Structural and functional changes in human kidneys with healthy aging

Musab S. Hommos, Richard J. Glassock, Andrew D Rule

Research output: Contribution to journalReview article

40 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)2838-2844
Number of pages7
JournalJournal of the American Society of Nephrology
Volume28
Issue number10
DOIs
StatePublished - Oct 1 2017

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Nephrons
Kidney
Arteriosclerosis
Arteriolosclerosis
Nephrosclerosis
Albuminuria
Chronic Kidney Failure
Atrophy
Comorbidity
Cysts
Fibrosis
Mortality

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 journalReview article

Hommos, Musab S. ; Glassock, Richard J. ; Rule, Andrew D. / Structural and functional changes in human kidneys with healthy aging. In: Journal of the American Society of Nephrology. 2017 ; Vol. 28, No. 10. pp. 2838-2844.
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