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Creatinine reabsorption by the aged kidney

  • Nephrology - Original Paper
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Abstract

Aim

The handling of renal creatinine in human beings has classically been described as the result of two particular physiological processes: glomerular filtration and proximal tubular secretion. However, there are particular physiological situations in which tubular creatinine reabsorption has been documented, such as in the case of healthy newborns and premature babies. We performed a prospective study in order to evaluate if there is tubular creatinine reabsorption in healthy elderly people.

Patients and method

We studied prospectively nine healthy volunteers, four of them young (20–33 years old) and the remaining five, old (65–73 years old). Since creatinine is secreted in the proximal tubules, and its secretion can be completely blocked by cimetidine administration, a creatinine clearance with cimetidine reliably represents the glomerular filtration rate. Therefore, if the ratio creatinine clearance (Ccr)/creatinine clearance with cimetidine (CcrWC) is higher than one, this would indicate net creatinine secretion, whereas a ratio lower than one would indicate a net renal creatinine tubular reabsorption; a ratio equal to one indicates creatinine filtration. Finally, the Ccr, CcrWC, and Ccr/CcrWC ratios were compared between the young and old group.

Statistical tests

Mann-Whitney and Wilcoxon tests were used.

Results

As expected, creatinine clearance in the elderly was significantly lower than in the young [Ccr: 74.4 ml/min (47.9–100.9) (old) vs. 153.8 ml/min (108.3–199.2) (young), p = 0.014]. Similarly, the creatinine clearance with cimetidine (CcrWC) was significantly lower in the elderly compared to the young [CcrWC: 81.8 ml/min (69.2–94.5) (old) vs. 122.5 ml/min (82.6–162.4) (young), p = 0.028]. The ratio of Ccr/CcrWC was 0.9 in the elderly vs. 1.26 in the young (p = 0.014), indicating net creatinine reabsorption in the elderly and net creatinine secretion in the young.

Conclusion

Our findings indicate that there seems to be a net reabsorption of creatinine in the renal tubules of healthy old persons.

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Authors and Affiliations

  1. Nephrology Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Carlos G. Musso, Manuel Vilas, Juliana Reynaldi & Luis Algranati

  2. Internal Medicine Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Hernán Michelángelo & Bernardo Martinez

  3. Nephrology Division, Hospital Universitario de Salamanca, Salamanca, Spain

    Juan F. Macías Núñez

Authors
  1. Carlos G. Musso
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  2. Hernán Michelángelo
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  3. Manuel Vilas
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  4. Juliana Reynaldi
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  5. Bernardo Martinez
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  6. Luis Algranati
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  7. Juan F. Macías Núñez
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Correspondence to Carlos G. Musso.

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Musso, C.G., Michelángelo, H., Vilas, M. et al. Creatinine reabsorption by the aged kidney. Int Urol Nephrol 41, 727–731 (2009). https://doi.org/10.1007/s11255-008-9508-7

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  • DOI: https://doi.org/10.1007/s11255-008-9508-7

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