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Santos S, Lousa I, Carvalho M, Sameiro-Faria M, Santos-Silva A, Belo L. Anemia in Elderly Patients: Contribution of Renal Aging and Chronic Kidney Disease. Geriatrics (Basel) 2025; 10:43. [PMID: 40126293 PMCID: PMC11932280 DOI: 10.3390/geriatrics10020043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2025] [Revised: 03/09/2025] [Accepted: 03/12/2025] [Indexed: 03/25/2025] Open
Abstract
Renal aging is a physiological process characterized by structural and functional changes in the kidneys. The presence of disorders or pathologies can exacerbate these age-related changes, potentially leading to organ dysfunction. Chronic kidney disease (CKD), a significant global public health issue, is particularly prevalent in the elderly and is often associated with the age-related decline in kidney function. Anemia is one of the most frequent complications of CKD and is also highly prevalent in the elderly. Mild anemia, often multifactorial, is the most common presentation. Understanding the mechanisms driving anemia in this population is crucial to ensure appropriate treatment. The primary etiologies include nutritional deficiency, anemia of unknown cause, and anemia of chronic diseases, including CKD. This review provides an in-depth exploration of the complex pathophysiological mechanisms underlying anemia in elderly patients with CKD.
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Affiliation(s)
- Simone Santos
- UCIBIO i4HB, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal; (S.S.); (I.L.); (M.S.-F.); (A.S.-S.)
| | - Irina Lousa
- UCIBIO i4HB, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal; (S.S.); (I.L.); (M.S.-F.); (A.S.-S.)
| | - Márcia Carvalho
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa, Praça de 9 de Abril 349, 4249-004 Porto, Portugal;
- LAQV/REQUIMTE, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- RISE-Health, Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Fundação Ensino e Cultura Fernando Pessoa, Rua Carlos da Maia 296, 4200-150 Porto, Portugal
| | - Maria Sameiro-Faria
- UCIBIO i4HB, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal; (S.S.); (I.L.); (M.S.-F.); (A.S.-S.)
- Centro Hospitalar Universitário do Porto, Centro Materno-Infantil do Norte, Serviço de Pediatria, Unidade de Nefrologia Pediátrica, 4050-651 Porto, Portugal
| | - Alice Santos-Silva
- UCIBIO i4HB, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal; (S.S.); (I.L.); (M.S.-F.); (A.S.-S.)
| | - Luís Belo
- UCIBIO i4HB, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal; (S.S.); (I.L.); (M.S.-F.); (A.S.-S.)
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Skrajnowska D, Bobrowska-Korczak B. The Effects of Diet, Dietary Supplements, Drugs and Exercise on Physical, Diagnostic Values of Urine Characteristics. Nutrients 2024; 16:3141. [PMID: 39339741 PMCID: PMC11434675 DOI: 10.3390/nu16183141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 09/13/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objectives: This review summarizes the current knowledge about factors that affect the physical characteristics of urine. It highlights proper urine sample collection and displays factors like diet, hydration status, and medications that can alter urine color, odor, clarity, specific gravity and pH. Results: Urinalysis is a minimally invasive examination of a patient's health, especially concerning nephrological and endocrinological abnormalities, as well as dietary habits and stimulants used. Certain deviations in appearance, composition or frequency/pain during urination may indicate an ongoing disease process in the body. Based on laboratory results, further medical treatment is determined. The reason for a change in the color of the urine, for its clouding or intense odor may be a disease, as well as the consumption of food, medication, intensive physical exercise or inadequate hydration of the body. Well-standardized procedures for collecting, transporting, preparing and analyzing samples should become the basis for an effective diagnostic strategy in urinalysis. It is worth noting that pharmacists in pharmaceutical care are often the first people to whom a patient turns for health advice and for the interpretation of simple laboratory tests. Acquiring the ability to interpret the results of laboratory tests and the principles of proper sampling for laboratory tests is indispensable in the process of possible counseling and providing reliable answers to patients' questions. Conclusions: Although urinalysis is not recommended as a routine screening tool for the general population, it can prove to be a valuable source of patient health data in some cases as the data will be useful to physicians and pharmacists to more effectively diagnose and better care for patients.
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Affiliation(s)
| | - Barbara Bobrowska-Korczak
- Department of Toxicology and Food Science, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Street, 02-091 Warsaw, Poland;
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Musso CG, Alvarez Gregori J, Jauregui JR, Macías Núñez JF. Creatinine, urea, uric acid, water and electrolytes renal handling in the healthy oldest old. World J Nephrol 2012; 1:123-6. [PMID: 24175249 PMCID: PMC3782214 DOI: 10.5527/wjn.v1.i5.123] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 06/09/2012] [Accepted: 09/25/2012] [Indexed: 02/06/2023] Open
Abstract
Renal physiology in the healthy oldest old has the following characteristics, in comparison with the renal physiology in the young: a reduced creatinine clearance, tubular pattern of creatinine back-filtration, preserved proximal tubule sodium reabsorption and uric acid secretion, reduced sodium reabsorption in the thick ascending loop of Henle, reduced free water clearance, increased urea excretion, presence of medulla hypotonicity, reduced urinary dilution and concentration capabilities, and finally a reduced collecting tubules response to furosemide which expresses a reduced potassium excretion in this segment due to a sort of aldosterone resistance. All physiological changes of the aged kidney are the same in both genders.
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Affiliation(s)
- Carlos Guido Musso
- Carlos Guido Musso, José Ricardo Jauregui, Ageing Biology Unit, Hospital Italiano of Buenos Aires, Gascón 450, Argentina
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Musso CG, Jauregui R, Andresik D, Vilas M, Segalini A, Vazquez C. Sodium and urea urinary saving patterns in the elderly can change according to circumstances. Int Urol Nephrol 2011; 43:611-2. [DOI: 10.1007/s11255-011-9946-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 03/10/2011] [Indexed: 10/18/2022]
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