Structural and Functional Changes With the Aging Kidney

Aleksandar Denic, Richard J. Glassock, Andrew D Rule

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Senescence or normal physiologic aging portrays the expected age-related changes in the kidney as compared to a disease that occurs in some but not all individuals. The microanatomical structural changes of the kidney with older age include a decreased number of functional glomeruli from an increased prevalence of nephrosclerosis (arteriosclerosis, glomerulosclerosis, and tubular atrophy with interstitial fibrosis), and to some extent, compensatory hypertrophy of remaining nephrons. Among the macroanatomical structural changes, older age associates with smaller cortical volume, larger medullary volume until middle age, and larger and more numerous kidney cysts. Among carefully screened healthy kidney donors, glomerular filtration rate (GFR) declines at a rate of 6.3 mL/min/1.73 m2 per decade. There is reason to be concerned that the elderly are being misdiagnosed with CKD. Besides this expected kidney function decline, the lowest risk of mortality is at a GFR of ≥75 mL/min/1.73 m2 for age 2 for age ≥65 years. Changes with normal aging are still of clinical significance. The elderly have less kidney functional reserve when they do actually develop CKD, and they are at higher risk for acute kidney injury.

Original languageEnglish (US)
Pages (from-to)19-28
Number of pages10
JournalAdvances in Chronic Kidney Disease
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2016

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Kidney
Glomerular Filtration Rate
Nephrosclerosis
Arteriosclerosis
Nephrons
Diagnostic Errors
Acute Kidney Injury
Hypertrophy
Atrophy
Cysts
Fibrosis
Tissue Donors
Mortality

Keywords

  • Aging
  • Glomerular filtration rate
  • Glomerulosclerosis
  • Kidney function
  • Nephrosclerosis

ASJC Scopus subject areas

  • Nephrology

Cite this

Structural and Functional Changes With the Aging Kidney. / Denic, Aleksandar; Glassock, Richard J.; Rule, Andrew D.

In: Advances in Chronic Kidney Disease, Vol. 23, No. 1, 01.01.2016, p. 19-28.

Research output: Contribution to journalArticle

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