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Niere Und Harnwege

H.-W. Birk, C. V. D. Horst, K. Juenemann, W. Weidner, Mario Ludwig, T. Schneider, H. Sperling, G. Lümmen, H. Ruebben
Published 2004 ·

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Die Nierenleistung nimmt mit zunehmendem Alter progredient ab. Reduzierte glomerulare Filtrationrate (GFR) und eingeschrankte tubulare Leistungen schmalern die Adaptationsfahigkeit der Nieren und machen sie empfindlicher fur toxische und ischamische Schadigungen; die Inzidenz des akuten Nierenversagens steigt mit dem Lebensalter. Zur adaptierten Dosierung nierengangiger Pharmaka muss die individuelle Nierenfunktion uber Berechnung der Kreatininclearance ermittelt werden, da die Kreatininserumwerte im Alter die GFR nicht widerspiegeln. Nephrotoxische Pharmaka sollten gemieden oder nur unter engmaschiger Kontrolle eingesetzt werden. Der Tendenz zu Kochsalzmangel, Hypokaliamie und Dehydratation muss entgegengewirkt werden. Beim Auftreten renaler Symptome sollte auch beim Alteren eine Nierenbiopsie angestrebt werden. Die Zunahme arteriosklerotischer Veranderungen fuhrt zur Haufung von Nierenarterienstenosen.
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