Ageing and kidney: a primer

Ageing is an inevitable process that affects all organs and kidneys are no way an exception. There is an urgent need to understand ageing as a holistic process. The changes occurring in ageing kidneys resemble to those occurring in chronic kidney disease. However, many differences exist between them. Old age is a risk factor for acute kidney injury and increased risk of urinary tract infections and asymptomatic bacteriruria, Serum creatinine is a suboptimal indicator of renal function in the elderly because loss of muscle mass in elderly decreases creatinine production. Serum cystatinc measurement, with reference values adjusted for age represents a promising marker to measure renal function in the elderly. The default management strategy for renal failure in elderly is more of conservative in developing countries when compared to developed countries where there is changing trend from conservative to initiation of renal replacement therapy. The decision when to initiate renal replacement therapy is more challenging. Haemodialysis or peritoneal dialysis each has its own advantages and disadvantages.