老年人肾脏变化及功能评估

Kidney variation and function evaluation in elderly patients

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.