In the last century, blood creatinine was simply tested to detect chronic kidney disease. Now everything is twisted around the glomerular filtration rate. Over the past 20 years, this indicator among older people is increasingly found to be reduced. It is unlikely that they all have chronic kidney disease. It got to the point that half of people over 70 could be diagnosed. The nephrologists were alarmed and said that there was no enough diagnoses for all the elderly, and something was wrong.
Some doctors were glad that now it would be possible to treat grandparents quickly, while other doctors objected that it was not very good to stigmatize elderly people with all kinds of diagnoses. Like they have the right to quietly and peacefully fade away as part of normal aging.
Those who are simpler about aging kidneys cite as an example the age-related decrease in the function of external respiration, which is found in the elderly. There, no one is outraged and live peacefully.
Even the most abnormal of all normal aging processes can easily exacerbate any kidney disease. Or weaken the kidneys so that some bad situation will finish them off. Or grandma's medications will be slowly eliminated by the aging kidneys and may accumulate to a toxic dose.
Well, and the most annoying thing is that not every recipient can transplant an aging kidney. And an elderly person may have dreamed of giving his organ to someone all his life. It's a shame.
We have already discussed the story about the kidneys shriveled from high blood pressure.
So if you take two seemingly healthy kidneys with an age difference of 8 years, then under a microscope they will differ approximately like a kidney of a hypertensive person and a kidney of a healthy person of the same age. Time does not spare our kidneys. Sclerosis develops in them. Moreover, they have not figured out why this is happening. And that's all.
If you take a guy 25 years old, then out of every 20 kidney glomeruli, one will be shriveled. And at the age of 75, at the age of 75, 6 of 20 glomeruli wrinkle. This is the arithmetic.
In principle, the kidneys become smaller with age. Sometimes this is masked by fat, which is deposited inside the kidney. Everything is like people.
There, cysts and all sorts of neoplasms begin to appear.
In fairness, in about one third of older adults, glomerular filtration rate may increase. But this is not a sign of good health, but rather the initial stages of various diseases, when the kidneys feverishly produce urine in an attempt to clear up the accumulated problems. This is usually not very good either.
Interestingly, with age, not only the kidneys become weak, but also the muscles weaken and wither in a parallel course. The smaller the muscles, the less they produce creatinine.
It turns out that the kidneys filter worse, but this is not very noticeable due to the fact that there is nothing to filter.
In an ideal world, grandfather would have good muscles and good kidney filtration. And it would equalize too.
In our unfair world, if the grandfather has developed athletic muscles, then simple methods of calculating the glomerular filtration rate will be mistaken and write the grandfather as a kidney patient. He will have to be further examined in order to rehabilitate him as an athlete. This is our injustice.
With age, the kidneys' famous ability to manipulate sodium (salt) is also lost. Grandparents, limiting salt in their diet on the recommendation of a cardiologist, may inadvertently lose a large part of precious sodium and start stumbling out of the blue.
Or, conversely, eating salty, they risk increasing their blood pressure and overloading the heart. Also, you will not go around too much. There is a lot of injustice all around.
What will happen and what to do
Everything is bad here. If an elderly person has a scale of blood pressure or cholesterol, then this can be corrected. But with a glomerular filtration rate, this will not work. We'll have to live with the one that is.
So you have to adapt. We must force ourselves to love the fat-soluble drugs that are excreted without the involvement of the kidneys.
It is necessary to follow the recommendations of the manufacturers of water-soluble drugs, who literally type tables into their instructions in order to choose their dose or regimen for each speed.
Well, you will have to protect the kidneys from the sudden ditching of all sorts of harmful chemicals like non-steroidal anti-inflammatory or X-ray contrasts.
I think that's enough for today. Was everything clear?
Be sure to read my other articles on related topics out of those links in the text (which are with small pictures).
