Glassock Richard, Denic Aleksandar, Rule Andrew D
Geffen School of Medicine, UCLA, USA.
Division of Nephrology and Hypertension, Mayo Clinic, USA.
J Bras Nefrol. 2017 Mar;39(1):59-64. doi: 10.5935/0101-2800.20170010.
Aging is a nearly universal phenomenon in biology only partially controlled by genetic endowment. Individuals and their organs age at varying rates. The kidneys manifest the aging process by steady loss of nephrons and a corresponding decrease in glomerular filtration rate (GFR) beginning about age 30 years. The mechanisms responsible for this observation is are elusive. However, defining chronic kidney disease based on arbitrary, fixed thresholds of GFR in the later phases of life can be problematical as it may over-diagnosis CKD in the elderly. A modest, persisting reduction of GFR (around 45-59 ml/min/1.73m2) without abnormal proteinuria does not seem to confer much of an adverse effect on mortality and remaining life expectancy in older adults and the development of end-stage renal disease in such subjects is very uncommon. Old kidneys should not be equated with "diseased" kidneys.
衰老几乎是生物学中普遍存在的现象，仅部分受遗传因素控制。个体及其器官的衰老速度各不相同。肾脏通过从大约30岁开始肾单位的稳定丧失和相应的肾小球滤过率（GFR）下降来体现衰老过程。导致这一现象的机制尚不清楚。然而，在生命后期基于任意、固定的GFR阈值来定义慢性肾脏病可能会有问题，因为这可能会过度诊断老年人的慢性肾脏病。在没有异常蛋白尿的情况下，GFR适度、持续降低（约45 - 59毫升/分钟/1.73平方米）似乎不会对老年人的死亡率和剩余预期寿命产生太大不利影响，而且这类患者很少发展为终末期肾病。不应将衰老的肾脏等同于“患病”的肾脏。
