ACUTE RENAL FAILURE IN THE ELDERLY

Acute renal failure is a frequent disorder in the old population and the increased incidence of this renal syndrome in this age group is favoured by some factors such as the histological and funtional changes of the aged kidney, the reduced capability of this population to metabolize drugs, and their exposure to polypharmacy and to a great number of systemic diseases such as diabetes mellitus, hypertension and cardiac failure1. Among the main senile renal changes that make old people prone to acute renal failure we find: a disturbance in the autoregulatory vascular defence2 a reduction in the number of glomoruli and glomerular capilaries 2 their renal tubular frailty3 a salt and water wasting secondary to a reduced tubular reabsorbtion capability of these substances4, 5 From the current evidence that nephology and geriatrics have, the following “pearls ” for the assessment and treatment of acute renal failure in the elderly can be delineated: 1) Acute renal failure is frequently multifactorial1, 6, 7: In fact multifactorial physiopathology is expected for acute renal failure in any age group. However, there are some etiologies that should be always rouled out in the aged patient