The Effect of Age on Creatinine Clearance in Men: A Cross-sectional and Longitudinal Study

Rowe, John W.; Andres, Reubin; Tobin, Jordan D.; Norris, Arthur H.; Shock, N. W.

doi:10.1093/geronj/31.2.155

Cited by 1,053 publications

(420 citation statements)

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“…Early studies by the group of Dr. Nathan Shock in Baltimore strongly supported this thesis. In so-called healthy human volunteers, the cardiac output (Brandfonbrener et al 1955), renal creatinine clearance (Rowe et al 1976) and all other physiological parameters examined were demonstrated to steadily decline with age. However, later by the same group in Baltimore, in a longitudinal study, neither the cardiac output (Rodeheffer et al 1984) nor renal creatinine clearance (Lindeman et al 1985) was shown to decline with age.…”

Section: What Really Declines With Age?mentioning

confidence: 99%

What really declines with age?

Kitani¹

2007

AGE

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In order to understand the basic mechanisms underlying the organismic aging process, considerable efforts have been devoted in the last half-century to biochemical (enzyme activity) alterations in specific tissues and organs of various organisms associated with aging. When a decline in enzyme activities with age has been found in a study, especially for key enzymes such as antioxidant enzymes, the results have often been interpreted as a cause for the aging of the entire body. Retrospectively, however, these changes turned out to be so variabledepending on species, strains and sexes of animalsthat the interpretation of these results in general terms of aging became invalid. Further, unlike the prediction for the whole human body, many enzyme activities in a vital organ, such as the liver, remained unchanged, as long as the old subjects remained healthy. However, enzyme activities in old animals and humans are often more susceptible to morbidities and frailties, which themselves are often accompanied by infections and malnutrition. Despite the rather stable enzyme functions in the liver with age, a distinct and progressive decline in the lateral diffusion coefficient of proteins of hepatocyte plasma membranes has been demonstrated by fluorescence recovery after photobleaching (FRAP), which was implicated as the cause for the decline of hepatocyte functions such as ouabain (and taurocholate) hepatic uptake and their eventual biliary excretion. Since a similar decline in protein diffusion coefficients was observed in brain and muscle cells, it is likely that these changes are occurring in common with many cell types of the body, thus causing a delay in transmembrane transport of endogenous and exogenous substances whose transports are mediated by membrane proteins. In attempts to prolong the life spans of animals other than by calorie restriction, but instead using deprenyl or tetrahydrocurcumin, works by the author and coworkers are introduced and discussed. Despite limited success along these lines thus far, further attempts are encouraged, primarily to understand the mechanisms underlying organismic aging processes and to find a practical way to prolong the health span of the elderly.

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Section: What Really Declines With Age?mentioning

confidence: 99%

What really declines with age?

Kitani¹

2007

AGE

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“…FG menor que 60mL/min/1,73m 2 representa diminuição de cerca de 50% da função renal normal e, abaixo deste nível, aumenta a prevalência das complicações da DRC. [6][7][8] Embora a diminuição da FG relacionada à idade possa dever-se ao processo de envelhecimento normal, a diminuição da FG no idoso é um preditor independente de evolução adversa da doença, tal como óbito e doença cardiovascular. [9][10][11] Além do mais, a FG diminuída no idoso deve implicar em ajustes nas dosagens das medicações, semelhantemente ao que se faz em todos os pacientes com DRC.…”

Section: Diagnóstico Da Drc Avaliação Da Filtração Glomerularunclassified

Doença renal crônica: frequente e grave, mas também prevenível e tratável

Bastos

Bregman²,

Kirsztajn³

2010

Rev. Assoc. Med. Bras.

180

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ResumoA doença renal crônica é considerada problema de saúde pública em todo o mundo. No Brasil, a incidência e a prevalência de falência de função renal estão aumentando; o prognóstico ainda é ruim e os custos do tratamento da doença são altíssimos. Independentemente da etiologia da doença de base, os principais desfechos em pacientes com DRC são as suas complicações (anemia, acidose metabólica, desnutrição e alteração do metabolismo de cálcio e fósforo), decorrentes da perda funcional renal, óbito (principalmente, por causas cardiovasculares) e perda de função renal. Estudos recentes indicam que estes desfechos indesejados podem ser prevenidos ou retardados se a DRC for diagnosticada precocemente e as medidas nefro e cardioprotetoras implementadas o mais rápido possível. O atual estagiamento da doença e uma descrição dessas medidas preventivas são apresentados na presente revisão. Artigo de Revisão introduçãoA nova definição da doença renal crônica (DRC), em uso desde 2002, propiciou um estagiamento da doença que independe da sua causa. A partir desta nova abordagem, ficou evidente que a DRC é muito mais frequente do que até então se considerava e sua evolução clínica está associada a taxas altas de morbimortalidade. 1 Os rins são órgãos fundamentais para a manutenção da homeostase do corpo humano. Assim, não é surpresa constatarmos que, diminuição progressiva da função renal, implique em comprometimento de essencialmente todos os outros órgãos. A função renal é avaliada pela filtração glomerular (FG) e a sua diminuição é observada na Doença Renal Crônica (DRC), associada a perda das funções regulatórias, excretórias e endócrinas do rim. Quando a FG atinge valores muito baixos, inferiores a 15 mL/min/1,73m 2 , estabelece-se o que denominamos falência funcional renal (FFR), ou seja, o estágio mais avançado do continuum de perda funcional progressiva observado na DRC.A DRC é, atualmente, considerada um problema de saúde pública mundial. No Brasil, a incidência e a prevalência de FFR estão aumentando, o prognóstico ainda é ruim e os custos do tratamento da doença são altíssimos. O número projetado atualmente para pacientes em tratamento dialítico e com transplante renal no Brasil está próximo dos 120.000, a um custo de 1,4 bilhão de reais. 2 Independentemente da doença de base, os principais desfechos em pacientes com DRC são as suas complicações (anemia, acidose metabólica, alteração do metabolismo mineral e desnutrição), decorrentes da perda funcional renal, óbito (principalmente por causas cardiovasculares) e FFR. Estudos recentes indicam que estes desfechos indesejados podem ser prevenidos ou retardados se a DRC for diagnosticada precocemente e as medidas nefro e cardioprotetoras implementadas precocemente. 1,3-5 Infelizmente, a DRC é subdiagnosticada e tratada inadequadamente, resultando na perda de oportunidade para a implementação de prevenção primária, secundária e terciária, em parte devido à falta de conhecimento da definição e classificação dos estágios da doença, bem como a não utilização de testes s...

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“…An important age-dependent decrease in the rate of elimination of many drugs is due to the decay in renal function (Rowe et al, 1976). In the elderly the total body water, and the lean body mass, is proportionally smaller and they have a higher proportion of body fat (Crooks et al, 1976).…”

Section: Introductionmentioning

confidence: 99%

Intra‐ and inter‐individual variation in pharmacokinetics of intravenously infused amoxycillin and ampicillin to elderly volunteers.

Sjövall¹,

Alván²,

Huitfeldt³

1986

Brit J Clinical Pharma

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1 The purpose of this study was to investigate the disposition of two aminopenicillins and their intra-and inter-individual variation in pharmacokinetic parameters in healthy, elderly volunteers. Two groups, each of 12 active, community-dwelling volunteers between 69 and 83 years of age participated. One group was given 500 mg of amoxycillin, the other group 500 mg of ampicillin as single i.v. infusions. Within the drug groups each volunteer was given the infusion at two different occasions separated by a time-period of 1 week. Amoxycillin and ampicillin were determined in plasma and urine by modern column liquid chromatographic methods.2 The mean plasma clearance was about 200 ml min-' 1.73 m2 for both drugs and renal clearance accounted for approximately 80% of this. As expected, drug clearance was correlated to renal function as determined by 5tCr-EDTA. The volume of distribution at steady-state (V.,) was about 0.3 1 kg-' for both drugs. Compared to our previous results in younger subjects, plasma and renal clearances were essentially similar in this study, but slightly longer half-lives and higher V. were seen for amoxycillin and ampicillin.3 The intra-individual variation, expressed as the error of a single determination (CV), was small, for plasma clearance 3.7% and 6.4% after amoxycillin and ampicillin. The corresponding inter-individual variation in clearance was higher, 14.4% after amoxycillin, and 11.9% after ampicillin. The results confirm a higher relative efficiency of a crossover vs a completely randomized parallel groups design in parenteral studies of these penicillins. 4 In our elderly subjects there was only an approximately 30% decrease in renal function. This was not enough to reduce the drug clearance and offers an explanation for the similarity between our present results in the elderly and our previous results in younger subjects. Elderly volunteers may be different from patients with disease as a confounding factor. Studies on elderly active and community-dwelling volunteers, as in this study, may therefore be more representative as to the effect of age per se on drug kinetics.

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The Effect of Age on Creatinine Clearance in Men: A Cross-sectional and Longitudinal Study

Cited by 1,053 publications

References 0 publications

What really declines with age?

What really declines with age?

Doença renal crônica: frequente e grave, mas também prevenível e tratável

Intra‐ and inter‐individual variation in pharmacokinetics of intravenously infused amoxycillin and ampicillin to elderly volunteers.

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