Anatomic |
Decrease in renal mass, mostly from cortex |
Increased renal fat and fibrosis |
Sclerosis of cortical nephrons with longest loops of Henle |
Functional |
Decreased renal blood flow |
Impaired vasodilation in response to dopamine |
Decreased creatinine clearance |
Impaired sodium excretion and conservation |
Decreased potassium excretion and conservation |
Decreased concentrating and diluting capacity |
Impaired excretion of acid loads |
Decreased serum renin and aldosterone |
Altered intrarenal nitric oxide actions |
Increased dependence on renal prostaglandins to maintain intrarenal perfusion |
Decreased vitamin D activation |
Increased vulnerability to dye, ischemia, or other insults |
Impaired recovery after insults |
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