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Related Experiment Videos

When kidneys get old: an essay on nephro-geriatrics.

Richard Glassock1, Aleksandar Denic2, Andrew D Rule2

  • 1Geffen School of Medicine, UCLA, USA.

Jornal Brasileiro De Nefrologia
|March 30, 2017
PubMed
Summary

Kidney aging involves a natural decline in glomerular filtration rate (GFR). Modest GFR reduction in older adults without proteinuria does not indicate chronic kidney disease or impact longevity.

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Area of Science:

  • Gerontology
  • Nephrology
  • Renal Physiology

Background:

  • Aging is a universal biological process affecting organs at different rates.
  • Kidneys naturally lose nephrons and show decreased glomerular filtration rate (GFR) starting around age 30.
  • The precise mechanisms driving age-related kidney function decline remain unclear.

Purpose of the Study:

  • To evaluate the clinical significance of age-related GFR decline in older adults.
  • To question the diagnostic criteria for chronic kidney disease (CKD) based on fixed GFR thresholds in the elderly.
  • To determine if modest GFR reduction without proteinuria adversely affects mortality or life expectancy in the aging population.

Main Methods:

  • Analysis of age-related changes in kidney structure and function.

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  • Review of diagnostic criteria for CKD in elderly populations.
  • Correlation of reduced GFR levels with mortality and end-stage renal disease (ESRD) incidence in older adults.

    • Main Results:

    • Kidney aging is characterized by a steady loss of nephrons and declining GFR.
    • Fixed GFR thresholds for CKD diagnosis may lead to over-diagnosis in the elderly.
    • A persistent GFR reduction (45-59 ml/min/1.73m2) without proteinuria shows minimal adverse effects on mortality and life expectancy.

    Conclusions:

    • Age-related kidney function decline is a normal physiological process.
    • Kidneys in older adults with modest GFR reduction and no proteinuria should not be automatically classified as "diseased".
    • Current CKD diagnostic criteria may require re-evaluation for the aging population to avoid over-medicalization.