Aging effects on renal function and practical implications for health care

Physiological aging: Anatomical and physiological renal changes occur durin g normal aging in humans. These changes are different from the renal effect s of many diseases frequently linked to aging and which require specific di agnosis, prevention and therapy, Renal aging varies from one patient to ano ther or from one population to another. During common aging, anatomical cha nges are mild and physiological changes mainly affect glomerular filtration rate and water and salt metabolism regulation. In the elderly: Glomerular filtration rate decreases slowly in healthy elde rly people to reach 80 ml/mn at 80 years without any metabolic consequence. However, in old hospitalized patients, acute renal failure is frequent and occurs mainly during inflammatory or infectious disorders, dehydration or drug combinations enhancing regulation of glomerular filtration. Tubular fu nction changes expose the elderly to increasing risk of dehydration which c ould be prevented in highly predictable situations such as gastrointestinal symptoms, poorly salted diets or anorexia. Estimation of the creatinine cl earance is necessary whenever an acute medical events, mostly infectious di seases, occur in elderly people to adapt drugs doses to renal catabolism.