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The aging kidney.

G A Kaysen, B D Myers

    Clinics in Geriatric Medicine
    |February 1, 1985
    PubMed
    Summary

    Kidney function declines with age due to reduced mass and glomerular filtration rate, affecting drug clearance and urine concentration. Aging impairs hormone regulation, leading to impaired sodium retention and vitamin D metabolism.

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    Area of Science:

    • Nephrology
    • Gerontology
    • Physiology

    Background:

    • Kidney mass and glomerular filtration rate (GFR) decrease with aging.
    • Renal blood flow reduction due to atherosclerosis and hypertension may contribute to age-related kidney changes.
    • Glomerular damage from increased pressure, as nephron number declines, is another potential cause of renal senescence.

    Purpose of the Study:

    • To review the physiological changes in the aging kidney.
    • To discuss the consequences of reduced GFR in the elderly.
    • To highlight functional impairments beyond GFR decline.

    Main Methods:

    • Review of existing literature on renal senescence.
    • Analysis of age-related changes in kidney function in rats and humans.
    • Examination of hormonal regulation and metabolic functions of the aging kidney.

    Main Results:

    • Aging kidneys show reduced mass and GFR, impacting drug clearance and acidification.
    • Impaired ability to concentrate or dilute urine due to dysregulated antidiuretic hormone (ADH) secretion and action.
    • Reduced responsiveness of the renin-angiotensin-aldosterone system leads to impaired sodium retention.
    • Vitamin D hydroxylation is decreased disproportionately to GFR reduction.

    Conclusions:

    • Renal senescence involves complex physiological changes beyond GFR decline.
    • Aging affects multiple kidney functions, including water balance, electrolyte regulation, and hormone metabolism.
    • Further research is needed to fully elucidate the mechanisms and consequences of renal senescence.

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