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Kidney damage: because it is typical of the elderly

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Kidney damage: because it is typical of the elderly

The term planned obsolescence indicates the strategy that many industries implement to limit the life cycle of their products, in order to induce consumers to buy the latest model. There is something similar in man too. It is written in the DNA. Each organ (heart, brain, pancreas, kidneys, ears, eyes, liver, etc.) has a naturally predefined duration. It is known that children of diabetic parents are destined to develop diabetes in their mature age. Exceptions always exist, it will be said, but in hindsight they are not real exceptions: it is the virtuous conduct of the individual that will give the pancreas longer life.

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If the individual maintains the right weight over time, he will be able to moderate himself at the table, making the right choices for quality and quantity, will lead a life with regular physical activity, will have preserved a lot of energy for the precious organ. It is as if the pancreas was meant to produce tot. units and no more than insulin in life, as well as the ovaries can produce tot. ovules throughout the fertile period. The deterioration of the organs, with age, is however progressive and the deficit is established little by little, giving signs that it is always advisable to grasp, in order to implement the most suitable remedies. With advancing age, therefore, periodic checks are basic and do not allow exceptions.

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For example, for renal function, only one test is enough: creatinine, a faithful index of the good health of the organ. Be careful, however, to evaluate well and correlate the result of the exam with the individual. A normal value in the elderly, especially in a woman, does not always correspond to a well-preserved renal function. Creatinine, in fact, is a substance that is released into the blood as a “waste” of muscle tissue. Diehard gym-goers produce plenty of it, but the kidney cleanses the blood from this product by maintaining the normal level of 1 mg / dl, maximum 1.2 mg in people with more developed muscle mass.

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Compared to these subjects, a 70-year-old woman who has never done intense physical activity will have twenty times less musculature, therefore her creatinine level should be much lower than 1 (which is normal). There are formulas that take into account size and age, but the foolproof method is to carry out creatinine clearance, which is a 24-hour evaluation of the excretion of the substance in the urine.

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The kidney purifies the blood of all toxic substances, contributes to the production of red blood cells, regulates the metabolism of calcium and phosphorus and transforms the precursor of vitamin D into active, maintains the correct Ph (degree of acidity) of the blood, regulates the excretion of liquids and contributes to the maintenance of the right blood pressure values. It weighs about 130 grams and has a longitudinal diameter of 11-12 cm. The kidney of the elderly, on the other hand, is two cm. shorter and hardly reaches 80 grams. The organ is richly vascularized and the general state of the cardiovascular system greatly influences its function.

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With these characteristics it is clear that all the problems that directly or indirectly create an obstacle to the arterial circulation, negatively affect the functionality of the kidney. And sometimes heavily, considering that the loss of active kidney tissue is no longer recoverable (as is the case with the lungs). And what are the problems to avoid? Let’s start with the diseases that day after day cause irreversible kidney damage: type 2 diabetes mellitus, arterial hypertension, hypercholesterolemia and atherosclerosis, gout and hyperuricemia, rheumatic and connective tissue diseases, all urinary tract infections, to limit ourselves to the main ones.

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Contrasting these pathologies with appropriate therapies is an absolute imperative, if you want to avoid dangerous consequences, but it is not enough to obtain a narrow normalization of the altered values: it is necessary to obtain an optimal compensation and push the therapy, sometimes, to the maximum tolerated doses. Then there are the harmful behaviors: smoking, the abuse of NSAIDs (non-steroidal anti-inflammatory drugs), a diet that is too rich in proteins or an excessive intake of alcoholic beverages. A diabetic with hypertension and a smoker who does not do everything possible to safeguard his kidneys has already bought a ticket for lifetime hemodialysis.

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