Pub Date : 2021-04-19DOI: 10.37586/2686-8636-1-2021-76-81
L. Merkusheva, N. Runikhina, O. Tkacheva
Individuals age >65 years old are the fastest expanding population demographic throughout the developed world. Consequently, more aged patients than before are receiving diagnoses of impaired renal function and nephrosclerosis. In this review, we examine these features of the aged kidney and explore the various validated and putative pathways contributing to the changes observed with aging. Senescence or normal physiologic aging portrays the expected age-related changes in the kidney as compared to chronic kidney disease (CKD) in some individuals. The microanatomical structural changes of the kidney with older age include a decreased number of functional glomeruli from an increased prevalence of nephrosclerosis (arteriosclerosis, glomerulosclerosis, and tubular atrophy with interstitialfibrosis), and to some extent, compensatory hypertrophy of remaining nephrons. Among the macroanatomical structural changes, older age associates with smaller cortical volume. There is reason to be concerned that the elderly are being misdiagnosed with CKD. In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular filtration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water -soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease.
{"title":"Kidney aging.Geriatric view","authors":"L. Merkusheva, N. Runikhina, O. Tkacheva","doi":"10.37586/2686-8636-1-2021-76-81","DOIUrl":"https://doi.org/10.37586/2686-8636-1-2021-76-81","url":null,"abstract":"Individuals age >65 years old are the fastest expanding population demographic throughout the developed world. Consequently, more aged patients than before are receiving diagnoses of impaired renal function and nephrosclerosis. In this review, we examine these features of the aged kidney and explore the various validated and putative pathways contributing to the changes observed with aging. Senescence or normal physiologic aging portrays the expected age-related changes in the kidney as compared to chronic kidney disease (CKD) in some individuals. The microanatomical structural changes of the kidney with older age include a decreased number of functional glomeruli from an increased prevalence of nephrosclerosis (arteriosclerosis, glomerulosclerosis, and tubular atrophy with interstitialfibrosis), and to some extent, compensatory hypertrophy of remaining nephrons. Among the macroanatomical structural changes, older age associates with smaller cortical volume. There is reason to be concerned that the elderly are being misdiagnosed with CKD. In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular filtration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water -soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130804948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-03DOI: 10.37586/2686-8636-4-2020-281-293
O. Tkacheva, Y. Kotovskaya, L. A. Aleksanian, A. S. Mil'to, A. Naumov, I. Strazhesko, N. M. Vorob'eva, E. N. Dudinskaia, I. P. Malaia, K. I. Krylov, E. A. Tiukhmenev, A. V. Rozanov, V. S. Ostapenko, T. M. Manevich, A. I. Shchedrina, F. A. Semenov, E. A. Mkhitarian, N. O. Khovasova, N. V. Sharaskina, K. Eruslanova, N. Kotovskaya
Novel coronavirus SARS-CoV-2 infection (COVID-19) is a dangerous disease for older adults. Preventive measures in this population should involve three groups of measures: 1) prevention of infection; 2) prevention of functional decline and geriatric syndromes, including social support; 3) control of chronic comorbidity. Older adults are common to present with atypical COVID-19 symptoms, and mildness of symptoms (no fever, cough, shortness of breath) does not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, that is why it is screening should be widely implied. Risk of malnutrition resulting in sarcopenia increases during the hospitalization, especially if mechanical ventilation required, and promotes frailty progression and decreases quality of life after the discharge from the hospital. Geriatric assessment is an important component of the decision making process in the management of older adults. Full version was published as Tkacheva O.N., Kotovskaya Yu.V., Aleksanyan L.A., Milto A.S., Naumov A.V., Strazhesko I.D., Vorobyeva N.M., Dudinskaya E.N., Malaya I.P., Krylov K.Yu., Tyukhmenev E.A., Rozanov A.V., Ostapenko V.S., Manevich T.M., Shchedrina A.Yu., Semenov F.A., Mkhitaryan E.A., Khovasova N.O., Yeruslanova E.A., Kotovskaya N.V., Sharashkina N.V. Novel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatrics. Cardiovascular Therapy and Prevention. 2020; 19(3): 2601. DOI: 10.15829/1728-8800-2020-2601
{"title":"Consensus statement of the Russian association of gerontologists and geriatricians «Novel coronavirus SARS-COV-2 infection in older adults: specific issues of prevention, diagnostics and management» (key points)","authors":"O. Tkacheva, Y. Kotovskaya, L. A. Aleksanian, A. S. Mil'to, A. Naumov, I. Strazhesko, N. M. Vorob'eva, E. N. Dudinskaia, I. P. Malaia, K. I. Krylov, E. A. Tiukhmenev, A. V. Rozanov, V. S. Ostapenko, T. M. Manevich, A. I. Shchedrina, F. A. Semenov, E. A. Mkhitarian, N. O. Khovasova, N. V. Sharaskina, K. Eruslanova, N. Kotovskaya","doi":"10.37586/2686-8636-4-2020-281-293","DOIUrl":"https://doi.org/10.37586/2686-8636-4-2020-281-293","url":null,"abstract":"Novel coronavirus SARS-CoV-2 infection (COVID-19) is a dangerous disease for older adults. Preventive measures in this population should involve three groups of measures: 1) prevention of infection; 2) prevention of functional decline and geriatric syndromes, including social support; 3) control of chronic comorbidity. Older adults are common to present with atypical COVID-19 symptoms, and mildness of symptoms (no fever, cough, shortness of breath) does not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, that is why it is screening should be widely implied. Risk of malnutrition resulting in sarcopenia increases during the hospitalization, especially if mechanical ventilation required, and promotes frailty progression and decreases quality of life after the discharge from the hospital. Geriatric assessment is an important component of the decision making process in the management of older adults. Full version was published as Tkacheva O.N., Kotovskaya Yu.V., Aleksanyan L.A., Milto A.S., Naumov A.V., Strazhesko I.D., Vorobyeva N.M., Dudinskaya E.N., Malaya I.P., Krylov K.Yu., Tyukhmenev E.A., Rozanov A.V., Ostapenko V.S., Manevich T.M., Shchedrina A.Yu., Semenov F.A., Mkhitaryan E.A., Khovasova N.O., Yeruslanova E.A., Kotovskaya N.V., Sharashkina N.V. Novel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatrics. Cardiovascular Therapy and Prevention. 2020; 19(3): 2601. DOI: 10.15829/1728-8800-2020-2601","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"75 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127290368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-02DOI: 10.37586/2686-8636-3-2020-199-204
A. B. Lokshina
The study of cognitive impairments (CI) began with a more severe form- dementia, which is usually the result of a long-running pathological process. It is preceded by non-demented cognitive disorders (including mild cognitive impairment syndrome — MCI), whose early detection increases the potential for therapeutic effects and even prevention of disadaptation as a result of dementia. The article reviews current publications on the problem of MCI. Special attention is paid to the diagnosis and treatment of this clinically heterogeneous syndrome. Historical issues of MCI studying are considered, modern principles of its classification and diagnostic criteria are given, and the main aspects of patient management are described. The results of a number of russian and international studies of MCI syndrome are described, including a comparison of these data among themselves.
{"title":"Modern aspects of diagnosis and treatment of mild cognitive impairment","authors":"A. B. Lokshina","doi":"10.37586/2686-8636-3-2020-199-204","DOIUrl":"https://doi.org/10.37586/2686-8636-3-2020-199-204","url":null,"abstract":"The study of cognitive impairments (CI) began with a more severe form- dementia, which is usually the result of a long-running pathological process. It is preceded by non-demented cognitive disorders (including mild cognitive impairment syndrome — MCI), whose early detection increases the potential for therapeutic effects and even prevention of disadaptation as a result of dementia. The article reviews current publications on the problem of MCI. Special attention is paid to the diagnosis and treatment of this clinically heterogeneous syndrome. Historical issues of MCI studying are considered, modern principles of its classification and diagnostic criteria are given, and the main aspects of patient management are described. The results of a number of russian and international studies of MCI syndrome are described, including a comparison of these data among themselves.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121619956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-02DOI: 10.37586/2686-8636-3-2020-250-259
K. R. Akhundova, E. Dudinskaya, O. Tkacheva
In the 21st century, diabetes mellitus type 2 is considered among pandemics and has a serious medical and social significance in both developed and developing countries of the world. The increase in life expectancy of the population is also associated with an increase in the frequency of diabetes among the elderly. In this regard, new approaches are needed in the diagnosis and treatment of diabetes in this age group. The clinical picture and treatment of diabetes in elderly patients has its own characteristics and specifics for a number of reasons. This review presents the results of Russian and international recommendations and research on the coverage of the problem of diagnosis and treatment of type 2 diabetes in the elderly.
{"title":"Geriatric aspects of diabetes mellitus","authors":"K. R. Akhundova, E. Dudinskaya, O. Tkacheva","doi":"10.37586/2686-8636-3-2020-250-259","DOIUrl":"https://doi.org/10.37586/2686-8636-3-2020-250-259","url":null,"abstract":"In the 21st century, diabetes mellitus type 2 is considered among pandemics and has a serious medical and social significance in both developed and developing countries of the world. The increase in life expectancy of the population is also associated with an increase in the frequency of diabetes among the elderly. In this regard, new approaches are needed in the diagnosis and treatment of diabetes in this age group. The clinical picture and treatment of diabetes in elderly patients has its own characteristics and specifics for a number of reasons. This review presents the results of Russian and international recommendations and research on the coverage of the problem of diagnosis and treatment of type 2 diabetes in the elderly.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133235421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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