Kidney Disease in Old Age

Abstract

In older people important causes of chronic kidney diseases (CKD) are diabetes and hypertension, which are responsible for up to two-thirds of the cases. Other risk factors are urinary infections, abuse of pain relieving medications (NSAIDs), different types of primary glomerulonephritis, and some inherited disease. An acute renal failure (ARF) is common caused by an event that leads to a sudden kidney malfunction, such as dehydration, nephrotoxic medicines, e.g., NSAIDs and contrast agents, or postrenal obstruction. Kidney sonography may help to determine whether kidney problems are acute or chronic. The treatment of acute kidney injury includes correcting the cause and supporting the kidneys with fluid. Only in some cases dialysis is indicated when severe hyperkalemia, metabolic acidosis, or volume overload cannot be managed. Progression to end-stage renal disease (ESRD) is typically characterized by the loss of a number ofbiological functions, including fluid and electrolyte balance, and endocrine, neurological, hematological, and cardiovascular dysfunctions. Elderly patients often develop complications like anemia, poor nutritional health, and nerve damage very early. Disturbances in calcium homeostasis chronic also increase the risk of an arterial and systemic calcifications. For these reasons, identification and management of CKD patients are of paramount importance to implement interventions aimed at slowing the progression of kidney disease and delaying the onset of its complications.