Handling of water and electrolytes in the healthy old

This paper reviews the handling of water and electrolytes by the ageing kidney and the clinical consequences in everyday clinical practice. Normal physiology in the adult kidney is discussed, followed by description of the main physiological changes (adaption) that occur as the kidney ages. Clearly,...

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Bibliographic Details
Published in:Reviews in clinical gerontology 2009-02, Vol.19 (1), p.1-12
Main Authors: Alvarez Gregori, Joaquin-A., Macías Núñez, Juan-F.
Format: Article
Language:English
Subjects:
ageing
elderly
electrolytes
hydration
renal function
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Summary:This paper reviews the handling of water and electrolytes by the ageing kidney and the clinical consequences in everyday clinical practice. Normal physiology in the adult kidney is discussed, followed by description of the main physiological changes (adaption) that occur as the kidney ages. Clearly, successful management of the elderly patient requires a knowledge of these changes, which result in: (i) increased tendency for volume depletion and dehydration; (ii) decreased ability to tolerate a volume load; (iii) increased propensity for potassium disturbances (hypo- and hyperkalaemia); (iv) diminished production of renin and blunted physiological response to the effects of aldosterone and antidiuretic hormone; (v) increased tendency to lower levels of phosphate; and (vi) tendency for the development of hypocalcaemia and hypomagnesaemia. A brief review of the role of extracellular fluid volume depletion and other factors contributing to acute renal failure in elderly patients is also presented.
ISSN:0959-2598
1469-9036
DOI:10.1017/S0959259809990116