Kidney diseases in the elderly
1. Both effective kidney plasma flow and glomerular filtration rate decrease in parallel to progressive sclerotic changes seen in glomeruli, interstitium, and vasculature of the aging kidney.
2. A decrease in both concentrating and diluting ability can predispose elderly patients to osmolar disorders of hyponatremia and hypernatremia.
3. Decreased kidney reserve with aging increases susceptibility for acute kidney injury.
4. Isolated systolic hypertension is most common in the elderly.
5. Blood pressure reduction should always be gradual in older patients.
6. Membranous nephropathy is common in older patients presenting with nephrotic syndrome, and pauci-immune glomerulonephritis can be a common presentation of rapidly progressive glomerulonephritis in older patients.
7. Revascularization for atherosclerotic renal artery lesions may not add benefit to treatment with medical therapy alone.
8. Elderly patients with chronic kidney disease die primarily from cardiovascular disease.
9. Kidney transplant graft loss in the elderly is primarily from patient death.
10. Prevalence of simple cysts increases with age.
