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Renal changes with ageing 

Renal changes with ageing
Chapter:
Renal changes with ageing
Author(s):

Chris Dodds

DOI:
10.1093/med/9780199604999.003.0008
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date: 20 August 2019

The physiological impact of ageing on renal function is discussed. Glomerulosclerosis, relative podocyte depletion, and thickening of the basement membrane occur. Filtration is reduced but does not constitute the severity of renal failure defined in younger populations. Changes in water and electrolyte balance are reviewed, including current views on the falls in concentrating ability and slowed homeostatic responses. Endocrine function falls and the changes on the renin–angiotensin–aldosterone system are described, including the controversy surrounding the use of angiotensin-converting enzyme inhibitors in the very elderly. Reduction in erythropoietin production and the impact this has on responses to chronic hypoxia are described. The complex actions of calcitriol are discussed as they are reduced in the elderly, effecting many common disorders such as osteoporosis, falls, colon, breast, and prostate malignancies, and pain. Finally, the vulnerability of ageing kidneys to hypotension or hypoxia is discussed with regard to anaesthesia and drug therapy.

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