The Conundrums of Chronic Kidney Disease and Aging

Overview

Journal J Nephrol

Publisher Springer

Specialty Nephrology

Date 2016 Nov 26

PMID 27885585

Citations 15

Authors

Richard J Glassock

Aleksandar Denic

Andrew D Rule

Affiliations

Soon will be listed here.

Abstract

Chronic kidney disease (CKD), as presently defined, is a common disorder. Aging is a nearly universal phenomenon that can affect renal anatomy and function, but at variable rates in individuals. Loss of nephrons and a decline in glomerular filtration rate (GFR) is a characteristic of normal aging, called renal senescence. Using fixed and absolute thresholds for defining CKD on the basis of GFR for all ages may lead to diagnostic uncertainty (a conundrum) in both young and older subjects. This brief review will consider the physiological and anatomical changes of the kidney occurring in the process of normal renal senescence focusing on GFR and will examine the relevance of these observation for the diagnosis of CKD using GFR as the distinguishing parameter. Once a better understanding of the pathobiology underlying renal senescence is obtained, specific interventions may become available to slow the process.

Citing Articles

Biomarkers of chronic kidney disease in older individuals: navigating complexity in diagnosis.

Muglia L, Di Dio M, Filicetti E, Greco G, Volpentesta M, Beccacece A Front Med (Lausanne). 2024; 11:1397160.

PMID: 39055699 PMC: 11269154. DOI: 10.3389/fmed.2024.1397160.

Chronic Kidney Disease Stage and Cardiovascular and Mortality Events Among Older Adults: The SPRINT Trial.

Turbay-Caballero V, Ricardo A, Chen J, Missikpode C, Lash J, Aroca-Martinez G Kidney Med. 2024; 6(7):100845.

PMID: 38966681 PMC: 11222801. DOI: 10.1016/j.xkme.2024.100845.

Age-dependent changes in the gut microbiota and serum metabolome correlate with renal function and human aging.

Sun L, Li Z, Hu C, Ding J, Zhou Q, Pang G Aging Cell. 2023; 22(12):e14028.

PMID: 38015106 PMC: 10726799. DOI: 10.1111/acel.14028.

Vascular Calcification in Chronic Kidney Disease: An Update and Perspective.

Ren S, Mao N, Yi S, Ma X, Zou J, Tang X Aging Dis. 2022; 13(3):673-697.

PMID: 35656113 PMC: 9116919. DOI: 10.14336/AD.2021.1024.

A study on the status of normoalbuminuric renal insufficiency among type 2 diabetes mellitus patients: A multicenter study based on a Chinese population.

Jia X, Zang L, Pang P, Jiang L, Du J, Gu W J Diabetes. 2021; 14(1):15-25.

PMID: 34623029 PMC: 9060045. DOI: 10.1111/1753-0407.13230.

References

Malmgren L, McGuigan F, Berglundh S, Westman K, Christensson A, Akesson K . Declining Estimated Glomerular Filtration Rate and Its Association with Mortality and Comorbidity Over 10 Years in Elderly Women. Nephron. 2015; 130(4):245-55. DOI: 10.1159/000435790. View

Matsushita K, van der Velde M, Astor B, Woodward M, Levey A, de Jong P . Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010; 375(9731):2073-81. PMC: 3993088. DOI: 10.1016/S0140-6736(10)60674-5. View

Luyckx V, Brenner B . Birth weight, malnutrition and kidney-associated outcomes--a global concern. Nat Rev Nephrol. 2015; 11(3):135-49. DOI: 10.1038/nrneph.2014.251. View

Brenner B . Nephron adaptation to renal injury or ablation. Am J Physiol. 1985; 249(3 Pt 2):F324-37. DOI: 10.1152/ajprenal.1985.249.3.F324. View

Klenk J, Keil U, Jaensch A, Christiansen M, Nagel G . Changes in life expectancy 1950-2010: contributions from age- and disease-specific mortality in selected countries. Popul Health Metr. 2016; 14:20. PMC: 4877984. DOI: 10.1186/s12963-016-0089-x. View

Martinez D . Mortality patterns suggest lack of senescence in hydra. Exp Gerontol. 1998; 33(3):217-25. DOI: 10.1016/s0531-5565(97)00113-7. View

Gansevoort R, Matsushita K, van der Velde M, Astor B, Woodward M, Levey A . Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts. Kidney Int. 2011; 80(1):93-104. PMC: 3959732. DOI: 10.1038/ki.2010.531. View

Glassock R, Rule A . The implications of anatomical and functional changes of the aging kidney: with an emphasis on the glomeruli. Kidney Int. 2012; 82(3):270-7. PMC: 3513938. DOI: 10.1038/ki.2012.65. View

Boubred F, Buffat C, Feuerstein J, Daniel L, Tsimaratos M, Oliver C . Effects of early postnatal hypernutrition on nephron number and long-term renal function and structure in rats. Am J Physiol Renal Physiol. 2007; 293(6):F1944-9. DOI: 10.1152/ajprenal.00141.2007. View

10.

Brenner B, Meyer T, Hostetter T . Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. N Engl J Med. 1982; 307(11):652-9. DOI: 10.1056/NEJM198209093071104. View

11.

Rule A, Amer H, Cornell L, Taler S, Cosio F, Kremers W . The association between age and nephrosclerosis on renal biopsy among healthy adults. Ann Intern Med. 2010; 152(9):561-7. PMC: 2864956. DOI: 10.7326/0003-4819-152-9-201005040-00006. View

12.

Hudson J, Bean J, Burger C, Stephens A, McFarland M . Estimated glomerular filtration rate leads to higher drug dose recommendations in the elderly compared with creatinine clearance. Int J Clin Pract. 2015; 69(3):313-20. DOI: 10.1111/ijcp.12532. View

13.

Tonelli M, Riella M . Chronic kidney disease and the aging population. J Nephrol. 2014; 27(1):1-5. DOI: 10.1007/s40620-014-0038-3. View

14.

Chin M, Wrolstad D, Bakris G, Chertow G, de Zeeuw D, Goldsberry A . Risk factors for heart failure in patients with type 2 diabetes mellitus and stage 4 chronic kidney disease treated with bardoxolone methyl. J Card Fail. 2014; 20(12):953-8. DOI: 10.1016/j.cardfail.2014.10.001. View

15.

Sud M, Tangri N, Pintilie M, Levey A, Naimark D . Risk of end-stage renal disease and death after cardiovascular events in chronic kidney disease. Circulation. 2014; 130(6):458-65. DOI: 10.1161/CIRCULATIONAHA.113.007106. View

16.

Eriksen B, Stefansson V, Jenssen T, Mathisen U, Schei J, Solbu M . Elevated blood pressure is not associated with accelerated glomerular filtration rate decline in the general non-diabetic middle-aged population. Kidney Int. 2016; 90(2):404-410. DOI: 10.1016/j.kint.2016.03.021. View

17.

Glassock R, Delanaye P, El Nahas M . An Age-Calibrated Classification of Chronic Kidney Disease. JAMA. 2015; 314(6):559-60. DOI: 10.1001/jama.2015.6731. View

18.

Ocampo A, Reddy P, Izpisua Belmonte J . Anti-Aging Strategies Based on Cellular Reprogramming. Trends Mol Med. 2016; 22(8):725-738. DOI: 10.1016/j.molmed.2016.06.005. View

19.

Hallan S, Matsushita K, Sang Y, Mahmoodi B, Black C, Ishani A . Age and association of kidney measures with mortality and end-stage renal disease. JAMA. 2012; 308(22):2349-60. PMC: 3936348. DOI: 10.1001/jama.2012.16817. View

20.

LINDEMAN R, Tobin J, SHOCK N . Association between blood pressure and the rate of decline in renal function with age. Kidney Int. 1984; 26(6):861-8. DOI: 10.1038/ki.1984.229. View