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Renal Genitourinary Problems in Aging - Chapter 9

Renal Genitourinary Problems in Aging - Chapter 9



Kidney ...

Maintenance of blood volume
Maintenance of blood nutrients
Excretes waste
Regulates blood pressure
Participates in red blood cell production
Activates Vitamin D



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    Renal Genitourinary Problems in Aging - Chapter 9 Renal Genitourinary Problems in Aging - Chapter 9 Presentation Transcript

    • Renal Genitourinary Problems inAgingChapter 9
    • The KidneyNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),National Institutes of Health, 2004, NIH Public. No. 04-4807. Washington,DC: U.S. Department of Health and Human Services.
    • Kidney• Roles– Maintenance of blood volume– Maintenance of blood nutrients– Excretes waste– Regulates blood pressure– Participates in red blood cell production– Activates Vitamin D
    • Kidney• Medical conditions affecting the renal system– Urinary incontinence– Urinary tract infections– Prostate disease– Genitourinary malignancies– Sexual dysfunction– Stone disease– Electrolyte imbalance– Renal disease/failure
    • Kidney• Changes with age– Decrease in size and weight– Functional disability• Decline in GFR
    • Urinary Tract Problems• Incontinence– Common in older adults– No evidence-based approach to prevent• Urinary Tract Infections– One of the top 10 principle hospital diagnosis ofolder adults– Prevention of UTIs• Cranberry products• Vitamin C• Estrogen
    • Prostate Disease• Benign prostatic hyperplasia– Common among aged men– BPH interferes with the quality of life– Managed with medication or surgery• Impotence and Erectile Dysfunction– Moderate to severe and managed withmedication
    • Prostate Disease• Stones– Urolithiasia• Urinary tract– Nephrolithiasia• Kidney– Not clear why they develop• Dehydration may contribute• Diet high in protein, sodium, calcium, andoxalate
    • Genitourinary Malignancies• Kidney Cancer– Surgery is the only option for treatment• Prostate Cancer– Many treatment options• Bladder Cancer– Cystoscopy may be considered
    • Kidney Problems• Usually related to other health problems• Loss of renal function effects– Body’s metabolism– Nutrition requirements– Nutrition status• Metabolic acidosis• Anemia is common
    • Hypertension• Prevalence is highest in older AfricanAmericans and women• Sodium-sensitive hypertension• Orthostatic hypotension• Postprandial hypotension• Renovascular disease• Treatment– Medication– Lifestyle modifications
    • Fluid and Electrolyte Problems• Hyponatremia– An excess of fluid as indicated by serum sodium– Management• Find and treat underlying cause• Hypernatremia– Dehydration– Management• Measure and correct input and outputimbalance
    • Fluid and Electrolyte Problems• Hypokalemia– Low serum potassium levels– Commonly occurs with diuretics– Management includes potassium replacement• Hyperkalemia– High serum potassium levels
    • Renal Disease and Failure
    • Renal Disease and Failure• Acute renal insufficiency/failure
    • Renal Disease and Failure• Acute tubular necrosis– Caused by ischemia or nephrotoxins– Occurs after surgery– Associated with trauma or sepsis– Precipitant of acute renal failure– Dialysis may be necessary
    • Renal Disease and Failure• Chronic Renal Failure– Irreversible loss of kidney function– Effects nearly all body organ systems– Progressive to the point of ESRD– Goal of therapy• Slow progression of kidney failure– Early diagnosis• Serum creatine levels, creatine clearance
    • Renal Disease and Failure• Chronic Renal Failure (cont.)– Chronic Kidney Disease• Renal function declines as the number ofnephrons decline• Occurs with aging, hypertension, and diabetes• GFR effects excretion of water-soluble drugs–Estimating creatinine clearance–Cockcroft-Gault Formula
    • Renal Disease and Failure• Chronic Renal Failure (cont.)– Problems associated with GFR• Anemia of chronic kidney disease• “The silent crippler”• Renal osteodystrophy
    • End Stage Renal Disease• Occurs when kidneys can no longer functionon their own• Usually caused by– Diabetes– Hypertension– Glomerulonephritis
    • End Stage Renal Disease• Dialysis– African Americans are more likely to developkidney disease– Numerous assessment tools used for evaluation• Serum creatinine and creatinine index– Nutrition intake recommendations• 30 – 35 kcal/kg body weight• 1.2 – 1.3 g protein/kg body weight• Supplementation as needed
    • End Stage Renal Disease
    • Conclusion• Renal Genitourinary Problems in Aging– Diet and nutrition therapy can help in themanagement of many of these problems