The Elderly Patient with Kidney Disease: Overview and Evaluation

The inevitable aging process leads to structural and functional changes in most organs, including the kidney. In this chapter, we will outline changes that occur in kidney structure and function with aging and use that background to provide a practical guide to the evaluation and interpretation of kidney tests in older adults. In the first section, we will focus on both the micro-and macro-anatomic changes that occur and the physiological or functional changes that can follow. Although age-associated changes may lead to decreased renal function, these processes are often part of normal physiology and do not necessarily represent pathology. We will then detail the commonly used tests for kidney function in the context of older adults. Finally, we will provide important considerations when evaluating and treating older adults referred for kidney disease.