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Renal function in the elderly

M M Lubran1

  • 1Harbor-UCLA Medical Center, Torrance 90502, USA.

Annals of Clinical and Laboratory Science
|March 1, 1995
PubMed
Summary
This summary is machine-generated.

Kidney function declines with age, marked by reduced renal size, glomerular filtration rate (GFR), and impaired tubular function. Serum creatinine is an unreliable marker of kidney health in older adults.

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Area of Science:

  • Nephrology
  • Gerontology
  • Physiology

Background:

  • Renal size and volume diminish with aging.
  • Intrarenal vascular changes and a decrease in glomeruli number are observed.
  • Juxtamedullary nephron mass reduction impacts filtration.

Purpose of the Study:

  • To detail the physiological changes in the aging kidney.
  • To evaluate the reliability of creatinine clearance for assessing GFR in the elderly.
  • To describe alterations in tubular function with advancing age.

Main Methods:

  • Review of physiological changes in renal structure and function with age.
  • Analysis of glomerular filtration rate (GFR) decline and its estimation.
  • Assessment of tubular function, including urine concentrating and excreting abilities.

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Main Results:

  • Glomerular filtration rate (GFR) decreases significantly in the elderly.
  • Endogenous creatinine clearance approximates GFR but is influenced by tubular secretion.
  • Serum creatinine is an insensitive and often inaccurate marker for renal function in older individuals.
  • Tubular functions, such as maximal urine concentration and salt excretion, are impaired.
  • Nocturnal polyuria is a common finding in the aged population.
  • Acid-base balance maintenance is compromised under acid load conditions.

Conclusions:

  • Aging kidneys exhibit structural and functional decline, affecting filtration and tubular processes.
  • Standard methods for assessing renal function, particularly using serum creatinine, are unreliable in the elderly.
  • The aging kidney's capacity to handle physiological stress, like acid loads, is reduced.