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Kidney aging—inevitable or preventable?

Nature Reviews Nephrology volume 7, pages 706–717 (2011)Cite this article

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Abstract

The aging process affects all organs, including the kidneys. As part of this process, progressive scarring and a measurable decline in renal function occur in most people over time. The improved understanding of the processes that can lead to and/or hasten scarring and loss of renal function over time parallels advances in our understanding of the aging process. Clinical factors, including hypertension, diabetes mellitus, obesity, abnormal lipid levels and vitamin D deficiency, have been associated with increasing renal sclerosis with age. In addition, tissue factors such as angiotensin II, advanced glycation end products, oxidative stress and Klotho are associated with renal aging. These associations and possible interventions, including the control of blood pressure, blood sugar, weight, diet and calorie restriction might make renal aging more preventable than inevitable.

Key Points

  • A progressive decline in renal function occurs in most, but not all, people as a result of aging

  • Several genetic and environmental factors accelerate the age-related decline in kidney function

  • Work over the past 10 years has identified numerous hormonal and metabolic pathways that hold great promise for slowing the age-related decline in kidney function

  • Control of hypertension, metabolic factors and inflammatory processes in aging individuals might decrease the rate of renal functional decline associated with age

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Figure 1: Potential mediators of age-related decline in renal function.
Figure 2: Potential strategies for the prevention of age-related nephropathy.

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Acknowledgements

The authors would like to thank Dr. Robert W. Schrier for more than 30 years of inspiration to work in the field of aging and potential mechanisms to slow down the progression of age-related renal disease. The authors would also like to thank Jolene Richardson and Amber Leider for their administrative assistance. Some of the original studies from the authors' laboratory cited in this review were supported by NIH grants R01 AG026529 and R01 DK066029.

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Authors and Affiliations

  1. Dallas VA Medical Center, The University of Texas Southwestern Medical Center, Dallas, 75216, TX, USA

    Devasmita Choudhury

  2. Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado, Denver, Aurora, 80045, CO, USA

    Moshe Levi

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  1. Devasmita Choudhury
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  2. Moshe Levi
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Both authors contributed equally to all aspects of this Review.

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Correspondence to Moshe Levi.

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Competing interests

M. Levi has received grant/research support from Abbott, Daiichi Sankyo, Genzyme, Intercept and Merck. D. Choudhury declares no competing interests.

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Choudhury, D., Levi, M. Kidney aging—inevitable or preventable?. Nat Rev Nephrol 7, 706–717 (2011). https://doi.org/10.1038/nrneph.2011.104

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