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Nephroprevention in the Elderly

  • Maria Mercedes Capotondo
  • Carlos Guido MussoEmail author
Chapter

Abstract

Nephroprevention strategies attempt to avoid the appearance of nephropathy (primary prevention) or slow the progression of chronic kidney disease (CKD) and its complications (secondary prevention). Frailty is a cumulative decline of multiple physiological systems that occur with aging and lead individuals to a status of diminished physiological reserve and increased vulnerability to stressors (senescence). There is a deteriorating interdependence between CKD and aging where CKD makes aging accelerate and worsen (senescence), while senescence makes CKD accelerate its progression (senescent nephropathy), since frailty status is the common path which catalyzes this spiral of damage. This particular subgroup of CKD frail elderly patients suffers from a condition called senescent nephropathy, which usually has different clinical complications, therapeutic needs, and worse overall prognosis compared to CKD in fit elderly patients (chronic nephropathy). Even though, the nephroprevention strategies are similar between young adult and senior chronic kidney disease patients, standard targets should be adequate to very old and/or frail elderly individuals. Additionally, the diagnosis of senescent nephropathy in this group implies the need of prescribing anti-frailty interventions in order to slow patient’s functional decline, hospitalization, and mortality.

Keywords

Elderly Nephroprevention Aging Senescence Chronic kidney disease Frailty Senescent nephropathy 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Maria Mercedes Capotondo
    • 1
  • Carlos Guido Musso
    • 1
    • 2
    • 3
    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

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