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Tutorial kidney ageing

Q: Ageing is related to the following changes in kidney structure:

Decrease in cortical volume Increase in medullary volume

Q: Albumin is not normally lost in urine, but in older people we do observe albuminuria. What is a cause for albuminuria?

Changes in permeability of the capillary wall in glomeruli

Q: During ageing, Bowman's space gradually fills with a matrix-like hyaline material, most likely due to disrupted balance between formation and breakdown of the extracellular matrix in the glomerulus. What is a consequence?

Decreased glomerular filtration rate

Q: What can be concluded from Micheal Lustgarten's experiment? (more options) people who eat more vegetables have a better kidney function Lustergarten's kidney function was probably higher on days without meat intake than on days with meat intake sardine consumption leads to improved kidney function, due to its omega-3 content food intake can have an acute effect on kidney function

2. Lustergarten's kidney function was probably higher on days without meat intake than on days with meat intake 4. food intake can have an acute effect on kidney function We have now learned that it is indeed possible to prevent age-related kidney function decline by means of nutrition. But which foods can be consumed ‘safely’ and which are better to avoid?

19 important questions on Tutorial kidney ageing

Where is the nephron located?

Between the renal cortex and the renal medulla

What is not a function of the kidneys?
regulate acid homeostasis
regulate blood pressure
filter waste products
serving as a calcium pool for the body
converting vitamin D into its active form

4. serving as a calcium pool for the body

Which molecules can pass the membranes between the arteriole and the tubule cells?

Amino acids
Glucose
Ions

NIET protein, white blood cells, red blood cells

Why is urea partly reabsorbed from the collecting tubule in the medulla?

To increase urea content in the medulla to promote passive water re-absorption from Henle's loop

Can you explain the term 'counter current multiplication?

'Counter current’ means that the descending and ascending limbs of Henle’s loop go in opposite direction. Multiplication means that when ions are actively reabsorbed in the ascending limb, water is passively reabsorbed in the descending limb. By actively pumping ions into the medulla, we can multiply the amount of water which drives passively in the interstitium.

Many older adults are falsely diagnosed with CKD
True, as based on literature, often only eGFR is used to define CKD (<60 ml/min/1.73m2)
False, as a single measurement of eGFR is sufficient to estimate kidney function and should therefore be used to define CKD(<60 ml/min/1.73m2)
True, because serum creatinine alone is used to define CKD (<60 ml/min/1.73m2)

True, as based on literature, often only eGFR is used to define CKD (<60 ml/min/1.73m2)

Ageing is related to the following changes in kidney structure:

Decrease in cortical volume
Increase in medullary volume

Albumin is not normally lost in urine, but in older people we do observe albuminuria. What is a cause for albuminuria?

Changes in permeability of the capillary wall in glomeruli

During ageing, Bowman's space gradually fills with a matrix-like hyaline material, most likely due to disrupted balance between formation and breakdown of the extracellular matrix in the glomerulus. What is a consequence?

Decreased glomerular filtration rate

True/False Nephron hypertrophy is more related to ageing than to lifestyle factors?

False

Nephrosclerosis does not associate with:
glomerular filtration rate
albuminuria
blood pressure

glomerular filtration rate

True/False Older individuals should not donate a kidney

False

What can be concluded from Micheal Lustgarten's experiment? (more options)
people who eat more vegetables have a better kidney function
Lustergarten's kidney function was probably higher on days without meat intake than on days with meat intake
sardine consumption leads to improved kidney function, due to its omega-3 content
food intake can have an acute effect on kidney function

2. Lustergarten's kidney function was probably higher on days without meat intake than on days with meat intake
4. food intake can have an acute effect on kidney function

We have now learned that it is indeed possible to prevent age-related kidney function decline by means
of nutrition. But which foods can be consumed ‘safely’ and which are better to avoid?

What can be concluded from Micheal Lustgarten's experiment? (more options)
people who eat more vegetables have a better kidney function
Lustergarten's kidney function was probably higher on days without meat intake than on days with meat intake
sardine consumption leads to improved kidney function, due to its omega-3 content
food intake can have an acute effect on kidney function

Take a look at figure 1 of the paper written by van Westing et al., in which associations between commonly consumed foods and incident CKD are depicted. Is the following statement true or false? Based on Figure 1, it is likely that a high protein intake decreases kidney function.

False

Figure 1. Under vegetables, a subcategory of nitrate-containing vegetables is made. Why would nitrate be especially interesting?

Nitrate can lower blood pressure and thereby improve kidney function

Figure 2 shows the risk between beverage intake and CKD incidence. Three studies looked at the influence of coffee intake on CKD risk. Gain et al. Found a trend for an increased risk in an Iranian population, while the other two studies in USA and Korea found significant protective associations for coffee intake. What could be the reason for the increased risk in Iran?

Coffee in Iran is often prepared in an unfiltered fashion. Unfiltered coffee has an adverse nutritional profile compared to filtered coffee, mainly due to the presence of cafestol

What are the functions of de kidney's

Filtration
Collection
Homeostasis

pH
blood pressure (when lots of salt is taken in)
osmolarity
excretion of waste products --> urea

functions = unit = nephron [filtration and collection] --> located between cortex and medulla

How can you improve the eGFR? With nutrition

A high total vegetable intake is correlated with high eGFR

dairy, nuts+seeds (SFA, MUFA, PUFA(O3, O6)), total vegetables, fruit (berries), sardines, beef, eggs were entered into a backward elimination regression model
variables are sequentially removed until the best performing regression model remains

higher intake of sardines and vegetables, lower beef is correlated with higher eGFR

Fiber, omega-3 and protein intake are significantly correlated with eGFR

higher intake of fiber and O3, but a lower protein intake is correlated with higher eGFR
higher fiber --> increased gut bacterial production of butyrate --> better kidney function

The question on the page originate from the summary of the following study material:

Nutrition and the Aging Body

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Tutorial kidney ageing

19 important questions on Tutorial kidney ageing

Where is the nephron located?

What is not a function of the kidneys?regulate acid homeostasis regulate blood pressurefilter waste products serving as a calcium pool for the body converting vitamin D into its active form

Which molecules can pass the membranes between the arteriole and the tubule cells?

Why is urea partly reabsorbed from the collecting tubule in the medulla?

Can you explain the term 'counter current multiplication?

Ageing is related to the following changes in kidney structure:

Albumin is not normally lost in urine, but in older people we do observe albuminuria. What is a cause for albuminuria?

During ageing, Bowman's space gradually fills with a matrix-like hyaline material, most likely due to disrupted balance between formation and breakdown of the extracellular matrix in the glomerulus. What is a consequence?

True/False Nephron hypertrophy is more related to ageing than to lifestyle factors?

Nephrosclerosis does not associate with:glomerular filtration rate albuminuriablood pressure

True/False Older individuals should not donate a kidney

Take a look at figure 1 of the paper written by van Westing et al., in which associations between commonly consumed foods and incident CKD are depicted. Is the following statement true or false? Based on Figure 1, it is likely that a high protein intake decreases kidney function.

Figure 1. Under vegetables, a subcategory of nitrate-containing vegetables is made. Why would nitrate be especially interesting?

What are the functions of de kidney's

How can you improve the eGFR? With nutrition

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What is not a function of the kidneys?
regulate acid homeostasis
regulate blood pressure
filter waste products
serving as a calcium pool for the body
converting vitamin D into its active form

Nephrosclerosis does not associate with:
glomerular filtration rate
albuminuria
blood pressure