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Renal Aging and Chronic Kidney Disease in the Elderly: Which Are the Differences?

  • Carlos Guido Musso
  • Juan Florencio Macías-NúñezEmail author
Chapter

Abstract

Aging is a universal asynchronic and heterogeneous process which induces a series of changes in the organisms through time, characterized by the attenuation of functional performance compared to the maximal functional strength reached around the second decade of life. The glomerular filtration rate (GFR) reduction secondary to aging has a particular rate (1 ml/min per year since 40 years of age), but this is not necessarily the glomerular filtration declination rate in chronic nephropathy. A GFR reduction according to age, in a setting of normal creatininemia, uremia, hemoglobin, parathyroid hormone level, urinalysis, and kidney imaging, should be interpreted as normal renal aging instead of chronic kidney disease (CKD). However, it is worth mentioning that there is a minority of old individuals who have a relatively high GFR which can be interpreted as glomerular hyperfiltration due to early CKD (negative renal reserve) or to a successful renal aging (preserved renal reserve).

Keywords

Aging Senescence Chronic kidney disease Senescent nephropathy 

References

  1. 1.
    Musso CG, Jauregui JR. How to differentiate renal senescence from chronic kidney disease in clinical practice. Postgrad Med. 2016;128(7):716–21.  https://doi.org/10.1080/00325481.2016.1209963.CrossRefPubMedGoogle Scholar
  2. 2.
    Musso CG. Geriatric nephrology and the ‘nephrogeriatric giants’. Int Urol Nephrol. 2002;34(2):255–6.CrossRefGoogle Scholar
  3. 3.
    Musso CG, Núñez JF. Feed-back between geriatric syndromes: general system theory in geriatrics. Int Urol Nephrol. 2006;38(3–4):785–6.PubMedGoogle Scholar
  4. 4.
    Forciea M, Lavizzo-Mourey R, Schwab E. Geriatric secrets. Philadelphia: Hanley & Belfus; 2000.Google Scholar
  5. 5.
    Rennke H, Denker B. Renal pathophysiology. Philadelphia: Lippincott Williams & Wilkins; 1994. p. 267–90.Google Scholar
  6. 6.
    Aiello F, Dueñas EP, Musso CG. Senescent nephropathy: the new renal syndrome. Healthcare (Basel). 2017;5(4):E81.  https://doi.org/10.3390/healthcare5040081.CrossRefGoogle Scholar
  7. 7.
    Musso CG, Macías Nuñez JF, Oreopoulos DG. Physiological similarities and differences between renal aging and chronic renal disease. J Nephrol. 2007;20(5):586–7.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Keller F. Kidney function and age. Nephrol Dial Transplant. 1987;2(5):382.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Musso CG, Oreopoulos DG. Aging and physiological changes of the kidneys including changes in glomerular filtration rate. Nephron Physiol. 2011;119(Suppl 1):p1–5.  https://doi.org/10.1159/000328010.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Musso CG, Oreopoulos D. Renal changes in the elderly. In: Katlic, editor. Cardiothoracic surgery. London: Springer; 2011. p. 293–9.CrossRefGoogle Scholar
  11. 11.
    Musso CG, Macías-Núñez JF. Dysfunction of the thick loop of Henle and senescence: from molecular biology to clinical geriatrics. Int Urol Nephrol. 2011;43(1):249–52.CrossRefGoogle Scholar
  12. 12.
    Musso CG, Alvarez Gregori J, Jauregui JR, Macías Núñez JF. Creatinine, urea, uric acid, water and electrolytes renal handling in the healthy oldest old. World J Nephrol. 2012;1(5):123–6.CrossRefGoogle Scholar
  13. 13.
    Musso CG, Musso CAF, Joseph H, De Miguel R, Rendo P, Gonzalez E, Algranati L, dos Ramos Farias E. Plasma erythropoietin levels in the oldest old. Int Urol Nephrol. 2004;36(2):259–62.CrossRefGoogle Scholar
  14. 14.
    Musso CG, Juarez R, Vilas M, Navarro M, Rivera H, Jauregui R. Renal calcium, phosphorus, magnesium and uric acid handling: comparison between stage III- chronic kidney disease and healthy oldest old. Int Urol Nephrol. 2012;44(5):1559–62.CrossRefGoogle Scholar
  15. 15.
    Musso CG. Potassium metabolism in patients with chronic kidney disease (CKD). Part I: patients not on dialysis (stages 3–4). Int Urol Nephrol. 2004;36(3):465–8.CrossRefGoogle Scholar
  16. 16.
    Musso CG, de Miguel R, Algranati L, Farias E. Renal potassium excretion: comparison between chronic renal disease patients and old people. Int Nephrol and Urol. 2005;37:167–70.CrossRefGoogle Scholar
  17. 17.
    Musso C, Liakopoulos V, De Miguel R, Imperiali N, Algranati L. Transtubular potassium concentration gradient: comparison between healthy old people and chronic renal failure patients. Int Urol Nephrol. 2006;38(2):387–90.CrossRefGoogle Scholar
  18. 18.
    Musso CG, Michelángelo H, Vilas M, Martinez B, Bonetto A, Jauregui R, Algranati L. Renal creatinine handling in very old patients with chronic renal disease. Int Urol Nephrol. 2011;43(3):899–902.CrossRefGoogle Scholar
  19. 19.
    Musso CG, Alvarez-Gregori J, Macias-Nuñez JF. Renal handling of uric acid, magnesium, phosphorus, calcium, and acid-base in the elderly. In: Macias-Nuñez J, Cameron S, Oreopoulos D, editors. The ageing kidney in health and disease. New York: Springer; 2008. p. 155–71.CrossRefGoogle Scholar
  20. 20.
    Álvarez-Grégori J, Robles N, Mena C, Ardanuy R, Jauregui J, Macías Nçuñez JF. The value of a formula including haematocrit, blood urea and gender (HUGE) as a screening test for chronic renal insufficiency. J Nutr Health Aging. 2011;15(6).2011):1–5.CrossRefGoogle Scholar
  21. 21.
    Musso CG, Maytin S, Conti P, Terrasa S, Primerano A, Reynaga A, Vilas M, Jauregui J. HUGE equation accuracy for screening chronic kidney disease: a prospective study. J Aging Res Clin Pract. 2017;6:158–62.Google Scholar
  22. 22.
    Musso CG, de Los Rios E, Vilas M, Terrasa S, Bratti G, Varela F, Diez GR, Jauregui J, Luna D. The HUGE formula (hematocrit, urea, gender) for screening for chronic kidney disease in elderly patients: a study of diagnostic accuracy. Int Urol Nephrol. 2016.  https://doi.org/10.1007/s11255-016-1486-6.CrossRefGoogle Scholar
  23. 23.
    Dawson-Saunders B, Trapp R. Medical biostatistics. Mexico. Manual Moderno. 1993. p. 51–2.Google Scholar
  24. 24.
    Musso CG. Renal reserve test: its methodology and significance. S J Kidney Dis Transpl. 2011;22(5):990–3.Google Scholar
  25. 25.
    Musso CG, Jauregui J. The ageing kidney: a proposal for its classification. Electron J Biomed. 2016;1:3–6.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Carlos Guido Musso
    • 1
    • 2
    • 3
  • Juan Florencio Macías-Núñez
    • 4
    Email author
  1. 1.Nephrology DivisionHospital Italiano de Buenos AiresBuenos AiresArgentina
  2. 2.Physiology DepartmentInstituto Universitario del Hospital Italiano de Buenos AiresBuenos AiresArgentina
  3. 3.Ageing Biology UnitHospital Italiano de Buenos AiresBuenos AiresArgentina
  4. 4.Departamento de MedicinaUniversity of SalamancaSalamancaSpain

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