Aging and the Kidneys: Anatomy, Physiology and Consequences for Defining Chronic Kidney Disease | Zendy

Richard J. Glassock | Zendy; Andrew D. Rule | Zendy

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Aging and the Kidneys: Anatomy, Physiology and Consequences for Defining Chronic Kidney Disease

Author(s) -

Richard J. Glassock,

Andrew D. Rule

Publication year - 2016

Publication title -

the nephron journals/nephron journals

Language(s) - English

Resource type - Journals

eISSN - 2235-3186

pISSN - 1660-8151

DOI - 10.1159/000445450

Subject(s) - nephron , kidney disease , medicine , overdiagnosis , renal function , glomerulosclerosis , nephrology , disease , glomerulus , physiology , pathology , kidney , podocyte , intensive care medicine , endocrinology , proteinuria

The varied functions of the kidneys are influenced by the complex process of aging. The glomerular filtration rate (GFR) steadily declines with normal aging, and the progress of this process can be influenced by superimposed diseases. Microscopically, nephron numbers decrease as global glomerulosclerosis becomes more evident. The precise mechanisms underlying nephron loss with aging are not well understood, but derangements in podocyte biology appear to be involved. Classifications of chronic kidney disease (CKD) incorporate GFR values and attendant risk of adverse events. Arbitrary and fixed thresholds of GFR for defining CKD have led to an overdiagnosis of CKD in the elderly. An age-sensitive definition of CKD could offer a solution to this problem and more meaningfully capture the prognostic implications of CKD.

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