Glomerular Disease in the Elderly Population

Abstract

As the second millennium dawns, it has become increasingly apparent that the elderly population will constitute an increasing fraction of the total disease burden of society. In the last decade of the 20th Century, approximately one in every 15 individuals was over the age of 65 and as the ‘baby boomers’ reach maturity, this fraction was expected to increase. Renal disease, in general, becomes increasingly common with aging, particularly those diseases related to urinary-tract obstruction and infection and to atherosclerosis. However, glomerular disease also is quite prevalent. The types of glomerular disease observed in the elderly generally reflect those seen in the population as a whole, however, certain disorders may have an increased prevalence among them. For example, renal complications of type 2 non-insulin dependent diabetes are seen with increasing frequency in the aging population. Amyloidosis, renal para-neoplastic syndromes and adverse effects of therapeutic agents are examples of renal and glomerular disorders also seen with increased frequency in older patients. This paper discusses glomerular disease in the elderly, focusing on specific issues of geriatric care that need to be embraced by practicing nephrologists.