Introduction into Geriatric Medicine/Ageing

Question 1

Describe how the liver functions changes with age [5]

Answer 1

• Liver size decreases by up to 45% with related reduction in hepatic blood flow
• Reduced production of albumin, clotting factors
• Impaired glucose metabolism
• Impaired ability to clear medications and alcohol
• Production and flow of bile decreases with age –gallstone

Question 2

Describe how the kidney functions changes with age [=]

Answer 2

Reduction in renal mass (cortical thinning, medulla spared)
Reduced blood flow
Reduced levels of renin / aldosterone –> Impared RAS
Reduced eGFR
Creatinine levels are lower therefore lower rises in creatinine are more significant (as muscle size is lower; but coud be AKI)
Greater GBM permeability
SIADH is common/Increased frequency of hypo and hypernatraemia
More likely to get AKI