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Changes in renal function with aging

L H Beck1

  • 1Division of General Internal Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.

Clinics in Geriatric Medicine
|May 23, 1998
PubMed
Summary
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Older adults experience reduced kidney function and impaired fluid balance, making them vulnerable to dehydration and electrolyte abnormalities. This decline affects their ability to manage stress and can be worsened by medications.

Area of Science:

  • Nephrology
  • Geriatrics
  • Internal Medicine

Background:

  • Aging is associated with a significant loss of kidney volume (20%-25%) and a progressive decline in glomerular filtration rate (GFR) with each decade.
  • Despite these changes, older individuals generally maintain fluid homeostasis but have a reduced capacity to cope with physiological stresses.

Purpose of the Study:

  • To examine the age-related changes in kidney function and their impact on fluid and electrolyte balance in older adults.
  • To identify factors contributing to the failure of homeostasis, including medications and impaired physiological responses.

Main Methods:

  • Review of physiological changes in aging kidneys, including GFR, sodium and potassium handling, and acid excretion.
  • Analysis of common medications in older patients and their potential to cause electrolyte disturbances, particularly hyperkalemia.

Related Experiment Videos

  • Evaluation of age-related defects in thirst, urinary concentrating ability, and free water excretion contributing to water imbalance.

    • Main Results:

    • Reduced kidney function in older adults leads to limitations in sodium conservation, potassium secretion, and acid excretion.
    • Medications commonly prescribed to older patients are a frequent cause of hyperkalemia.
    • Impaired thirst, urinary concentrating ability, and free water excretion contribute to hypernatremia or hyponatremia in sick older patients.

    Conclusions:

    • Aging kidneys have a diminished capacity to maintain fluid and electrolyte homeostasis, increasing vulnerability to stresses.
    • Medications and impaired water balance mechanisms significantly contribute to electrolyte and fluid derangements in the elderly.
    • Understanding these age-related changes is crucial for managing fluid and electrolyte disorders in older populations.