate the renal function. GFR decreases steadily, starting in the middle age. Evaluation of elderly patients should include careful consideration of possible fluid and electrolyte disturbances. Acute renal failure is most frequent among the aged, mainly due to the comorbidities and the intervention they require. Diabetes and renovascular diseases including hypertension now account for most of the cases ofchronic kidney disease. The elderly are the fastest growing population of patients requiringenal replacement therapy in this aging society. This repreents one of the great public health issues.

Keyword

Aging process; Renal function; Urinary abnormality; Acute renal failure; Chronic kidney disease

MeSH Terms

Acute Kidney Injury
Aged*
Aging
Comorbidity
Glomerular Filtration Rate
Humans
Hypertension
Kidney
Kidney Diseases
Middle Aged
Public Health
Renal Insufficiency, Chronic

Cited by  1 articles

Current Controversies over the Management of Elderly Hypertension with Impaired Renal Function
Moon–Jae Kim
J Korean Soc Hypertens. 2011;17(4):148-155.    doi: 10.5646/jksh.2011.17.4.148.


Reference

1. Lindeman RD. Overview: renal physiology and pathophysiology of aging. Am J Kidney Dis. 1990. 16(4):275–282.
Article
2. Brown WW. Introduction: Aging and the kidney. Adv Ren Replace Ther. 2000. 7(1):1–3.
3. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976. 16(1):31–34.
Article
4. Mimran A, Ribbstein J, Jover B. Aging and sodium homeostasis. Kidney Int Suppl. 1992. 37:s107–s113.
5. Rowe JW, Shock NW, DeFronzo RA. The influence of age on the renal response to water deprivation in man. Nephron. 1976. 17(4):270–278.
Article
6. Grero PS, Hodkinson HM. Hypercalcaemia in elderly hospital in-patients:value of discriminant analysis in differential diagnosis. Age Ageing. 1977. 6(1):14–20.
Article
7. Cameron JS. Nephrotic syndrome in the elderly. Semin-Nephrol. 1996. 16(4):319–329.
8. Ponticelli C, Passerini P, Como G, Melis P, Vigano E, Pozzi C. Primary nephrotic syndrome in the elderly. Contrib Nephrol. 1993. 105:33–37.
Article
9. Korbert SM, Schwartz MM, Lewis EJ. Minimal-change glomerulopathy of adulthood. Am J Nephrol. 1988. 8(4):291–297.
Article
10. Haas M, Spargo BH, Wit EJ, Meehan SM. Etiologies and outcome of acute renal insufficiency in older adults:a renal biopsy study of 259 cases. Am J Kidney Dis. 2000. 35(3):433–447.
Article
11. Bakris GL, Kern SR. Renal dysfunction resulting from NSAIDs. Am Fam Physician. 1989. 40(4):199–204.
12. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for CKD. V. : Definition and classification of stages of chronic kidney disease. 2002. New York, NY: National Kidney Foundation.
13. Bailey JL, England BK, Long RC Jr, Mitch WE. Brenner BM, editor. Pathophysiology of uremia. the Kidney (vol 2). 2000. 6th ed. Philadelphia: W.B. Saunders;2059–2078.
14. Chan L, Schrier RW. Schrier RW, editor. Chronic renal failure: Manifestations and pathogenesis. Renal and Electrolyte Disorders. 1997. 6th ed. Philadelphia: Lippincott-Raven Publishers;507–547.
15. Wedr AB. The renally compromised older hypertensive:therapeutic considerations. Geriatrics. 1991. 46(2):36–46.
17. Churchill DN, Blake PG, Jindal KK, Teffelmire EB. Clinical practice guidelines for initiation of dialysis. J Am Soc Nephrol. 1999. 10:s289–s291.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr