Abstract
Aging is associated with significant changes in structure and function of the kidney, even in the absence of age-related comorbidities.On themacrostructural level, kidney cortical volume decreases, surface roughness increases, and the number and size of simple renal cysts increasewith age.Onthemicrostructural level, the histologic signs of nephrosclerosis (arteriosclerosis/arteriolosclerosis, global glomerulosclerosis, interstitial fibrosis, and tubular atrophy) all increase with age. The decline of nephron number is accompanied by a comparable reduction inmeasured whole-kidney GFR. However, single-nephron GFR remains relatively constant with healthy aging as does glomerular volume. Only when glomerulosclerosis and arteriosclerosis exceed that expected for age is there an increase in single-nephron GFR. In the absence of albuminuria, agerelated reduction in GFR with the corresponding increase in CKD (defined by an eGFR<60 ml/min per 1.73 m2) has been shown to associate with a very modest to no increase in age-standardized mortality risk or ESRD. These findings raise the question of whether disease labeling of an age-related decline in GFR is appropriate. These findings also emphasize the need for a different management approach for many elderly individuals considered to have CKD by current criteria.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2838-2844 |
| Number of pages | 7 |
| Journal | Journal of the American Society of Nephrology |
| Volume | 28 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2017 |
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ASJC Scopus subject areas
- Nephrology
Cite this
Structural and functional changes in human kidneys with healthy aging. / Hommos, Musab S.; Glassock, Richard J.; Rule, Andrew D.
In: Journal of the American Society of Nephrology, Vol. 28, No. 10, 01.10.2017, p. 2838-2844.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Structural and functional changes in human kidneys with healthy aging
AU - Hommos, Musab S.
AU - Glassock, Richard J.
AU - Rule, Andrew D
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Aging is associated with significant changes in structure and function of the kidney, even in the absence of age-related comorbidities.On themacrostructural level, kidney cortical volume decreases, surface roughness increases, and the number and size of simple renal cysts increasewith age.Onthemicrostructural level, the histologic signs of nephrosclerosis (arteriosclerosis/arteriolosclerosis, global glomerulosclerosis, interstitial fibrosis, and tubular atrophy) all increase with age. The decline of nephron number is accompanied by a comparable reduction inmeasured whole-kidney GFR. However, single-nephron GFR remains relatively constant with healthy aging as does glomerular volume. Only when glomerulosclerosis and arteriosclerosis exceed that expected for age is there an increase in single-nephron GFR. In the absence of albuminuria, agerelated reduction in GFR with the corresponding increase in CKD (defined by an eGFR<60 ml/min per 1.73 m2) has been shown to associate with a very modest to no increase in age-standardized mortality risk or ESRD. These findings raise the question of whether disease labeling of an age-related decline in GFR is appropriate. These findings also emphasize the need for a different management approach for many elderly individuals considered to have CKD by current criteria.
AB - Aging is associated with significant changes in structure and function of the kidney, even in the absence of age-related comorbidities.On themacrostructural level, kidney cortical volume decreases, surface roughness increases, and the number and size of simple renal cysts increasewith age.Onthemicrostructural level, the histologic signs of nephrosclerosis (arteriosclerosis/arteriolosclerosis, global glomerulosclerosis, interstitial fibrosis, and tubular atrophy) all increase with age. The decline of nephron number is accompanied by a comparable reduction inmeasured whole-kidney GFR. However, single-nephron GFR remains relatively constant with healthy aging as does glomerular volume. Only when glomerulosclerosis and arteriosclerosis exceed that expected for age is there an increase in single-nephron GFR. In the absence of albuminuria, agerelated reduction in GFR with the corresponding increase in CKD (defined by an eGFR<60 ml/min per 1.73 m2) has been shown to associate with a very modest to no increase in age-standardized mortality risk or ESRD. These findings raise the question of whether disease labeling of an age-related decline in GFR is appropriate. These findings also emphasize the need for a different management approach for many elderly individuals considered to have CKD by current criteria.
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UR - http://www.scopus.com/inward/citedby.url?scp=85030474318&partnerID=8YFLogxK
U2 - 10.1681/ASN.2017040421
DO - 10.1681/ASN.2017040421
M3 - Review article
C2 - 28790143
AN - SCOPUS:85030474318
VL - 28
SP - 2838
EP - 2844
JO - Journal of the American Society of Nephrology : JASN
JF - Journal of the American Society of Nephrology : JASN
SN - 1046-6673
IS - 10
ER -