Noronha Irene L, Santa-Catharina Guilherme P, Andrade Lucia, Coelho Venceslau A, Jacob-Filho Wilson, Elias Rosilene M
Renal Division, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil.
Laboratory of Cellular, Genetic and Molecular Nephrology, University of São Paulo Medical School, São Paulo, Brazil.
Front Med (Lausanne). 2022 Sep 15;9:769329. doi: 10.3389/fmed.2022.769329. eCollection 2022.
In the last decades, improvements in the average life expectancy in the world population have been associated with a significant increase in the proportion of elderly people, in parallel with a higher prevalence of non-communicable diseases, such as hypertension and diabetes. As the kidney is a common target organ of a variety of diseases, an adequate evaluation of renal function in the approach of this population is of special relevance. It is also known that the kidneys undergo aging-related changes expressed by a decline in the glomerular filtration rate (GFR), reflecting the loss of kidney function, either by a natural senescence process associated with healthy aging or by the length of exposure to diseases with potential kidney damage. Accurate assessment of renal function in the older population is of particular importance to evaluate the degree of kidney function loss, enabling tailored therapeutic interventions. The present review addresses a relevant topic, which is the effects of aging on renal function. In order to do that, we analyze and discuss age-related structural and functional changes. The text also examines the different options for evaluating GFR, from the use of direct methods to the implementation of several estimating equations. Finally, this manuscript supports clinicians in the interpretation of GFR changes associated with age and the management of the older patients with decreased kidney function.
在过去几十年中，世界人口平均预期寿命的提高与老年人比例的显著增加相关，与此同时，高血压和糖尿病等非传染性疾病的患病率也更高。由于肾脏是多种疾病的常见靶器官，因此在针对这一人群的治疗过程中，对肾功能进行充分评估具有特殊意义。众所周知，肾脏会经历与衰老相关的变化，表现为肾小球滤过率（GFR）下降，这反映了肾功能的丧失，其原因可能是与健康衰老相关的自然衰老过程，也可能是由于接触有潜在肾脏损害的疾病的时长。准确评估老年人群的肾功能对于评估肾功能丧失程度尤为重要，有助于进行针对性的治疗干预。本综述探讨了一个相关主题，即衰老对肾功能的影响。为此，我们分析并讨论了与年龄相关的结构和功能变化。本文还研究了评估GFR的不同方法，从使用直接方法到应用多种估算方程。最后，本手稿为临床医生解读与年龄相关的GFR变化以及管理肾功能下降的老年患者提供支持。
