Skip to main content

The Kidney in the Elderly

  • Chapter
  • First Online:
Radiological Imaging of the Kidney

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 3143 Accesses

Abstract

The aims of this chapter are to illustrate the typical imaging findings of the kidney in elderly patients and the typical features of the main renal pathologies in the elderly patient. The kidneys present some important morphologic changes according to the patient’s age, which can be detected first by gray-scale ultrasound (US) and color Doppler US, and second, by all the other imaging modalities. These changes have an impact on patient management, particularly with respect to drug therapy. The landmark is diffuse irregular margins due to nephronangiosclerosis of the intrarenal arteries. The fundamental alterations of renal morphology in elderly patients include size reduction, parenchymal thickness reduction, margin irregularities, and increased cortico-medullary differentiation. The main renal pathologies, including vascular and tumoral diseases, present some peculiar features in the elderly patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 309.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alpers CE (2005) The kidney. In: Kumar V, Abbas AK, Fausto N (eds) Robbins and Cotran pathologic basis of disease. Elsevier Saunders, Philadelphia, pp 955–1021

    Google Scholar 

  • Berdjis N, Hakenberg OW, Novotny V et al. (2006) Treating renal cancer in the elderly. BJU Int 97:703–705

    Article  PubMed  Google Scholar 

  • Bertolotto M, Martegani A, Aiani L et al. (2008) Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast-enhanced CT. A feasibility study. Eur Radiol 18(2):376–383

    Article  Google Scholar 

  • Bertolotto M, Quaia E, Galli G et al. (2000) Color Doppler sonographic appearance of renal perforating vessels in subjects with normal and impaired renal function. J Clin Ultrasound 28:267–276

    Article  PubMed  CAS  Google Scholar 

  • Bosniak MA, Birnbaum BA, Krinsky GA et al. (1995) Small renal parenchymal neoplasms: further observations on growth. Radiology 197(3):589–597

    PubMed  CAS  Google Scholar 

  • Bude RO, Rubin JM (1995) Detection of renal artery stenosis with Doppler sonography: it is more complicated than originally thought (editorial). Radiology 196:612–613

    PubMed  CAS  Google Scholar 

  • Bude RO, Rubin JM, Platt JF et al. (1994) Pulsus tardus: its cause and potential limitations in detection of arterial stenosis. Radiology 190:779–784

    PubMed  CAS  Google Scholar 

  • Cohan RH, Cowan NC, Ellis JH (2006) Unknown ESUR cases 2004. Abdom Imaging 31:141–153

    Article  PubMed  CAS  Google Scholar 

  • Cohen JJ (1992) Vascular disorders of the kidney. In: Wyngaarden JB, Smith LH, Bennett JC (eds) Cecil textbook of medicine. Saunders, Philadelphia, pp 598–599

    Google Scholar 

  • Coley BD, Mattrey RF, Roberts A et al. (1991) Potential role of PFOB enhanced sonography of the kidney. II. Detection of partial infarction. Kidney Int 39:740–745

    Article  CAS  Google Scholar 

  • Correas JM, Claudon M, Tranquart F et al. (2003) Contrast-enhanced ultrasonography: renal applications. J Radiol 84:2041–2054

    PubMed  CAS  Google Scholar 

  • Correas JM, Helenon O, Moreau JF (1999) Contrast enhanced ultrasonography of native and transplant kidney diseases. Eur Radiol 9 (suppl 3):394–400

    Article  Google Scholar 

  • Dagher PR, Herget-Rosenthal S, Ruehm SG et al. (2003) Newly developed techniques to study and diagnose acute renal failure. J Am Soc Nephrol 14:2188–2198

    Article  PubMed  Google Scholar 

  • Davison AM (1998) Renal disease in the elderly. Nephron 80:6–16

    Article  PubMed  CAS  Google Scholar 

  • Desberg AL, Paushter DM, Lammert GK et al (1990) Renal artery stenosis: evaluation with color Doppler flow imaging. Radiology 177:749–753

    PubMed  CAS  Google Scholar 

  • Faubert PF, Porush JG (1998) Renal disease in the elderly, 2nd edn. Marcel Decker, Basel, Switzerlad

    Google Scholar 

  • Ferrucci L, Giallauria F, Guralnik JM (2008) Epidemiology of aging. Radiol Clin N Am 46:643–652

    Article  PubMed  Google Scholar 

  • Fliser D (2008) Assessment of renal function in elderly patients. Curr Opin Nephrol Hypertens 17 (6):604–608

    Article  PubMed  Google Scholar 

  • Gleckman R, Blagg N, Hibert D et al. (1982) Acute pyelonephritis in the elderly. South Med J 75(5):551–554

    Article  PubMed  CAS  Google Scholar 

  • Grabstald H, Whitmore WF, Melamed MR (1971) Renal pelvic tumors. JAMA 218:845–854

    Article  PubMed  CAS  Google Scholar 

  • Grant EG, Melany ML (2001) Ultrasound contrast agents in the evaluation of the renal arteries. In: Goldberg BB, Raichlen JS, Forsberg F (eds) Ultrasound contrast agents. Basic principles and clinical applications, 2nd edn. Martin Dunitz, London, pp 289–295

    Google Scholar 

  • Helenon O, Rody EL, Correas JM et al (1995) Color Doppler US of renovascular disease in native kidneys. Radiographics 15:833–854

    PubMed  CAS  Google Scholar 

  • Jayson M, Sanders H (1998) Increased incidence of serendipitously discovered renal cell carcinoma. Urology 51:203–205

    Article  PubMed  CAS  Google Scholar 

  • Jordan J, Low R, Jeffrey RB (1990) CT findings in acute renal cortical necrosis. J Comput Assist Tomogr 14(1):155–156

    Article  PubMed  CAS  Google Scholar 

  • Kalva SP, Mueller PR (2008) Vascular imaging in the elderly. Radiol Clin N Am 46:663–683

    Article  PubMed  Google Scholar 

  • Kawashima A, Sandler CM, Ernst RD et al. (2000) CT evaluation of renovascular disease. Radiographics 20:1321–1340

    PubMed  CAS  Google Scholar 

  • Levey AS, Eckardt KU, Tsukamoto Y et al. (2005) Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 67:2089–2100

    Article  PubMed  Google Scholar 

  • Linehan JA, Nguyen MM (2009) Kidney cancer: the new landscape. Curr Opin Urol 19(2):133–137

    Article  PubMed  Google Scholar 

  • Mulder WJ, Hillen HF (2001) Renal function and renal disease in the elderly: part I. Eur J Intern Med 12(4):327–333

    Article  PubMed  Google Scholar 

  • National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39(suppl 1):S1–S266

    Google Scholar 

  • Nocks BN, Heney NM, Daly JJ et al. (1982) Transitional cell carcinoma of the renal pelvis. Urology 19:472–477

    Article  PubMed  CAS  Google Scholar 

  • Pozzi Mucelli R, Bertolotto M, Quaia E (2001) Imaging techniques in acute renal failure. In: Ronco C, Bellomo R, La Greca G (eds) Blood purification in intensive care. Contrib Nephrol, Basel, Karger, pp 76–91

    Chapter  Google Scholar 

  • Pozzi Mucelli R, Faccioli N, Manfredi R (2008) Imaging findings of genitourinary tumors in the elderly. Radiol Clin N Am 46:773–784

    Article  PubMed  Google Scholar 

  • Prakash J, Saxena RK, Sharma OP (2001) Spectrum of renal disease in the elderly: single center experience from a developing country. Int Urol Nephrol 33(2):227–233

    Article  PubMed  CAS  Google Scholar 

  • Quaia E, Bertolotto M (2002) Renal parenchymal diseases: is characterization feasible with ultrasound? Eur Radiol 12:2006–2020

    PubMed  Google Scholar 

  • Silverman SG, Israel GM, Herts BR et al. (2008) Management of the incidental renal mass. Radiology 249:16–31

    Article  PubMed  Google Scholar 

  • Stavros AT, Parker SH, Yakes WF et al (1992) Segmental stenosis of the renal artery: pattern recognition of tardus and parvus abnormalities with duplex sonography. Radiology 184:487–492

    PubMed  CAS  Google Scholar 

  • Stevens LA, Coresh J, Greene T et al. (2006) Assessing kidney function – measured and estimated glomerular filtration rate. N Engl J Med 354:2473–2483

    Article  PubMed  CAS  Google Scholar 

  • Stevens LA, Levey AS (2005) Chronic kidney disease in the elderly – how to assess risk. N Engl J Med 352:2122–2124

    Article  PubMed  CAS  Google Scholar 

  • Taylor GA, Ecklund K, Dunning PS (1996) Renal cortical perfusion in rabbits: visualization with color amplitude imaging and an experimental mircobubble-based US contrast agent. Radiology 201:125–129

    PubMed  CAS  Google Scholar 

  • Urban BA, Fishman EK (2000) Renal lymphoma: CT patterns with emphasis on helical CT. Radiographics 20:197–212

    PubMed  CAS  Google Scholar 

  • Wong-You-Cheong JJ, Wagner BJ, Davis CJ (1998) Transitional cell carcinoma of the urinary tract: radiologic-pathologic correlation. Radiographics 18:123–142

    PubMed  CAS  Google Scholar 

  • Zhang H, Prince MR (2004) Renal MR angiography. Magn Reson Imaging Clin N Am 12:487–503

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Emilio Quaia .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Quaia, E., Cavallaro, M. (2010). The Kidney in the Elderly. In: Quaia, E. (eds) Radiological Imaging of the Kidney. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-87597-0_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-87597-0_28

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-87596-3

  • Online ISBN: 978-3-540-87597-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics