Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Renal reserve in the oldest old

  • 133 Accesses

  • 15 Citations

Abstract

Introduction

Decline in glomerular filtration rate (GFR) is one of several changes in renal physiology in the elderly. Renal reserve (RR) is the kidney′s capacity to increase its basal GFR by at least 20% after a protein overload. Even though it has already been reported that RR is preserved in healthy old people, there is no information whether RR is also preserved in the healthy very old one (older than 74 of age), which we decided to study and report our findings in this paper.

Material and method

We studied RR in 16 healthy persons divided into three age groups: young: 20–40 years old (n: 5): 64–74 years old (n: 6) and oldest old: >74 years old (n: 5). Renal reserve test was performed by assessing creatinine clearance with cimetidine before and after an oral protein load. Statistical analysis was performed using ANOVA test.

Results

Even though renal reserve response was present in all age groups, its magnitude (delta GFR) was significantly higher in the healthy young group (103.6 ± 53 ml/min) compared to the old one (34.1 ± 40 ml/min) (P = 0.002), while it was significantly lower in the healthy oldest old (20.7 ± 0.7 ml/min) group compared to the other two groups (P = 0.002).

Conclusion

Renal reserve is preserved in healthy very old people, but its magnitude decreases significantly with age.

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

References

  1. 1.

    Macías Núñez JF, López Novoa JM (2008) Physiology of the healthy aging kidney. In: Macías Núñez JF, Cameron S, Oreopoulos D (eds) The aging kidney in health and disease. Springer, New York, pp 93–111

  2. 2.

    Musso CG, Michelángelo H, Vilas M, Reynaldi J, Martinez B, Algranati L, Macías Núñez JF (2009) Creatinine reabsorption by the aged kidney. Int Urol Nephrol 41(3):727–731

  3. 3.

    Rodrigo E, Martin de Francisco AL, Escallada R, Ruiz JC, Fresnedo GF, Pineira C, Arias M (2002) Measurement of renal function in pre-ESRD patients. Kidney Int 61(Suppl 80):S11–S17

  4. 4.

    Mackenzie W (1998) Assessing renal function from creatinine measurements in adults with chronic renal failure. Am J Kidney Dis 32:23–31

  5. 5.

    Hilbrands L, Artz M, Wetzel FM, Koene RAP (1991) Cimetidine improves the reliability of creatinine as a marker of glomerular filtration. Kidney Int 40:1171–1176

  6. 6.

    Gopal GK, Kapoor SC (1991) Preservation of renal reserve in chronic renal disease. Am J Kidney Dis 17:18–24

  7. 7.

    Bosch J (1995) Renal reserve: a functional view of glomerular filtration rate. Semin Nephrol 15(5):381–385

  8. 8.

    Hellerstein S, Berenbom M, Erwin P, Wilson N, DiMaggio S (2004) Measurement of renal functional reserve in children. Pediatr Nephrol 19:1132–1136

  9. 9.

    Lang F, Öttl I, Häussinger D, Deetjen P, Ahloulay M, Bankir L (1995) Renal hemodynamic response to intravenous and oral amino acids in animals. Semin Nephrol 15(5):415–418

  10. 10.

    Capasso G, Mollica F, Saviano C, De Santo N (1995) Tubule effects of glomerular hyperfiltration: an integrated view. Semin Nephrol 15(5):419–425

  11. 11.

    Woods L (1995) Intrarenal mechanisms of renal reserve. Semin Nephrol 15(5):386–395

Download references

Author information

Correspondence to C. G. Musso.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Musso, C.G., Reynaldi, J., Martinez, B. et al. Renal reserve in the oldest old. Int Urol Nephrol 43, 253–256 (2011). https://doi.org/10.1007/s11255-010-9769-9

Download citation

Keywords

  • Renal reserve
  • Oldest old