Baylis C, Schmidt R
Department of Physiology, West Virginia University, Morgantown 26506-9229, USA.
Semin Nephrol. 1996 Jul;16(4):265-76.
Glomerular filtration rate (GFR) decreases with advancing age, particularly in men, although the rate of decrease in GFR is highly variable. Renal vasoconstriction contributes to the decrease in GFR because of increased renal nerve activity, angiotensin II, endothelin, and decreases in vasodilatory prostacyclin levels. Intrarenal nitric oxide activity may be enhanced during aging, perhaps as part of a compensatory response. The atrial natriuretic peptide system is altered during aging, but there is probably no net change in intrarenal hemodynamic actions. Glomerular damage also contributes to age-dependent decreases in GFR. The primary mechanisms are unknown, but they involve a buildup of mesangial extracellular matrix materials. Increases in vasoconstrictor, growth promoting factors, and/or decreases in vasodilator, growth inhibiting factors may contribute. Androgens provide a risk factor. Glomerular hypertension and/or hypertrophy are not primary factors in the development of age-dependent glomerulopathy, but will worsen the process when present.
肾小球滤过率（GFR）随年龄增长而下降，男性尤为明显，尽管GFR的下降速率差异很大。肾血管收缩导致GFR下降，原因是肾神经活动增强、血管紧张素II、内皮素增加，以及血管舒张性前列环素水平降低。衰老过程中肾内一氧化氮活性可能增强，这或许是一种代偿反应的一部分。心房利钠肽系统在衰老过程中发生改变，但肾内血流动力学作用可能没有净变化。肾小球损伤也导致GFR随年龄下降。主要机制尚不清楚，但涉及系膜细胞外基质物质的积累。血管收缩因子、生长促进因子增加和/或血管舒张因子、生长抑制因子减少可能起作用。雄激素是一个危险因素。肾小球高血压和/或肥大不是年龄相关性肾小球病发生的主要因素，但存在时会使病情恶化。
