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Renal disease in the elderly.

A H Samiy

    The Medical Clinics of North America
    |March 1, 1983
    PubMed
    Summary

    Kidney function declines with age, often without symptoms. Elderly individuals are more susceptible to renal dysfunction due to reduced reserve capacity and increased risk of secondary kidney diseases.

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    Area of Science:

    • Nephrology
    • Geriatric Medicine
    • Renal Physiology

    Background:

    • Kidney structure and function significantly alter with aging, leading to reduced renal reserve.
    • While primary kidney diseases decrease, secondary kidney diseases and drug-induced nephropathies increase in the elderly.
    • Aging kidneys have a diminished capacity to handle hemodynamic changes and fluid imbalances, increasing susceptibility to dysfunction.

    Purpose of the Study:

    • To review the age-related changes in renal function and disease patterns in the elderly.
    • To highlight the challenges in diagnosing renal disease in geriatric populations.
    • To emphasize the importance of appropriate renal function assessment in older adults.

    Main Methods:

    • Literature review of age-related renal changes and diseases.
    • Analysis of common renal pathologies in the elderly, including primary and secondary glomerulonephritis, and tubulointerstitial nephropathy.
    • Discussion of diagnostic challenges and appropriate assessment methods for renal function in older adults.

    Main Results:

    • Renal plasma flow (RPF), glomerular filtration rate (GFR), and tubular reabsorptive capacity decline with age.
    • Acute renal failure (ARF) is common in the elderly, often triggered by hypovolemia, hypotension, or nephrotoxic agents.
    • Creatinine clearance is a more reliable indicator of renal function than serum creatinine in the elderly due to age-related muscle mass reduction.

    Conclusions:

    • Renal disease in the elderly often presents atypically and may be overlooked.
    • A decrease in creatinine clearance warrants further investigation and should not be dismissed as a normal aging process.
    • Prompt recognition and evaluation of renal dysfunction are crucial for effective management in geriatric patients.

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