Ageing is associated with a progressive decline in kidney function

• Chronic kidney disease in adults has a global prevalence of around 13%.

• The International Day of Older Persons is celebrated every 1 October. The United Nations chose “The resilience and contributions of older women” as its theme for 2022.

October 2022.- Ageing is a physiological process that causes structural and functional changes in all living beings, according to the World Health Organization (WHO). As we age, virtually all our organs’ functional capacities decline, and kidney function is no exception.

“A young adult’s kidneys filter 180 litres a day (125 ml/min), and with ageing, filtration falls by approximately 0.8 ml/min for each year of life,” explains Dr. Alberto Flores Almonte, head of the Nephrology unit at the Diabetes, Obesity and Specialties Medical Centre (CEMDOE).

As well as kidney function, ageing brings several structural changes, such as a progressive decrease in the number of nephrons, which are responsible for purifying the blood. These fall from approximately 1 to 1.2 million per kidney in young people to 550,000 per kidney at ages 70 to 75.

Older adults are also prone to nephrosclerosis, a chronic kidney disease that complicates high blood pressure, and show a thinning of the renal cortex, the outermost layer of kidney tissue. Kidney mass drops from around 260 g in young adults to less than 200 g in adults over 75.

Caring for older adults

Dr. Flores says there are no therapies aimed at stopping the progression of age-related kidney disease; however, there are measures to try to slow kidney damage in these patients.

He suggests improving proteinuria (protein in the urine), early referral to a nutritionist, controlling diabetes or hypertension if present, avoiding medications that are potentially toxic to the kidneys (non-steroidal anti-inflammatory painkillers), not self-medicating, strictly monitoring blood lipid profiles, not smoking and doing some kind of physical activity if possible.

Around 50% of older people have at least 2 other associated chronic diseases that often affect the kidneys and contribute to the decline of kidney function already reduced by the passing years.

Older people are also more prone to sudden loss of kidney function and to developing chronic toxicity from medicines cleared by the kidneys.

Timely follow-up

The CEMDOE specialist highlights another very important aspect to consider in older people: senile sarcopenia, a progressive and generalised skeletal muscle disease characterised by reduced muscle strength and mass, which limits a person’s physical performance.

“In older people, the development of renal cysts is also common, usually multiple and larger than in younger people. These cysts arise from tubular diverticular lesions typical of ageing and are usually benign, although they can sometimes reflect an underlying parenchymal lesion,” says Dr. Flores.

All this means that older patients with reduced kidney function warrant special care.

Flores says that “specialist nephrology follow-up from the early stages of kidney disease ensures slower disease progression and a better overall prognosis”.

CEMDOE’s Nephrology and Haemodialysis Unit focuses on the promotion, prevention, diagnosis and treatment of kidney diseases and is led by a multispecialty medical team. The haemodialysis rooms are strategically laid out and equipped with the most modern devices in the country, to give patients a satisfying experience.

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About CEMDOE

An outpatient medical centre specialising in chronic diseases that offers a comprehensive care model focused on the safety, quality and experience of patients and their families, supported by international processes, standards and policies that ensure the success of its purpose.

CEMDOE is part of INTEGRA, the Dominican Republic’s first health ecosystem, which aims to improve the population’s health in a sustainable way.

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