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Aging and Chronic Kidney Disease

  • Tao ZhangEmail author
Chapter

Abstract

With renal aging, a complex interplay of genetics, environmental changes, and cellular dysfunction leads to the histological and functional changes. The faster expanding population of elderly is more likely to experience chronic kidney disease (CKD) and progress to end-stage kidney disease (ESRD). Glomerular filtration rate (GFR) is the most important indicator commonly used for the diagnosis and grading of CKD. The MDRD and CG formulas are the most widely applied, and the CKD-EPISCr–cys formula is an acceptable choice for the elderly. The treatment of CKD in older patients requires overall consideration because the risk of cardiovascular disease mortality is greater than the risk of developing ESRD at the same GFR level. An individualized patient-centered approach may offer more benefits than a traditional disease-oriented approach in old patients. There are few clinical practice guidelines on the management of the elderly with CKD. The European guideline recommends the use of four variables (age, sex, eGFR, and albuminuria) to predict the risk of ESRD and of the REIN score to predict the risk of mortality in older patients with stage 5 CKD. Further studies are required for solving the controversy concerning CKD in the elderly.

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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Division of Nephrology, Department of GeriatricsFirst Affiliated Hospital, Nanjing Medical UniversityNanjingChina

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