Kidney aging process and the management of the elderly patient with renal impairment (Review)

Papacocea,Raluca Ioana; Timofte,Delia; Tanasescu,Maria-Daniela; Balcangiu-Stroescu,Andra-Elena; Balan,Daniela Gabriela; Tulin,Adrian; Stiru,Ovidiu; Vacaroiu,Ileana Adela; Mihai,Andrada; Popa,Cristian Constantin; Cosconel,Cristina-Ileana; Enyedi,Mihaly; Miricescu,Daniela; Raducu,Laura; Ionescu,Dorin

doi:10.3892/etm.2021.9697

Kidney aging process and the management of the elderly patient with renal impairment (Review)

Authors:
- Raluca Ioana Papacocea
- Delia Timofte
- Maria-Daniela Tanasescu
- Andra-Elena Balcangiu-Stroescu
- Daniela Gabriela Balan
- Adrian Tulin
- Ovidiu Stiru
- Ileana Adela Vacaroiu
- Andrada Mihai
- Cristian Constantin Popa
- Cristina-Ileana Cosconel
- Mihaly Enyedi
- Daniela Miricescu
- Laura Raducu
- Dorin Ionescu
View Affiliations

Affiliations: Discipline of Physiology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Dialysis, Emergency University Hospital, 050098 Bucharest, Romania, Department of Medical Semiology, Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Discipline of Physiology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Anatomy, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Cardiovascular Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Nephrology and Dialysis, St. John Emergency Clinical Hospital, 042122 Bucharest, Romania, Discipline of Diabetes, Nutrition and Metabolic Diseases‑N. Paulescu National Institute, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Discipline of Foreign Languages, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Discipline of Biochemistry, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Discipline of Plastic and Reconstructive Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
Published online on: January 25, 2021 https://doi.org/10.3892/etm.2021.9697
Article Number: 266
Copyright: © Papacocea et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

As life expectancy increases, a rise in the number of chronically ill patients is observed due to the aging population. Among the various diseases, chronic kidney disease is at present one of the main causes of morbidity and, due to its typical complications, it is also one of the most important causes of mortality in the general population. For these reasons, the understanding of the kidney aging process, its consequences and its adequate management are essential. The judicious use of certain types of drugs, the prevention of episodes of renal injury either by toxic mechanisms or by dehydration are important aspects and are part of the apropriate approach for elderly patients. The most effective treatment of various types of conditions with a negative impact on renal function and for which an increased incidence is known as we age should also be considered. Thus, in the case of elderly patients, in order to protect the kidneys, an integrative approach is recommended, one that includes both elements of prevention and the appropriate treatment of existing diseases.

View Figures

View References

1	Kalache A, de Hoogh AI, Howlett SE, Kennedy B, Eggerdorfer M, Marsman DS, Shao A and Griffiths JC: Nutrition interventions for healthy ageing across the lifespan: A conference report. Eur J Nutr. 58 (Suppl 1):S1–S11. 2019.PubMed/NCBI View Article : Google Scholar
2	https://www.who.int/ageing/healthy-ageing/en/. Accessed April 25, 2020.
3	Alvis BD and Hughes CG: Physiology considerations in geriatric patients. Anesthesiol Clin. 33:447–456. 2015.PubMed/NCBI View Article : Google Scholar
4	Yang HC and Fogo AB: Fibrosis and renal aging. Kidney Int Suppl (2011). 4:75–78. 2014.PubMed/NCBI View Article : Google Scholar
5	Denic A, Glassock RJ and Rule AD: Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 23:19–28. 2016.PubMed/NCBI View Article : Google Scholar
6	Hommos MS, Glassock RJ and Rule AD: Structural and functional changes in human kidneys with healthy aging. J Am Soc Nephrol. 28:2838–2844. 2017.PubMed/NCBI View Article : Google Scholar
7	Dai L, Qureshi AR, Witasp A, Lindholm B and Stenvinkel P: Early vascular ageing and cellular senescence in chronic kidney disease. Comput Struct Biotechnol J. 17:721–729. 2019.PubMed/NCBI View Article : Google Scholar
8	Diaconu C: Treatment of diabetes in patients with heart failure. Proceedings of the 3rd international conference on interdisciplinary management of diabetes mellitus and its complications-diabetes mellitus in internal medicine, interdiab. 2017, Serafinceanu C, Negoiţă O and Elian V (eds), pp170-177, 2017.
9	Dobrică EC, Gaman MA, Cozma MA, Bratu OG, Pantea Stoian A and Diaconu CC: Polypharmacy in type 2 diabetes mellitus: Insights from an internal medicine department. Medicina (Kaunas). 55(436)2019.PubMed/NCBI View Article : Google Scholar
10	Tanasescu MD, Balcangiu Stroescu AE, Raducu L, Limbau AM, Diaconescu AC, Balan DG and Ionescu D: Uterine cervical cancer and chronic kidney disease an association that should not be skipped. Rev Chim. 69:2524–2526. 2018.
11	Balan DG, Balcangiu-Stroescu AE, Tanasescu MD, Diaconescu A, Raducu L, Mihai A, Tanase M, Stanescu II and Ionescu D: Nutritional intervention in patients with diabetic renal disease-a brief presentation. Rev Chim. 69:4078–4082. 2018.
12	Balcangiu-Stroescu AE, Tanasescu MD, Diaconescu A, Raducu L, Balan DG, Mihai A, Tanase M, Stanescu II and Ionescu D: Diabetic nephropathy: A concise assessment of the causes, risk factors and implications in diabetic patients. Rev Chim. 69:3118–3121. 2018.
13	Bolignano D, Mattace-Raso F, Sijbrands EJ and Zoccali C: The aging kidney revisited: A systematic review. Ageing Res Rev. 14:65–80. 2014.PubMed/NCBI View Article : Google Scholar
14	Kazancioğlu R: Risk factors for chronic kidney disease: An update. Kidney Int Suppl (2011). 3:368–371. 2013.PubMed/NCBI View Article : Google Scholar
15	Chang PY, Chien LN, Lin YF, Wu MS, Chiu WT and Chiou HY: Risk factors of gender for renal progression in patients with early chronic kidney disease. Medicine (Baltimore). 95(e4203)2016.PubMed/NCBI View Article : Google Scholar
16	Duru OK, Li S, Jurkovitz C, Bakris G, Brown W, Chen SC, Collins A, Klag M, McCullough PA, McGill J, et al: Race and sex differences in hypertension control in CKD: Results from the kidney early evaluation program (KEEP). Am J Kidney Dis. 51:192–198. 2008.PubMed/NCBI View Article : Google Scholar
17	Reckelhoff JF, Zhang H and Granger JP: Decline in renal hemodynamic function in aging SHR: Role of androgens. Hypertension. 30:677–681. 1997.PubMed/NCBI View Article : Google Scholar
18	Weinstein JR and Anderson S: The aging kidney: Physiological changes. Adv Chronic Kidney Dis. 17:302–307. 2010.PubMed/NCBI View Article : Google Scholar
19	Gava AL, Freitas FP, Meyrelles SS, Silva IV and Graceli JB: Gender-dependent effects of aging on the kidney. Braz J Med Biol Res. 44:905–913. 2011.PubMed/NCBI View Article : Google Scholar
20	Rajashekar A, Perazella MA and Crowley S: Systemic diseases with renal manifestations. Prim Care. 35:297–328. 2008.PubMed/NCBI View Article : Google Scholar
21	Ferenbach DA and Bonventre JV: Mechanisms of maladaptive repair after AKI leading to accelerated kidney ageing and CKD. Nat Rev Nephrol. 11:264–276. 2015.PubMed/NCBI View Article : Google Scholar
22	O'Sullivan ED, Hughes J and Ferenbach DA: Renal aging: Causes and consequences. J Am Soc Nephrol. 28:407–420. 2017.PubMed/NCBI View Article : Google Scholar
23	Lu X and Hu MC: Klotho/FGF23 axis in chronic kidney disease and cardiovascular disease. Kidney Dis (Basel). 3:15–23. 2017.PubMed/NCBI View Article : Google Scholar
24	Kao MP, Ang DS, Pall A and Struthers AD: Oxidative stress in renal dysfunction: Mechanisms, clinical sequelae and therapeutic options. J Hum Hypertens. 24:1–8. 2010.PubMed/NCBI View Article : Google Scholar
25	Liguori I, Russo G, Curcio F, Bulli G, Aran L, Della-Morte D, Gargiulo T, Cacciatore F, Bonaduce D and Abete P: Oxidative stress, aging, and diseases. Clin Interv Aging. 13:757–772. 2018.PubMed/NCBI View Article : Google Scholar
26	Cachofeiro V, Goicochea M, de Vinuesa SG, Oubiña P, Lahera V and Luño J: Oxidative stress and inflammation, a link between chronic kidney disease and cardiovascular disease. Kidney Int Suppl. S4–S9. 2008.PubMed/NCBI View Article : Google Scholar
27	Totan A, Balcangiu-Stroescu AE, Melescanu Imre M, Miricescu D, Balan DG, Stanescu II, Ionescu D, Timofte D, Tanasescu MD and Greabu M: XOR-possible correlations with oxidative stress and inflammation markers in the context of diabetic kidney disease. Rev Chim. 70:1396–1398. 2019.
28	Bonventre JV: Current biomarkers in kidney disease: Dawning of a new era. https://www.kidneynews.org/kidney-news/special-sections/kidney-disease-biomarkers/current-biomarkers-in-kidney-disease-dawning-of-new-era. Accessed April 25, 2020.
29	Ortega LM and Heung M: The use of cell cycle arrest biomarkers in the early detection of acute kidney injury. Is this the new renal troponin? Nefrologia. 38:361–367. 2018.PubMed/NCBI View Article : Google Scholar : (In English, Spanish).
30	Sakhuja A: Novel biomarkers of renal function introduction and overview. https://emedicine.medscape.com/article/1925619-overview#a3. Accessed April 25, 2020.
31	Johnson ACM and Zager RA: Mechanisms underlying increased TIMP2 and IGFBP7 urinary excretion in experimental AKI. J Am Soc Nephrol. 29:2157–2167. 2018.PubMed/NCBI View Article : Google Scholar
32	Johnson AC and Zager RA: Plasma and urinary p21: Potential biomarkers of AKI and renal aging. Am J Physiol Renal Physiol. 315:F1329–F1335. 2018.PubMed/NCBI View Article : Google Scholar
33	Kovesdy CP: Updates in hyperkalemia: Outcomes and therapeutic strategies. Rev Endocr Metab Disord. 18:41–47. 2017.PubMed/NCBI View Article : Google Scholar
34	Rule AD and Glassock RJ: The aging kidney. https://www.uptodate.com/contents/the-aging-kidney. Accessed May 5, 2020.
35	Fassett RG: Current and emerging treatment options for the elderly patient with chronic kidney disease. Clin Interv Aging. 9:191–199. 2014.PubMed/NCBI View Article : Google Scholar
36	Prakash S and O'Hare AM: Interaction of aging and chronic kidney disease. Semin Nephrol. 29:497–503. 2009.PubMed/NCBI View Article : Google Scholar
37	Balcangiu-Stroescu AE, Tanasescu MD, Diaconescu A, Raducu L, Constantin AM, Balan DG, Tarmure V and Ionescu D: Cardiovascular comorbidities, inflammation and serum albumin levels in a group of hemodialysis patients. Rev Chim. 69:926–929. 2018.
38	Gaman MA, Dobrica EC, Pascu EG, Cozma MA, Epingeac ME, Gaman AM, Pantea Stoian A, Bratu OG and Diaconu CC: Cardio metabolic risk factors for atrial fibrillation in type 2 diabetes mellitus: Focus on hypertension, metabolic syndrome and obesity. J Mind Med Sci. 6:157–161. 2019.
39	Egan BM: Treatment of hypertension in older adults, particularly isolated systolic hypertension. https://www.uptodate.com/contents/treatment-of-hypertension-in-older-adults-particularly-isolated-systolic-hypertension. Accessed May 5, 2020.
40	Cai G, Zheng Y, Sun X and Chen X: Survey of Prevalence, Awareness and Treatment Rates in Chronic Kidney Disease Patients with Hypertension in China Collaborative Group. Prevalence, awareness, treatment, and control of hypertension in elderly adults with chronic kidney disease: Results from the survey of prevalence, awareness, and treatment rates in chronic kidney disease patients with hypertension in China. J Am Geriatr Soc. 61:2160–2167. 2013.PubMed/NCBI View Article : Google Scholar
41	Timofte D, Ionescu D, Medrihan L, Mandita A, Rasina A and Damian L: Vascular calcification and bone disease in hemodialysis patients assessment, association and risk factors. Nephrol Dial Transplant. 22:325–326. 2007.
42	Timofte D, Dragoș D, Balcangiu-Stroescu AE, Tănăsescu MD, Gabriela Bălan D, Răducu L, Tulin A, Stiru O and Ionescu D: Abdominal aortic calcification in predialysis patients: Contribution of traditional and uremia-related risk factors. Exp Ther Med. 20:97–102. 2020.PubMed/NCBI View Article : Google Scholar
43	Timofte D, Mandita A, Balcangiu-Stroescu AE, Balan DG, Raducu L, Tanasescu MD, Diaconescu AC, Dorin D, Cosconel CI and Ionescu D: Hyperuricemia and cardiovascular diseases-clinical and paraclinical correlations. Rev Chim. 70:1045–1046. 2019.
44	Abad K, Rivera FX and Owen JG: The Management of hypertension in elderly patients with chronic kidney disease. J Clin Outcomes Manag. 25:211–218. 2018.
45	Mandita A, Timofte D, Balcangiu-Stroescu AE, Balan D, Raducu L, Tanasescu MD, Diaconescu A, Dragos D, Cosconel CI, Stoicescu SM and Ionescu D: Treatment of high blood pressure in patients with chronic renal disease. Rev Chim (Bucharest). 70:993–995. 2019.