Michel C, Albert C, Viron B, Mignon F
Service de néphrologie, hôpital Tenon, Paris.
Rev Prat. 1992 Feb 15;42(4):421-5.
Ageing does not spare the kidneys but, remarkably, renal impairment is virtually asymptomatic as homaeostasis remains ensured. Nevertheless, in routine practice physicians must take into account the "physiological" renal insufficiency of the elderly. In old people with chronic renal impairment the diagnostic and therapeutic approaches are special, owing to the age-related risks attached to both paraclinical examinations and treatments. Yet in certain subjects treatment can be remarkably effective and prevent the progression to terminal uraemia, and this justifies the detection and exploration of renal insufficiency in elderly patients. In the last few years, iterative dialysis programmes have been made available to third or even fourth age patients who had reached the so-called end-stage renal failure. The results are encouraging, but there are still purely medical questions concerning the measures to be taken in priority and the numerous organization problems to be solved for optimal management of these patients.
衰老不会放过肾脏，但值得注意的是，由于仍能维持内环境稳定，肾功能损害实际上没有症状。然而，在日常实践中，医生必须考虑老年人的“生理性”肾功能不全。在患有慢性肾功能损害的老年人中，由于辅助临床检查和治疗都存在与年龄相关的风险，诊断和治疗方法具有特殊性。然而，在某些患者中，治疗可能非常有效，并能防止进展至终末期尿毒症，这使得对老年患者肾功能不全的检测和探查具有合理性。在过去几年中，已经为达到所谓终末期肾衰竭的高龄患者提供了反复透析方案。结果令人鼓舞，但在优先采取的措施方面仍存在纯粹的医学问题，以及为这些患者的最佳管理需要解决的众多组织问题。
