September 1986

Aging and the Kidney

Author Affiliations

From the Medical Service (Drs Brown, Spry, and Malone) and the Geriatric Research, Education, and Clinical Center (Drs Davis and Wongsurawat), St Louis Veterans Administration Medical Center; and the Department of Internal Medicine (Drs Brown, Davis, Spry, Wongsurawat, Malone, and Domoto), St Louis University School of Medicine.

Arch Intern Med. 1986;146(9):1790-1796. doi:10.1001/archinte.1986.00360210178026

• Numerous anatomic and physiologic alterations occur in the kidney with aging. These changes affect the ability of elderly patient(s) to maintain homeostasis and alter response to medications, stress, illness, or changes in diet, mobility, or environment. Drug-induced illness and drug interactions are major problems in the elderly. Bone disease and fractures are associated with negative calcium balance and decreased production of 1,25-dihydrocholecalciferol seen with aging. The geriatric patient is not immune to the primary glomerular diseases that occur in younger patients, although the relative incidence of pathologic diagnoses may differ. The high incidence of membranous glomerulonephritis in the elderly, and the well-known association between malignancy and membranous nephropathy strongly favor aggressive evaluation of the nephrotic syndrome in the geriatric age group. Attention must be given to consideration of appropriate end-stage renal disease treatment alternatives for the geriatric population, which now comprises the fastest-growing segment of the endstage renal disease population.

(Arch Intern Med 1986;146:1790-1796)