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Renal reserve in the elderly

D Fliser1, E Ritz, E Franek

  • 1Department of Internal Medicine, Ruperto-Carola University, Heidelberg, Germany.

Seminars in Nephrology
|September 1, 1995
PubMed
Summary
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Healthy aging preserves renal functional reserve in humans, even up to age 90. This kidney reserve, measured by the increase in glomerular filtration rate after an amino acid load, remains intact in older adults.

Area of Science:

  • Nephrology
  • Geriatric Medicine
  • Physiology

Background:

  • Renal reserve, the increase in glomerular filtration rate (GFR) post-amino acid load, is impaired in aged rats, and renal diseases progress faster in the elderly.
  • The predictive value of renal reserve for renal disease progression in the elderly is debated, with limited data available.

Purpose of the Study:

  • To investigate renal hemodynamics and renal reserve in healthy young and elderly human subjects.
  • To determine if renal functional reserve is maintained in advanced age.

Main Methods:

  • Examined renal hemodynamics before and after an amino acid infusion in 15 young (median age 26) and 10 elderly (median age 70) healthy, normotensive subjects.
  • Analyzed basal and post-infusion inulin (Cin) and para-aminohippurate (Cpah) clearances.

Related Experiment Videos

  • Reviewed two additional studies on renal reserve in elderly patients and healthy volunteers.

    • Main Results:

    • Elderly subjects had significantly lower median basal Cin (102 mL/min/1.73 m2) and Cpah (339 mL/min/1.73 m2) compared to young subjects (122 and 647 mL/min/1.73 m2, respectively).
    • Despite lower basal values, the median percent rise in Cin was similar in both groups (+16% in young, +17% in elderly).
    • Renal reserve was confirmed as well-preserved in elderly cohorts, with absolute reserve between 16-26 mL/min/1.73 m2, including individuals up to 89 years old.

    Conclusions:

    • Human renal functional reserve is preserved in healthy individuals at least until age 90.
    • Age does not significantly impair the ability of the kidneys to increase filtration rate in response to a physiological stimulus.
    • These findings challenge assumptions about age-related decline in kidney function and highlight preserved renal reserve in the elderly.