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中华肾病研究电子杂志 ›› 2015, Vol. 04 ›› Issue (04) : 182 -186. doi: 10.3877/cma.j.issn.2095-3216.2015.04.004

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老年人肾脏变化及功能评估
叶朝阳1,(), 崔琳琳1   
  1. 1. 200003 上海,第二军医大学长征医院肾内科 解放军肾脏病研究所
  • 出版日期:2015-08-28
  • 通信作者: 叶朝阳

Kidney variation and function evaluation in elderly patients

Chaoyang Ye1,(), Linlin Cui1   

  1. 1. Department of Nephrology, Changzheng Hospital, Second Military Medical University, Kidney institute of Chinese PLA, Shanghai 200003, China
  • Published:2015-08-28
  • Corresponding author: Chaoyang Ye
  • About author:
    Corresponding author: Ye Chaoyang, Email:
引用本文:

叶朝阳, 崔琳琳. 老年人肾脏变化及功能评估[J/OL]. 中华肾病研究电子杂志, 2015, 04(04): 182-186.

Chaoyang Ye, Linlin Cui. Kidney variation and function evaluation in elderly patients[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2015, 04(04): 182-186.

人口老龄化的加速发展给全社会带来严峻的医疗挑战,各种老年疾病随着器官功能减退日益凸显,其中以肾脏最为突出。40岁以后,肾脏功能开始减退,在一般情况下,尚能维持正常的生理活动,但在疾病或某种应激状态下,肾脏负荷增加,会导致各种肾脏疾病的发生。肾脏随增龄发生的结构和功能改变是一种生理性老化过程,需与肾脏本身疾病相区别。由于肾脏老年性改变,现有的肾脏评估方法对老年人群有一定的局限,尚无适用于老年人的完善评估方法。在对老年肾脏疾病诊断过程中,需首先明确肾功能改变是生理性老化还是病理性改变;治疗上应在病因的基础上考虑老年的生理特点,予以个体化治疗。

The acceleration of population ageing develops serious medical challenges to society. With organ dysfunction progresses, various age-related diseases have become increasingly prominent, the most prominent of which is the kidney. After the age of 40, the kidney function begins to wane, and can still maintain normal physiological activities in general conditions; but in case of diseases or under some kind of stress condition, the kidney load is increased, which can lead to occurrence of various kidney diseases. Structural and functional changes in kidney take place with age, as a process of physiological aging, which should be distinguished from the kidney diseases. Due to the age-related changes in kidney, the existing renal assessment methods have certain limitations for the elderly, and there has not been any perfect assessment method suitable for the elderly. In the process of diagnosis for the elderly patients with kidney diseases, it should be made clear first whether the renal function change is a physiological or pathological one, so that the treatment can be individualized based on etiology and physiological characteristics of the elderly.

[1]
Aymanns C, Keller F, Maus S, et al. Review on pharmacokinetics and pharmacodynamics and the aging kidney [J]. Clin J Am Soc Nephrol, 2010, 5(2): 314-327.
[2]
林宝.中国人口老龄化:2000-2010.中国人口年鉴,2011,6(5):209-213.
[3]
Nitta K, Okada K, Yanai M, et al. Aging and chronic kidney disease [J]. Kidney Blood Press Res, 2013, 38(1): 109-120.
[4]
Hsu CY, McCulloch CE, Fan D, et al. Community-based incidence of acute renal failure [J]. Kidney Int, 2007, 72(2): 208-212.
[5]
Stevens LA, Li S, Wang C, et al. Prevalence of CKD and comorbid illness in elderly patients in the United States: results from the Kidney Early Evaluation Program (KEEP) [J]. Am J Kidney Dis, 2010, 55(3 Suppl 2): 23-33.
[6]
Prakash S1, O′Hare AM. Interaction of aging and chronic kidney disease [J]. Semin Nephrol, 2009, 29(5): 497-503.
[7]
陈香美,周春华.关爱老年,防治老年慢性肾脏病[J].中国社区医师,2014,30(10):10-11.
[8]
Musso CG, Oreopoulos DG. Aging and physiological changes of the kidneys including changes in glomerular filtration rate [J]. Nephron Physiol, 2011, 119(Suppl 1): 1-5.
[9]
Rule AD, Cornell LD, Poggio ED. Senile nephrosclerosis--does it explain the decline in glomerular filtration rate with aging [J]? Nephron Physiol, 2011, 119(Suppl 1): 6-11.
[10]
Sands JM. Urine concentrating and diluting ability during aging [J]. J Gerontol A Biol Sci Med Sci, 2012, 67(12): 1352-1357.
[11]
Musso CG, Miguel Rd, Algranati L, et al. Renal potassium excretion: comparison between chronic renal disease patients and old people [J]. Int Urol Nephrol, 2005, 37(1): 167-170.
[12]
Cirillo M, Ciacci C, De Santo NG. Age, renal tubular phosphate reabsorption, and serum phosphate levels in adults [J]. N Engl J Med, 2008, 359(8): 864-866.
[13]
Otero Gonzalez A, Prol MP, Caride MJ, et al. Estimated glomerular filtration rate (eGFR), 25(OH) D3, chronic kidney disease (CKD), the MYH9 (myosin heavy chain 9) gene in old and very elderly people [J]. Int Urol Nephrol, 2015, 47(8): 1403-1408.
[14]
Leibowitz D, Maaravi Y, Stessman-Lande I. Cardiac structure and function and renal insufficiency in the oldest old [J]. Clin Cardiol, 2012, 35(12): 764-769.
[15]
Choudhury D, Levi M. Aging and kidney disease[M]//Brenner BM. The kidney. 8th ed. St. Louis Mo: Saunders, 2007: 681-701.
[16]
Glassock RJ, Winearls C. Ageing and the glomerular filtration rate: truths and consequences [J]. Trans Am Clin Climatol Assoc, 2009, 120: 419-428.
[17]
Dowling TC, Wang ES, Ferrucci L, et al. Glomerular filtration rate equations overestimate creatinine clearance in older individuals enrolled in the Baltimore Longitudinal Study on Aging: impact on renal drug dosing [J]. Pharmacotherapy, 2013, 33(9): 912-921.
[18]
Levey AS, Coresh J, Greene T,et a1.Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate [J]. Ann Intern Med, 2006, 145(4): 247-254.
[19]
李江涛,许晨,崔春黎,等.CKD-EPI公式对简化MDRD方程的慢性肾脏病患者分期的影响[J].中华肾脏病杂志,2011,27(5):655-658.
[20]
Woo KS, Choi JL, Kim BR, et al. Clinical usefulness of serum cystatin C as a marker of renal function [J]. Diabetes Metab J, 2014, 38(4): 278-284.
[21]
曾海深,朱进才,杨青云. β一微球蛋白和胱抑素水平与年龄相关性及肾功能评价意义研究[J].检验医学与临床,2013,10(11):1382-1384.
[22]
毛志国,叶朝阳.肾功能检测方法的回顾与进展[J].高血压杂志,2001,9(3):264-266.
[23]
Pascual J, Orofino L, Liano F, et al. Incidence and prognosis of acute renal failure in older patients [J]. J Am Geriatr Soc, 1990, 38(1): 25-30.
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