Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Ageing Biology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Int Urol Nephrol. 2019 Mar;51(3):461-465. doi: 10.1007/s11255-018-2061-0. Epub 2019 Jan 2.
There is interdependence between chronic kidney disease (CKD) and ageing whereby CKD makes ageing more accelerated and pronounced, whereas ageing accelerates chronic nephropathy's progression. Frailty status catalyzes this spiral, with renal and systemic negative consequences, and this condition can currently be documented by applying already validated clinical scores (frailty phenotype) or physical test (gate speed). Although, nephroprevention strategies are similar between young adult and senior CKD patients, standard targets should be adequate to very old and frail elderly individuals. For this purpose, an original algorithm is here proposed to adjust the conventional nephroprevention strategies to the condition of CKD frail patient (more relaxed targets and tighter control), as well as to prescribe anti-frailty interventions to slow patient's functional decline, hospitalization and mortality.
慢性肾脏病（CKD）和衰老之间存在相互依存关系，CKD 使衰老加速和明显，而衰老加速慢性肾病的进展。虚弱状态加速了这一螺旋式下降，导致肾脏和全身的负面后果，目前可以通过应用已经验证的临床评分（虚弱表型）或身体测试（门速）来记录这种情况。尽管年轻成人和老年 CKD 患者的肾病预防策略相似，但标准目标应该适用于非常高龄和虚弱的老年人。为此，本文提出了一种原始算法，将传统的肾病预防策略调整为 CKD 虚弱患者的情况（更宽松的目标和更严格的控制），并规定抗虚弱干预措施以减缓患者的功能下降、住院和死亡。
