Brown W W, Davis B B, Spry L A, Wongsurawat N, Malone J D, Domoto D T
Arch Intern Med. 1986 Sep;146(9):1790-6.
Numerous anatomic and physiologic alterations occur in the kidney with aging. These changes affect the ability of elderly patient(s) to maintain homeostasis and alter response to medications, stress, illness, or changes in diet, mobility, or environment. Drug-induced illness and drug interactions are major problems in the elderly. Bone disease and fractures are associated with negative calcium balance and decreased production of 1,25-dihydroxycholecalciferol seen with aging. The geriatric patient is not immune to the primary glomerular diseases that occur in younger patients, although the relative incidence of pathologic diagnoses may differ. The high incidence of membranous glomerulonephritis in the elderly, and the well-known association between malignancy and membranous nephropathy strongly favor aggressive evaluation of the nephrotic syndrome in the geriatric age group. Attention must be given to consideration of appropriate end-stage renal disease treatment alternatives for the geriatric population, which now comprises the fastest-growing segment of the end-stage renal disease population.
随着年龄增长，肾脏会出现许多解剖学和生理学改变。这些变化会影响老年患者维持体内平衡的能力，并改变其对药物、压力、疾病或饮食、活动能力或环境变化的反应。药物性疾病和药物相互作用是老年人面临的主要问题。骨病和骨折与钙负平衡以及随着年龄增长而出现的1,25-二羟胆钙化醇生成减少有关。老年患者也不能免于年轻患者中出现的原发性肾小球疾病，尽管病理诊断的相对发生率可能有所不同。老年人膜性肾小球肾炎的高发病率，以及恶性肿瘤与膜性肾病之间众所周知的关联，强烈支持对老年年龄组的肾病综合征进行积极评估。必须关注为老年人群体考虑适当的终末期肾病治疗方案，目前老年人群体是终末期肾病患者中增长最快的部分。
