Renal Function in an Ageing Community

As Bland (12) points out, there is now abundant evidence that with increasing age there is a gradual decline in kidney function as indicated by a reduction in effective renal plasma flow, in glomerular filtration, in both excretory and reabsorptive tubular mass, in the ability to excrete urea, and in the ability to concentrate the urine. From this one can predict that in the aged the power to regulate the acid-base equilibrium will be compromised. In fact, the aged can hold this balance in health, but the addition of physiological stress or disease can upset the mechanism completely. (107) These old people have a narrower margin on which to regulate this balance, and the prime factor involved is the decline in renal function, principally brought about by vascular degeneration