Kidney aging process and the management of the elderly patient with renal impairment (Review)

Abstract

As life expectancy increases, a rise in the number of chronically ill patients is observed due to the aging population. Among the various diseases, chronic kidney disease is at present one of the main causes of morbidity and, due to its typical complications, it is also one of the most important causes of mortality in the general population. For these reasons, the understanding of the kidney aging process, its consequences and its adequate management are essential. The judicious use of certain types of drugs, the prevention of episodes of renal injury either by toxic mechanisms or by dehydration are important aspects and are part of the apropriate approach for elderly patients. The most effective treatment of various types of conditions with a negative impact on renal function and for which an increased incidence is known as we age should also be considered. Thus, in the case of elderly patients, in order to protect the kidneys, an integrative approach is recommended, one that includes both elements of prevention and the appropriate treatment of existing diseases.

Changes in creatinine‐to‐cystatin C ratio over 4 years, risk of diabetes, and cardiometabolic control: The China Health and Retirement Longitudinal Study

“…Possible reasons may include changes in physical activity, dietary intake, inflammation, or body weight, as well as decreased renal function due to aging. 33,34 There is evidence that age, gender, and health behaviors like smoking or drinking, may affect the prevalence or the onset of diabetes 21,35,36 and that obesity may influence cystatin C. 34,37 However, our subgroup analysis showed that these factors did not have any significant moderating effects on the association between increases in creatinine-to-cystatin C ratio and low risk of diabetes. Moreover, our study found that participants with increases in creatinine-to-cystatin C ratio and decreases in BMI at follow-up showed significant risk reductions in diabetes compared with participants with increases in creatinine-to-cystatin C ratio and increases in BMI or those with decreases in creatinine-to-cystatin C ratio.…”

Ageing-Related Alterations in Renal Epithelial Glucose Transport

“…Other tubular dysfunctions include decreased sodium reabsorption, altered transcellular potassium gradient, impaired urinary concentration, and response to fludrocortisone [34]. All of these changes result in clinically susceptible circumstances that warrant further attention [35]. The interaction between all components of these changes is largely unclear.…”

Applying Logistic Regression to Predict Diabetic Nephropathy Based on Some Clinical and Paraclinical Characteristics of Type 2 Diabetic Patients

“…It can be seen that the glomerular filtration rate decreases with age. After the age of 40, the level of glomerular filtration in normal people tends to decrease gradually and increase rapidly after 60 years of age [19]. Studies in the laboratory have observed some biochemical deterioration in aging kidney cells, including fewer mitochondria, lower enzyme levels, and ATPase activity, decreased sodium transport, and oxygen consumption and decreased renal tubular transport [20].…”