Abstract
Kidney aging is under the influence of different factors including genetic factors, gender, ethnicity, and comorbidities, and normal aging process has an important role in daily clinical practice. In short, the physiological process of kidney aging includes reduced weight and preserved kidney volume, increased number of sclerotic glomeruli, increased size of remaining glomeruli, loss of afferent and peripheral arterioles and redistribution of blood into the medulla, decreased glomerular filtration, increased permeability of the glomerular basal membrane, tubular atrophy and interstitial fibrosis, reduced concentration and dilution ability of the kidney, and increased kidney sensitivity to toxic ischemic damage. The above-noted changes in the kidneys need to be known for establishing diagnosis of potential kidney disease/failure by adequate measurements of glomerular filtration, in order to adapt the therapy and to prevent numerous metabolic disturbances for which the kidney is responsible. Although age-related alterations are different to those induced by diseases, sometimes the two processes cannot be easily distinguished.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Al-Said J, Brumback MA, Moghazi S, Baugarten DA, O’Neill WC. Reduced renal function in patients with simple renal cysts. Kidney Int. 2004;65(6):2303–8.
Rule AD, Sasiwimonphan K, Lieske JC, Keddis MT, Torres VE, Vrtiska TJ. Characteristics of renal cystic and solid lesions based on contrast-enhanced computed tomography of potential kidney donors. Am J Kidney Dis. 2012;59(6):611–8.
Lorenz EC, Vrtiska TJ, Lieske JC, et al. Prevalence of renal artery and kidney abnormalities by computed tomography among healthy adults. Clin J Am Soc Nephrol. 2010;5(3):431–8.
Duan X, Rule AD, Elsherbiny H, et al. Automated assessment of renal cortical surface roughness from computerized tomography images and its association with age. Acad Radiol. 2014;21(11):1441–5.
Wang X, Vrtiska TJ, Avula RT, et al. Age, kidney function, and risk factor associate differently with cortical and medullary volumes of the kidney. Kidney Int. 2014;85(3):677–85.
Kubo M, Kiyohara Y, Kato I, et al. Risk factors for renal glomerular and vascular changes in an autopsy –based population survey: the Hisayama study. Kidney Int. 2003;63(4):1508–15.
Baert L, Steg A. Is the diverticulum of the distal and collecting tubules a preliminary stage of the simple cist in the adult? J Urol. 1977;118(5):707–10.
Elsherbiny HE, Alexander MP, Kremers WK, et al. Nephron hypertrophy and glomerulosclerosis and their association with kidney function and risk factors among living kidney donors. Clin J Am Soc Nephrol. 2014;9(11):1892–902.
Harman D. Aging: a theory based on free radical and radiation chemistry. J Gerontol. 1956;11(3):298–300.
Dai DF, Chiao YA, Marcinek DJ, Szeto HH, Rabinovitch PS. Mitochondrial oxidative stress in aging and health span. Longev Healthspan. 2014;3:6.
Perico N, Remuzzi G, Benigni A. Aging and the kidney. Curr Opin Nephrol Hypertens. 2011;20:312–27.
Yang H, Fogo A. Cell senescence in the aging kidney. J Am Soc Nephrol. 2010;21:1436–9.
Zhou X, Saxena R, Liu Z, et al. Renal senescence in 2008: progress and challenges. Int Urol Nephrol. 2008;40:823–39.
Darmady EM, Offer J, Woodhouse MA. The parameters of the ageing kidney. J Pathol. 1973;109(3):195–207.
Martin JE, Sheaff MT. Renal ageing. J Pathol. 2007;211(2):198–205.
Hoy WE, Douglas-Denton RN, Highson MD, Cass A, Johnson K, Bertram JF. A stereological study of glomerular number and volume: preliminary findings in a multiracial study of kidneys at autopsy. Kidney Int Suppl. 2003;63(83):S31–7.
Rule AD, Amer H, Cornell LD, et al. The association between age and nephrosclerosis on renal biopsy among healthy adults. Ann Intern Med. 2010;152(9):561–7.
Huber TB, Edelstein CL, Hartleben B, et al. Emerging role of autophagy in kidney function, diseases and aging. Autophagy. 2012;8(7):1009–31.
Wiggins JE. Aging in the glomerulus. J Gerontol A Biol Sci Med Sci. 2012;67(12):1358–64.
Gagliano N, Arioso B, Santanbrogio B, et al. Age-dependent expression of fibrosis-related genes and collagen deposition in rat kidney cortex. J Gerontol A Biol Sci Med Sci. 2000;55(8):365–72.
Lauks SP Jr, McClachlan MS. Aging and simple cysts of the kidney. Br J Radiol. 1981;54(637):12–4.
Lindeman RD, Goldman R. Anatomic and physiologic age changes in the kidney. Exp Gerontol. 1986;21(4–5):379–406.
Musso CG. Geriatric nephrology and the “nephrogeriatric giants”. Int Urol Nephrol. 2002;34:255–6.
Takazakura E, Sawabu N, Handa A, et al. Intrarenal vascular changes with age and disease. Kidney Int. 1972;2:224–30.
Silva FG. The ageing kidney: a review – part I. Int Urol Nephrol. 2005;37:185–205.
Silva FG. The ageing kidney: a review – part II. Int Urol Nephrol. 2005;37:419–32.
Hollenberg NK, Adams DF, Solomon HS, et al. Senescence and the renal vasculature in normal man. Circ Res. 1974;34:309–16.
Emamiam SA, Nielsen MB, Pedersen JF, Ytte L. Kidney dimensions at sonography: correlation with age, sex, and habitus in 665 adult volunteers. AJR Am J Roenthenol. 1993;160(1):83–6.
Gourtsoyiannis N, Prassopoulos P, Cavouras D, Pantelidis N. The thickness of the renal parenchyma decreases with age: a CT study of 360 patients. AJR Am J Roentgenol. 1990;155(3):541–4.
Glodny B, Unterholzner V, Taferner B, et al. Normal kidney size and its influencing factors – a 64-slice MDCT study of 1040 asymptomatic patients. BMC Urol. 2009;9:19.
McLachlan M, Wasserman P. Changes in sizes and distensibility of the aging kidney. Br J Radiol. 1981;54(642):488–91.
Schwarz A, Lenz T, Klaen R, Offermann G, Fiedler U, Nussberger J. Hygroma renale: pararenal lymphatic cysts associated with renin-dependent hypertension (page kidney). Case report on bilateral cysts and successful therapy by marsupialization. J Urol. 1993;150(3):953–7.
Smith HW. The kidney: the structure and function in health and disease. New York: Oxford University Press; 1951.
Davies DF, Shock NW. Age changes in glomerular filtration rate, effective renal plasma flow, and tubular excretory capacity in adult males. J Clin Invest. 1950;29(5):496–507.
Musso CG. Renal reserve test: its methodology and significance. Saudi J Kidney Dis Transpl. 2011;22(5):990–3.
Musso CG, Reynaldi J, Martinez B, Pierángelo A, Vilas M, Algranati L. Renal reserve in the oldest old. Int Urol Nephrol. 2011;43(1):253–6.
Alvarez Gregori J, Musso C, Macias Núñez JF. Renal ageing. In: Sastre J, Pamolona R, Ramón J, editors. Medical biogerontology. Madrid: Ergon; 2009. p. 111–23.
Keller F. Kidney function and age. Nephrol Dial Transplant. 1987;2(5):382.
Swedish Council on Health Technology Assessment. Methods to estimate and measure renal function (glomerular filtration rate): a systematic review, SBU Yellow Report No. 214. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2011.
Musso CG, Álvarez-Gregori J, Jauregui J, MacíasNúñez JF. Glomerular filtration rate equations: a comprehensive review. Int Urol Nephrol. 2016;48(7):1105–10.
Rule AD, Cornell LD, Poggio ED. Senile nephrosclerosis-does it explain the decline in glomerular filtration rate with aging? Nephron Physiol. 2011;119(Suppl):6–11.
Eriksen BO, Lochen ML, Arntzen KA, et al. Subclinical cardiovascular disease is associated with high glomerular filtration rate in the nondiabetic general population. Kidney Int. 2014;86(1):146–53.
Musso CG, Macías-Núñez JF. Dysfunction of the thick loop of Henle and senescence: from molecular biology to clinical geriatrics. Int Urol Nephrol. 2011;43(1):249–52.
Lye M. Distribution of body potassium in healthy elderly subjects. Gerontologie. 1981;27:286–92.
Phelps KR, Lieberman RL, Oh MS, et al. Pathophysiology of the syndrome of hyporeninemic hypoaldosteronism. Metabolism. 1980;29:186–99.
Musso CG, Miguel RD, Algranati L, Farias Edos R. Renal potassium excretion: comparison between chronic renal disease patients and old people. Int Urol Nephrol. 2005;37(1):167–70.
Musso CG, Juarez R, Vilas M, Navarro M, Rivera H, Jauregui R. Renal calcium, phosphorus, magnesium and uric acid handling: comparison between stage III chronic kidney disease patients and healthy oldest old. Int Urol Nephrol. 2012;44(5):1559–62.
Musso CG, Alvarez Gregori J, Jauregui JR, Macías Núñez JF. Creatinine, urea, uric acid, water and electrolytes renal handling in the healthy oldest old. World J Nephrol. 2012;1(5):123–6.
Musso CG, Michelángelo H, Vilas M, Reynaldi J, Martinez B, Algranati L, Macías Núñez JF. Creatinine reabsorption by the aged kidney. Int Urol Nephrol. 2009;41(3):727–31.
Wagner EA, Falciglia GA, Amlal H, et al. Short-term exposure to high-protein diet differentially affect glomerular filtration rate but not acid-base balance in older compared to younger adults. J Am Diet Assoc. 2007;107:1404–8.
Preisser L, Teillet L, Aliotti S, et al. Downregulation of aquaporin-2 and -3 in aging kidney is independent of V(2) vasopressin receptor. Am J Phyiol Renal Physiol. 2000;279:F144–52.
Musso CG, Macías Núñez JF. Renal handling of water and electrolytes in the old and old-old healthy aged. In: Núñez M, Cameron S, Oreopoulos D, editors. Renal ageing: health and disease. New York: Springer; 2008. p. 141–54.
Musso CG, Liakopoulos V, Ioannidis I, Eleftheriadis T, Stefanidis I. Acute renal failure in the elderly: particular characteristics. Int Urol Nephrol. 2006;38(3–4):787–93.
Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease improving global outcomes 2012 clinical practise guideline. Ann Intern Med. 2013;158(11):825–30.
Murata K, Bauman NA, Saenger AK, Larson TS, Rule AD, Lieske JC. Relative performance of the MDRD and CKD-EPI equations for estimating glomerular filtration rate among patients with varied clinical presentations. Clin J Am Soc Nephrol. 2011;6(8):1863–972.
Rule AD, Glassock RJ. GFR estimating equations: getting closer to the truth? Clin J Am Soc Nephrol. 2013;8(8):1414–20.
Stengel B, Metzger M, Froissart M, et al. Epidemiology and prognostic significance of chronic kidney disease in the elderly –the Three-City prospective cohort study. Nephrol Dial Transplant. 2011;26(10):3286–95.
Hallan SI, Matsushita K, Sang Y, et al. Age and association of kidney measures with mortality and end-stage renal disease. JAMA. 2012;308(22):2349–60.
Robles NR, Felix FJ, Lozano L, Miranda I, Fernandez-Berges D, Macías JF. The H.U.G.E. formula (Hematocrit, Urea, Sex) for screening chronic kidney disease (CKD) in an age-stratified general population. J Nutr Health Aging. 2015;19(6):688–92.
Musso CG, Maytin S, Conti P, Terrasa S, Primerano A, Reynaga A, Vilas M, Jauregui J. HUGE equation accuracy for screening chronic kidney disease: a prospective study. J Aging Res Clin Pract. 2017;6:158–62.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Dimkovic, N. (2019). Structural and Functional Renal Changes Secondary to Aging. In: Musso, C., Jauregui, J., Macías-Núñez, J., Covic, A. (eds) Clinical Nephrogeriatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-18711-8_1
Download citation
DOI: https://doi.org/10.1007/978-3-030-18711-8_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-18710-1
Online ISBN: 978-3-030-18711-8
eBook Packages: MedicineMedicine (R0)