Comment of the reviewer Ramón Díaz-Alersi MD.
Medicina Intensiva. Hospital Puerto Real. Cádiz. España
We are attending a progressive aging of the population that affects not only Europe and North America, but also many developing countries, in special, to those of Latin America. In Spain, the population with more than 65 years constitutes already more of 17% of the total and consumes more of 30% of medicines given through the National System of Health1. These people usually take between one and two medicines of average, that can reach five if the self-medication is considered.
Elderly renal physiology differs from the adult one, and it contributes to the old people susceptibility to develop acute renal failure, but that cannot be considered pathological, causes that their sensitivity to medicines is superior. In this article, Musso reviews fundamental aspects of the acute and chronic renal insufficiency in the elderly peoples, including their treatment.
Comment of the reviewer Prof. Marta Sofía López Rodríguez.
Assistant Professor in Anesthesiology of Higher Institute of Medical Science. Cira García Reyes Clinic. Havana City. Cuba
The life expectancy has risen in the past 100 years with the predominance of elderly patients. The aging kidney is characterized by modifications resulting from organic and functional disturbances conditions leading to the loss of renal function. Musso describe correctly the pathophysiological changes suffered by the aged kidney that expose the elderly to develop acute renal failure. The hydration is the first treatment for any acute renal failure but one should be cautious in these patients because suffering reduced cardiac reserve. It also points out that the best strategy against the consequences of the acute renal failure in these patients is avoiding situations that potentially can damage the kidney.
Received December 13, 2004.
Published January 12, 2005