Godin M, Moulin B, Etienne I, Fillastre J P
Service de Néphrologie, CHRU, Rouen.
Presse Med. 1992 Jul 22;21(26):1246-8.
Renal morphological and functional changes occur in the elderly. Between the ages of 50 and 80 years the renal mass diminishes by a mean of 20 percent, to the expense of the renal cortex. Glomerular sclerosis results in a gradual fall in the number of functioning glomeruli. Simultaneously, a decrease of about 7 percent in glomerular filtration rate per decade after the age of 40 years and a 10 percent decrease in renal plasma flow per decade, and therefore an increase in filtration fraction, are observed. These haemodynamic abnormalities are accompanied by changes in tubular function, including a delay in renal adjustment to sodium overload, and above all to sodium restriction, together with a decrease in concentrating and, to a lesser extent, diluting capacity. In actual fact, the intensity of glomerular sclerosis varies considerably from one subject to another, and the decrease in glomerular filtration rate is far from being constant. These changes are perhaps not ineluctably associated with aging; they might result from pathological processes that have gone unnoticed.
老年人会出现肾脏形态和功能的变化。在50至80岁之间,肾脏质量平均减少20%,肾皮质受累。肾小球硬化导致功能正常的肾小球数量逐渐减少。同时,40岁以后每十年肾小球滤过率约降低7%,肾血浆流量每十年降低10%,因此滤过分数增加。这些血流动力学异常伴随着肾小管功能的变化,包括肾脏对钠负荷过重的调节延迟,尤其是对钠限制的调节延迟,以及浓缩能力下降,稀释能力在较小程度上也下降。事实上,肾小球硬化的程度在个体之间差异很大,肾小球滤过率的降低也远非恒定不变。这些变化可能并非不可避免地与衰老相关;它们可能是由未被注意到的病理过程导致的。