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Handling of water and electrolytes in the healthy old

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  17 August 2009

Joaquin-A. Alvarez Gregori  and
Juan-F. Macías Núñez
Joaquin-A. Alvarez Gregori
Affiliation:
Faculty of Medicine, University of Salamanca, Spain C.S. Casto Prieto, UDMFYC, SACYL, Salamanca, Spain
Juan-F. Macías Núñez*
Affiliation:
Faculty of Medicine, University of Salamanca, Spain
*
Address for correspondence: Juan-F. Macías Núñez, Medicine Department, Faculty of Medicine, University of Salamanca, C/Alfonso X El Sabio, 37007 Salamanca, Spain. Email: jfmacias@usal.es
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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.

Keywords

renal functionelectrolyteshydrationageingelderly
Type
Biological gerontology
Information
Reviews in Clinical Gerontology , Volume 19 , Issue 1 , February 2009 , pp. 1 - 12
Copyright
Copyright © Cambridge University Press 2009

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