The Influence of Age on the Renal Response to Water Deprivation in Man

Rowe, John W.; Shock, N. W.; DeFronzo, Ralph A.

doi:10.1159/000180731

Cited by 307 publications

(102 citation statements)

References 13 publications

(20 reference statements)

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“…There is limited data on dehydration in the elderly in Europe, but preliminary analysis of 188 participants in our own study on dehydration in care home residents in Norfolk, England suggested that 20% had current water-loss dehydration (defined as having serum osmolality of over 300 mOsm/kg) and a further 28% had impending dehydration (serum osmolality of 295-300 mOsm/kg) (Hooper, unpublished, protocol (Rowe et. al., 1976).…”

Section: Prevalence Of Dehydration In Older Peoplementioning

confidence: 99%

Water-loss dehydration and aging

Hooper

Bunn

Jimoh

et al. 2014

Mechanisms of Ageing and Development

216

136

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This review defines water-loss and salt-loss dehydration. For older people serum osmolality appears the most appropriate gold standard for diagnosis of water-loss dehydration, but clear signs of early dehydration have not been developed. In older adults, lower muscle mass, reduced kidney function, physical and cognitive disabilities, blunted thirst, and polypharmacy all increase dehydration risk.Cross-sectional studies suggest a water-loss dehydration prevalence of 20-30% in this population.Water-loss dehydration is associated with higher mortality, morbidity and disability in older people, but evidence is still needed that this relationship is causal. There are a variety of ways we may be able to help older people reduce their risk of dehydration by recognising that they are not drinking enough, and being helped to drink more. Strategies to increase fluid intake in residential care homes include identifying and overcoming individual and institutional barriers to drinking, such as being worried about not reaching the toilet in time, physical inability to make or to reach drinks, and reduced social drinking and drinking pleasure. Research needs are discussed, some of which will be addressed by the FP7-funded NU-AGE (New dietary strategies addressing the specific needs of elderly population for a healthy ageing in Europe) trial.

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Section: Prevalence Of Dehydration In Older Peoplementioning

confidence: 99%

Water-loss dehydration and aging

Hooper

Bunn

Jimoh

et al. 2014

Mechanisms of Ageing and Development

216

136

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“…Older adults showed lower values of maximum and higher values of minimum Uosm than children or young adults. In six groups of adults the median decrease in maximum Uosm was 3.4 mosm/kg/y (Lindeman et al, 1966;Rowe et al, 1976;Nadvornikova et al, 1980;Tencer, 1988;Tryding et al, 1988;Tan et al, 1991).…”

Section: Maximum and Minimum Uosm And Agementioning

confidence: 99%

“…In adults urine solute excretion ranged from 1365 mosm/ 24-h in miners on a rest day in Australia (Cross et al, 1989) to about 400 mosm/24 h*1.73 m 2 in sweet potato eaters in Papua New Guinea (Oomen, 1967) and 362 mosm/24-h in results of renal concentrating test with (n) vasopressin after high fluid intake (Bendz, 1985); (K)12-18 h fluid restriction and/or vasopressin (children: Winberg, 1959;Edelmann et al, 1967;Monnens, 1971;Uttley et al, 1972;Abyholm and Monn, 1979;Stapleton and Miller, 1988;Marild et al, 1992; Miles et al, 1954;Isaacson, 1960;Toor et al, 1965;Macarnon et al, 1975;Rowe et al, 1976;Alwall, 1978;Monson and Richards 1978;Curtis and Donovan, 1979;Güllner et al, 1980;Askergren et al, 1981;Koppeschaar et al, 1985;Tencer, 1988;Tryding et al, 1988;Tan et al, 1991;Baumgarten et al, 2000; decrease in maximum Uosm at an age above 20 y: 3.4 mosm/kg/y); (&) more than 18 h fluid restriction and/or high protein intake (Miles et al, 1954;Polacek et al, 1965;Lindeman et al, 1966;Nadvornikova et al, 1980) mean values ( * ) and regression lines (-) of minimum urinary osmolality in renal diluting tests in children and adults during high oral water intake or intravenous hypotonic saline (Lindeman et al, 1966;Klahr et al, 1967;Rodriguez-Soriano et al, 1981;DiScala and Stein, 1982).…”

Section: Renal Solute Excretionmentioning

confidence: 99%

24-h hydration status: parameters, epidemiology and recommendations

2003

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Hydration of individuals and groups is characterised by comparing actual urine osmolality (Uosm) with maximum Uosm. Data of actual, maximum and minimum Uosm in infants, children and adults and its major influencing factors are reviewed. There are remarkable ontogenetic, individual and cultural differences in Uosm. In the foetus and the breast-fed infant Uosm is much lower than plasma osmolality, whereas in children and adults it is usually much higher. Individuals and groups may show long-term differences in Uosm. In industrialised countries, the gender difference of Uosm is common. There are large intercultural differences of mean 24-h Uosm ranging from 860 mosm/kg in Germany, 649 mosm/kg in USA to 392 mosm/kg in Poland. A new physiologically based concept called 'free-water reserve' quantifies differences in 24-h euhydration. In 189 boys of the DONALD Study aged 4.0-6.9 y, median urine volume was 497 ml/24-h and median Uosm 809 mosm/kg. Considering meanÀ2 s.d. of actual maximum 24-h Uosm of 830 mosm/kg as upper level of euhydration and physiological criterion of adequate hydration in these boys, median free-water reserve was 11 ml/24-h. Based on median total water intake of 1310 ml/ 24-h and the third percentile of free-water volume of À156 ml/24-h, adequate total water intake was 1466 ml/24-h or 1.01 ml/ kcal. Data of Uosm in 24-h urine samples and corresponding free-water reserve values of homogeneous groups of healthy subjects from all over the world might be useful parameters in epidemiology to investigate the health effects of different levels of 24-h euhydration.

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“…Nevertheless, it is questionable whether physiological age is any more real or valid a concept than chronological age (Costa & McCrae 1977). Chronological age may be nothing more than`a grid for recording the passage of time within which events (commonly called ageing) occur ' (Shock 1980). But physiological age is also a dubious concept.…”

Section: Introductionmentioning

confidence: 99%

Ageing and physiological functions

Young

1997

Phil. Trans. R. Soc. Lond. B

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In youth, most physiological functions have generous spare capacity. Even in health, however, increasing age is characterized by progressive erosion of these ‘safety margins’. Examples include the decline of bone mass (towards a threshold for likelihood of fracture), of glomerular filtration rate (towards a threshold for susceptibility to clinical renal failure), of renal tubular function (towards a threshold for clinically important susceptibility to dehydration), of hepatic function (towards a thresholds for accumulation following conventional ‘young adult’ doses of common medications), or of lower limb explosive power (towards thresholds for impaired functional mobility). Increasing age is also characterized by a rising prevalence of chronic pathologies, complicating attempts to determine the rate or the mechanism of the age–related decline in a physiological function. Nevertheless, it is clear that in many organs the loss of function is largely attributable to the loss of functioning cells, even in the absence of overt disease. This apparently fundamental aspect of ageing remains poorly understood.

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The Influence of Age on the Renal Response to Water Deprivation in Man

Cited by 307 publications

References 13 publications

Water-loss dehydration and aging

Water-loss dehydration and aging

24-h hydration status: parameters, epidemiology and recommendations

Ageing and physiological functions

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