Renal hemodynamic response to maximal vasodilating stimulus in healthy older subjects

Fuiano, Giorgio; Sund, Ståle; Mazza, Giuseppe; Rosa, Margherita; Caglioti, Alfredo; Gallo, Giancarlo; Natale, Giuseppa; Andreucci, Michele; Memoli, Bruno; Nicola, Luca De; Conte, Giuseppe

doi:10.1046/j.1523-1755.2001.00588.x

Cited by 46 publications

(59 citation statements)

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“…Humans may lose renal reserve as they age because of the loss of functional nephrons as a result of glomerulosclerosis and/or renal microvascular disease [28]. In the study by Ohashi et al, nephrosclerosis on implant biopsy but not donor age was independently associated with post-donation GFR change [29].…”

Section: Donor Kidney Function and Its Implications To The Donormentioning

confidence: 99%

Evaluation of Kidney Function and Structure in Potential Living Kidney Donors: Implications for the Donor and Recipient

2015

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Kidney transplantation is the best treatment for patients with end-stage renal disease and recipients of living kidney donors fare better than recipients of deceased donors. In view of the shortage of organ supply and the long waiting list, expansion of the living donor pool has been sought. Importantly, donor acceptance criteria must first and foremost be grounded in concerns for donor safety. Recent studies suggesting that live kidney donors may have higher rates of end-stage renal disease in the long term compared with otherwise similar healthy persons highlights the critical importance of pre-donation evaluation of renal function and structure, and careful application in donor selection criteria. The quality of organs from living donors may also affect recipient outcomes. Because donor kidney function, histology, and anatomy pertain to the quality of the donated organ, living donor characterization of the factors associated with these features is important to the donor as well as the recipient.

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Section: Donor Kidney Function and Its Implications To The Donormentioning

confidence: 99%

Evaluation of Kidney Function and Structure in Potential Living Kidney Donors: Implications for the Donor and Recipient

2015

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“…11 In older men, glomerular filtration is maintained and the filtration fraction is elevated 12 by (1) enhanced hyperfiltration of the residual glomeruli by constriction of the efferent arteriole in comparison with the afferent arteriole 13 and (2) a relative increase in the medullary blood flow due to a reduction in renal plasma blood flow in the renal cortex. 3 Hyperfiltration in the glomeruli of the aging kidney can result in glomerulosclerosis by increasing intraglomerular pressure.…”

Section: Physiology Of Aged Kidneysmentioning

confidence: 99%

“…15 The importance of prostaglandins in adrenergic activation has been demonstrated in experimental animal models. 16 The function of aging kidneys can be preserved through vasodilation to compensate for the loss of vasculature, 11,17 because such a treatment can impair the renal response to maximal vasodilation. 10 This prostaglandin-dependent homeostasis in the aging kidney is likely one of the reasons why older individuals exhibit a higher risk of non-steroidal anti-inflammatory drug-induced renal injury.…”

Section: Physiology Of Aged Kidneysmentioning

confidence: 99%

Pathophysiology of the aging kidney and therapeutic interventions

2012

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Kidneys are among the organs affected by the aging process. Aging kidneys are characterized by progressive scarring and measurable declines in renal function. Deficiencies in renal function are associated with mortality in all populations. Therefore, if the kidneys age at an accelerated rate relative to the other organs in a particular individual, then slowing or reversing the kidney aging process may be a therapeutically useful strategy. In this review, we will discuss the physiology and pathogenesis of kidney aging and analyze potential therapeutic strategies for halting the aging process in the kidneys.

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“…The age-related loss of renal parenchyma approximates 10% per decade of increasing age (14). This loss is accompanied by a decrease in renal plasma flow from 618 to 689 ml/min to 349 to 485 ml/min (15)(16)(17)(18). Tubular functions are compromised by life-long oxidative stress (19).…”

Section: Age-related Changes In Organ Functionmentioning

confidence: 99%

Review on Pharmacokinetics and Pharmacodynamics and the Aging Kidney

Aymanns¹,

Keller²,

Maus³

et al. 2010

Clinical Journal of the American Society of Nephrology

128

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In people who are aged >65 years, pharmacokinetics are influenced more by the loss of kidney function than by the aging process of any other organ. A GFR of 30 to 60 ml/min, suggestive of stage 3 kidney disease, is observed in 15 to 30% of elderly people. Drug dosing must be adjusted to both changing pharmacokinetics and pharmacodynamics; the pharmacodynamics might be influenced by the aging of other organs, too. Using our NEPharm database, we extracted abstracts with pharmacokinetic parameters since 1999 from a weekly PubMed search. The recorded data were analyzed and compared with published recommendations on drug dosage and use in the elderly. Purely age-related changes in pharmacokinetic parameters were recorded from publications on 127 drugs. The analysis of our NEPharm records revealed an average (mean ؎ SD) age-related prolongation of half-life of 1.39-fold (corresponding to ؉39 ؎ 61%). Contrasting to common opinion, mean changes in clearance (؊1 ؎ 54%) and volume of distribution (؉24 ؎ 56%) were even less. The modest changes in pharmacokinetics do not suggest general dosage modifications in the elderly for most drugs. Changes in pharmacodynamics justify the common medication rule in the elderly-"start low ؉ go slow"-especially for drugs that act on the central nervous system; however, in the case of anti-infective and anticancer therapy, the rule should be "hit hard ‫؍‬ start high ؉ go fast" to produce the target effect also in the elderly.

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Renal hemodynamic response to maximal vasodilating stimulus in healthy older subjects

Cited by 46 publications

References 0 publications

Evaluation of Kidney Function and Structure in Potential Living Kidney Donors: Implications for the Donor and Recipient

Evaluation of Kidney Function and Structure in Potential Living Kidney Donors: Implications for the Donor and Recipient

Pathophysiology of the aging kidney and therapeutic interventions

Review on Pharmacokinetics and Pharmacodynamics and the Aging Kidney

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