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Chronic kidney disease in the elderly: Unraveling the complexities of aging and renal decline

, Rizki Savina, Haerani Rasyid, , Nasrum Machmud, · Romanian Medical Journal · 2025

Background. The prevalence of chronic kidney disease (CKD) increases with age, primarily characterized by a decline in glomerular filtration rate (GFR) and elevated albuminuria. CKD in the elderly is influenced by both age-related changes in kidney function and the presence of common comorbidities. Objective. This literature review aims to explore the etiology and pathogenesis of CKD in the elderly population, focusing on the underlying mechanisms that contribute to kidney decline and disease progression. Results. Aging kidneys exhibit structural and functional alterations, such as reduced GFR and nephron loss, making the elderly more vulnerable to CKD. Common comorbidities, including hypertension, diabetes mellitus, and the use of medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics, exacerbate kidney function deterioration in older adults. Pathophysiological mechanisms underlying CKD in the elderly include premature aging driven by senescence-associated secretory phenotype (SASP) secretion, reduced autophagy in podocytes, mitochondrial dysfunction, and epigenetic modifications such as DNA methylation, histone modification, chromatin remodeling, and no

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