REVIEW   

Minerva Medica 2018 February;109(1):41-52

DOI: 10.23736/S0026-4806.17.05351-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The current management of kidney disease in the elderly

Agnieszka PERKOWSKA-PTASINSKA ✉, Dominika DEBORSKA-MATERKOWSKA, Magdalena DURLIK

Department of Transplantology, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland

Chronic kidney disease (CKD), diabetes and cardiovascular disease constitute three interrelated conditions of strong public health relevance. Elderly individuals account for the largest and the most rapidly growing age segment of the end-stage renal disease population. The elderly are affected by the same types of kidney diseases as younger individuals, but aging itself is associated with a gradual reduction in estimated glomerular filtration rate, which leads to the diminishment of the functional reserve and makes an individual more vulnerable to injurious effects of hypertension, cardiovascular disease, diabetes, and drugs’ toxicity. Although the spectrum of diseases affecting people aged ≥65 is the same as in younger population, there are some distinct differences in the frequency of certain nephropathies between these two age groups. The superimposition of aging-related lesions on other kidney diseases evolving in the elderly population makes the clinical picture more complex and reaching diagnosis more challenging. In elderly CKD patients the high prevalence of comorbidities and the often aberrant metabolism of medications have to be considered in individually tailored treatment strategies.

KEY WORDS: Chronic renal insufficiency - Aged - Glomerular filtration rate - Kidney transplantation