Hostname: page-component-5d59c44645-zlj4b Total loading time: 0 Render date: 2024-03-01T14:36:17.783Z Has data issue: false hasContentIssue false

Physiological changes of aging affecting salt and water balance

Published online by Cambridge University Press:  17 November 2008

Myron Miller*
Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, New York
Gabriel C Gold
Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, New York
Deborah A Friedlander
Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, New York
Myron Miller MD, Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, Box 1070, One Gustave L Levy Place, New York, New York 10029, USA.


Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Biological gerontology
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1Snyder, NA, Feigal, DW, Arieff, AI. Hypernatremia in elderly patients. A heterogeneous, morbid, and iatrogenic entity. Ann Intern Med 1987; 107: 309–19.Google Scholar
2Miller, M, Morley, JE, Rubenstein, LA, Ouslander, J, Strome, S. Hyponatremia in a nursing home population. The Gerontologist 1985; 25: 118.Google Scholar
3Lavizzo-Mourey, R, Johnson, J, Stolley, P. Risk factors for dehydration among elderly nursing home residents. J Am Geriatr Soc 1988; 36: 213–18.Google Scholar
4Owen, JA, Campbell, DG. A comparison of plasma electrolyte and urea values in healthy persons and in hospital patients. Clin Chem Acta 1968; 22: 611–18.Google Scholar
5Caird, FI, Andrews, GR, Kennedy, RD. Effect of posture on blood pressure in the elderly. Br Heart J 1973; 35: 527–30.Google Scholar
6Anderson, RJ, Chung, H, Kluge, R, Schrier, RW. Hyponatremia: prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med 1985; 102: 164–68.Google Scholar
7Hochman, I, Cabili, S, Peer, G. Hyponatremia in internal medicine ward patients: causes, treatment and prognosis. Isr J Med Sci 1989; 25: 7376.Google Scholar
8Kennedy, PGE, Mitchell, DM, Hoffbrand, BI. Severe hyponatremia in hospital inpatients. Br Med J 1978; 2: 1251–53.Google Scholar
9Tierney, WM, Martin, DK, Greenlee, MC, Zerbe, RL, McDonald, CJ. The prognosis of hyponatremia at hospital admission. J Genl Int Med 1986; 1: 380–85.Google Scholar
10Kleinfeld, M, Casimir, M, Borra, S. Hyponatremia as observed in a chronic disease facility. J Am Geriatr Soc 1979; 27: 156–61.Google Scholar
11Sunderam, SG, Mankikar, GD. Hyponatremia in the elderly. Age Ageing 1983; 12: 7780.Google Scholar
12Robertson, GL. Thirst and vasopressin function in normal and disordered states of water balance. J Lab Clin Med 1983; 101: 351–71.Google Scholar
13Phillips, PA, Rolls, BJ, Ledingham, JGG et al. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med 1984; 311: 753–59.Google Scholar
14Miller, PD, Krebs, RA, Neal, BJ, Mclntyre, DO. Hypodipsia in geriatric patients. Am J Med 1982; 73: 354–56.Google Scholar
15McLachlan, M, Wasserman, P. Changes in size and distensibility of the aging kidney. Br J Radial 1981; 54: 488–91.Google Scholar
16Kaplan, C, Pasternack, B, Shah, H, Gallo, G. Age-related incidence of sclerotic glomeruli in human kidneys. Am J Pathol 1975; 80: 227–34.Google Scholar
17Kappel, B, Olsen, S. Cortical interstitial tissue and sclerosed glomeruli in the normal human kidney, related to age and sex. Virchows Arch [A] 1980; 387: 271–77.Google Scholar
18Taylor, SA, Price, RG. Age-related changes in rat glomerular basement membrane. Int J Biochem 1982; 14: 201206.Google Scholar
19Darmady, EM, Offer, J, Woodhouse, MS. The parameters of the aging kidney. J Pathol 1973; 109: 195207.Google Scholar
20Goyal, VK. Changes with age in the human kidney. Exp Gerontol 1982; 17: 321–31.Google Scholar
21Pratz, J, Ripoche, P, Corman, B. Cholesterol content and water and solute permeabilities of kidney membranes from aging rats. Am J Physiol 1987; 253: R8R14.Google Scholar
22Takazakura, E, Wasabu, N, Handa, A, Takada, A, Shinoda, A, Takeuchi, J. Intrarenal vascular changes with age and diseases. Kidney Int 1972; 2: 224–30.Google Scholar
23Ljungqvist, A, Lagergren, C. Normal intrarenal arterial pattern in adult and aging human kidney. J Anat 1962; 96: 285–98.Google Scholar
24Davies, DF, Shock, NW. Age changes in glomerular filtration, effective renal plasma flow and tubular excretory capacity in adult males. J Clin Invest 1950; 29: 496506.Google Scholar
25Rowe, JW, Andres, RA, Tobin, JD, Norris, AH, Shock, NW. The effect of age on creatinine clearance in man: a cross-sectional and longitudinal study. J Gerontol 1976; 31: 155–63.Google Scholar
26Lindeman, RD, Tobin, JD, Shock, NW. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 1985; 33: 278–85.Google Scholar
27Cockroft, DW, Gault, MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 3141.Google Scholar
28Johnston, HH, Herzog, JP, Lauler, DP. Effect of prostaglandin E1 on renal hemodynamics, sodium and water excretion. Am J Physiol 1967; 213: 939–46.Google Scholar
29Martinez-Maldonado, M, Tsaparas, N, Eknoyan, G, Suki, WN. Renal actions of prostaglandins: comparison with acetylcholine and volume expansion. Am J Physiol 1972; 222: 1147–52.Google Scholar
30Data, JL, Chang, LC, Nies, AS. Alteration of canine renal vascular response to hemorrhage by inhibitors of prostaglandin synthesis. Am J Physiol 1976; 230: 940–45.Google Scholar
31Clive, DM, Stoff, JS. Renal syndromes associated with nonsteroidal anti-inflammatory drugs. N Engl J Med 1984; 310: 563–72.Google Scholar
32Nies, AS. Renal effects of nonsteroidal anti-inflammatory drugs. Agents Actions Suppl 1988; 24: 95106.Google Scholar
33Kokko, JP. Effect of prostaglandins on renal epithelial electrolyte transport. Kidney Int 1981; 19: 791–96.Google Scholar
34Berg, KG. Acute effects of acetylsalicyclic acid on renal function in normal man. Eur J Clin Pharmacol 1977; 11: 117–23.Google Scholar
35Stokes, JB. Effect of prostaglandin E2 on chloride transport across the rabbit thick ascending limb of Henle. J Clin Invest 1979; 64: 495502.Google Scholar
36Stokes, JB, Kokko, JP. Inhibition of sodium transport by prostaglandin E2 across the isolated, perfused rabbit collecting tubule. J Clin Invest 1977; 59: 1099–104.Google Scholar
37Higashihara, E, Stokes, JB, Kokko, JP, Campbell, WB, DuBose, TD. Cortical and papillary micropuncture examination of chloride transport in segments of the rat kidney during inhibition of prostaglandin production. J Clin Invest 1979; 64: 1277–87.Google Scholar
38Sica, DA, Hartford, A. Sodium and water disorders in the elderly. In: Zawade, ET Jr, Sica, DA eds. Geriatric nephrology and urology. Littleton: PSG 1985: 127–56.Google Scholar
39Lindeman, RD, Lee, DT, Yiengst, MJ, Shock, NW. Influence of age, renal disease, hypertension, diuretics and calcium on the antidiuretic responses to suboptimal infusions of vasopressin. J Lab Clin Med 1966; 68: 202–23.Google Scholar
40Crowe, MJ, Forsling, ML, Rolls, BJ, Phillips, PA, Ledingham, JGG, Smith, RF. Altered water excretion in healthy elderly men. Age Ageing 1987; 16: 285–93.Google Scholar
41Dontas, AS, Karkenos, S, Papanayioutou, P. Mechanisms of renal tubular defects in old age. Postgrad Med J 1972; 48: 295303.Google Scholar
42Lye, M. Electrolyte disorders in the elderly. In: Morgan, DB ed. Clinics in endocrinology and metabolism. Philadelphia: WB Saunders, 1984: 377–98.Google Scholar
43Zanuszewicz, W, Heinemann, H, Demartini, F et al. A clinical study of effects of hydrochlorothiazide on renal excretion of electrolyte and free water. N Engl J Med 1959; 261: 264–69.Google Scholar
44Hsou, HK, Peng, MT. Hypothalamic neuron number of old female rats. Gerontology 1978; 24: 434–40.Google Scholar
45Andrew, W. Structural alterations with aging in the nervous system. J Chronic Dis 1956; 3: 575–96.Google Scholar
46Frolkis, W, Golovchenko, SF, Medved, VI, Frolkis, RA. Vasopressin and cardiovascular system in aging. Gerontology 1982; 28: 290302.Google Scholar
47Currie, AR, Adamson, H, Van Dyke, HB. Vasopressin and oxytocin in the posterior lobe of the pituitary in man. J Clin Endocrinol Metab 1960; 20: 947–51.Google Scholar
48Fliers, E, Swaab, DF, Pool, CHR W, Verwer, RWH. The vasopressin and oxytocin neurons in the human supraoptic and paraventricular nucleus. Change with aging and in senile dementia. Brain Res 1985; 342: 4553.Google Scholar
49Hoogendijk, JE, Fliers, E, Swaab, DF, Verwer, RWH. Activation of vasopressin neurons in the human supraoptic and paraventricular nucleus in sensenence and senile dementia. J Neural Sci 1985; 69: 291–99.Google Scholar
50Fliers, E, Swaab, DF. Activation of vasopressinergic and oxytocinergic neurons during aging in the Wistar rat. Peptides 1983; 4: 165–70.Google Scholar
51Davies, I. Ageing in the hypothalamoneuro hypophysial renal system. Compr Gerontol 1987; 1: 1223.Google Scholar
52Helderman, JH, Vestal, RE, Rowe, JW, Tobin, JD, Andres, R, Robertson, GL. The response of arginine vasopressin to intravenous ethanol and hypertonic saline in man. The impact of aging. J Gerontol 1978; 33: 3947.Google Scholar
53Chiodera, P, Capretti, L, Marches, M. Abnormal arginine vasopressin response to cigarette smoking and metoclopramide (but not to insulin-induced hypoglycemia) in elderly subjects. J Gerontol 1991; 46: M6M10.Google Scholar
54Rondeau, E, Delima, J, Caillens, H, Ardaillou, R, Vahanian, A, Acar, J. High plasma anti-diuretic hormone in patients with cardiac failure. Influence of age. Mineral Electrolyte Metab 1982; 8: 267–74.Google Scholar
55Kirkland, J, Lye, M, Goddard, C, Vargas, E, Davies, I. Plasma arginine vasopressin in dehydrated elderly patients. Clin Endocrinol 1984; 20: 451–56.Google Scholar
56Engel, PA, Rowe, JW, Minaker, KL, Robertson, GL. Stimulation of vasopressin release by exogenous vasopressin: effect of sodium intake and age. Am J Physiol 1984; 246: E202E207.Google Scholar
57Robertson, GL, Rowe, JW. The effect of aging on neurohypophysical function. Peptides 1980; 1 (Suppl 1): 159–62.Google Scholar
58Robertson, GL, Shelton, RL, Athar, J. The osmoregulation of vasopressin. Kidney Int 1976; 10: 2537.Google Scholar
59Li, CH, Hsieh, SM, Nagai, I. The response of plasma arginine vasopressin to 14h. water deprivation in the elderly. Acta Endocrinol 1984; 105: 314–17.Google Scholar
60Rowe, JW, Minaker, KL, Robertson, GL. Age-related failure of volume pressure mediated vasopressin release in man. J Clin Endocrinol Metab 1982; 54: 661–64.Google Scholar
61Bevilacqua, M, Norbiato, G, Chebat, E et al. Osmotic and nonosmotic control of vasopressin release in the elderly: effect of metoclopramide. J Clin Endocrinol Metab 1987; 65: 1243–47.Google Scholar
62Norbiato, G, Bevilacqua, M, Chebat, E et al. Metoclopramide increases vasopressin secretion. J Clin Endocrinol Metab 1986; G3: 747–50.Google Scholar
63Steardo, L, lovino, M, Monteleone, P et al. Evidence that cholinergic receptors of muscarinic type may modulate vasopressin release induced by metoclopramide. J Neural Transm 1990; 82: 213–17.Google Scholar
64Gribbin, B, Pickering, TG, Sleight, P, Peto, R. Effect of age and high blood pressure on baroreflex sensitivity in man. Circ Res 1971; 29: 424–31.Google Scholar
65Miller, JH, Shock, NW. Age differences in the renal tubular response to antidiuretic hormone. J Gerontol 1953; 8: 446–50.Google Scholar
66Miller, M. Influence of aging on vasopressin secretion and water regulation. In: Schrier, RW ed. Vasopressin. New York: Raven Press, 1985: 249–58.Google Scholar
67Baylis, PH, Zerbe, RL, Robertson, GL. Arginine-vasopressin response to insulin induced hypoglycemia in man. J Clin Endocrinol Metab 1981; 53: 935–40.Google Scholar
68Moses, AM, Miller, M, Streeten, DHP. Pathophysiologic and pharmacologic alterations in the release and action of ADH. Metabolism 1976; 25: 697721.Google Scholar
69Miller, M, Moses, AM. Drug-induced states of impaired water excretion. Kidney Int 1976; 10: 96103.Google Scholar
70Weissman, P, Shenkman, L, Gregerman, RI. Chlorpropramide hyponatremia: drug-induced-inappropriate antidiuretic-hormone activity. N Engl J Med 1972; 284: 6571.Google Scholar
71Stewart, RB, May, FE, Hale, WE et al. Psychotropic drug use in an ambulatory elderly population. Gerontology 1982; 28: 328–35.Google Scholar
72Cohen, BJ, Mahelsky, M, Adler, L. More cases of SIADH with fluoxetine (correspondence). Am J Psychiatry 1990; 147: 948–49.Google Scholar
73Hwang, AS, Magraw, RM. Syndrome of inappropriate secretion of antidiuretic hormone due to fluoxetine (correspondence). Am J Psychiatry 1989; 146: 399.Google Scholar
74Caradoc-Davies, H. Opiate toxicity in elderly patients. Br Med J 1981; 282: 905906.Google Scholar
75Blum, M, Aviram, A. Ibuprofen induced hyponatremia. Rheumatol Rehabil 1980; 19: 258–59.Google Scholar
76Crowe, M. Hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion in the elderly. I Med J 1980; 73: 482–83.Google Scholar
77Ditzel, J. Hyponatremia in an elderly woman and inappropriate secretion of antidiuretic hormone. Acta Med Scand 1966; 179: 407–16.Google Scholar
78Goldstein, CS, Braunstein, S, Goldfarb, S. Idiopathic syndrome of inappropriate antidiuretic hormone secretion possibly related to advanced age. Ann Intern Med 1983; 99: 185–88.Google Scholar
79Lindeman, RD, Adler, S, Yiengst, MJ, Beard, ES. Natriuresis and carbohydrate-induced antinatriuresis after overnight fast and hydration. Nephron 1970; 7: 289300.Google Scholar
80Schalekamp, MA, Krauss, XH, Schalekamp-Kuyken, MP, Kolsters, G, Birkenhager, WH. Studies on the mechanisms of hypernatriuresis in essential hypertension in relation to measurements of plasma renin concentration, body fluid compartments and renal function. Clin Sci 1971; 41: 219–31.Google Scholar
81Epstein, M, Hollenberg, NK. Age as a determinant of renal sodium conservation in normal man. J Lab Clin Med 1976; 87: 411–17.Google Scholar
82Ohashi, M, Fujio, N, Nawata, H et al. High plasma concentrations of human atrial natriuretic polypeptide in aged men. J Clin Endocrinol Metab 1987; 64: 8185.Google Scholar
83McKnight, JA, Roberts, G, Sheridan, B, Brew, Atkinson A. Relationship between basal and sodium stimulated plasma atrial natriuretic factor, age, sex and blood pressure in normal man. J Human Hypertens 1989; 3: 157–63.Google Scholar
84Tajima, F, Sagawa, S, Iwamoto, J, Miki, K, Claybaugh, JR, Shiraki, K. Renal and endocrine responses in the elderly during headout water immersion. Am J Physiol 1988; 254: R977–83.Google Scholar
85Heim, JM, Gottmann, JW, Strom, TM, Gerzer, R. Effects of a bolus dose of atrial natriuretic factor in young and elderly volunteers. Eur J Clin Invest 1989; 19: 265–71.Google Scholar
86Ohashi, M, Fugio, N, Nawata, H, Kato, K, Matsuo, H, Ibayashi, H. Pharmacokinetics of synthetic alpha-human atrial natriuretic polypeptide in normal men; effect of aging. Regul Pept 1987; 19: 265–71.Google Scholar
87Jansen, TL, Tan, AC, Smits, P, de Boo, T, Benraad, TJ, Thien, T. Hemodynamic effects of atrial natriuretic factor in young and elderly subjects. Clin Pharmacol Ther 1990; 48: 179–88.Google Scholar
88Genest, J, Larochelle, P, Cusson, JR, Gutkowska, J, Cantin, M. The atrial natriuretic factor in hypertension: state of the art lecture. Hypertension 1988; 11 (Suppl 1): 1317.Google Scholar
89Cuneo, RC, Espiner, EA, Nicholls, MG, Yandle, TG, Livessey, JH. Effect of physiological levels of atrial natriuretic peptide on hormone secretion: inhibition of angiotensin-induced aldosterone secretion and renin release in normal man. J Clin Endocrinol Metab 1987; 65: 765–72.Google Scholar
90Clinkingbeard, C, Sessions, C, Shenker, Y. The physiological role of atrial natriuretic hormone in the regulation of aldosterone and salt and water metabolism. J Clin Endocrinol Metab 1990; 70: 582–89.Google Scholar
91Weidmann, P, De Myttenaere-Bursztein, S, Maxwell, MH, De Lima, J. Effect of aging on plasma renin and aldosterone in normal man. Kidney Int 1975; 8: 325–33.Google Scholar
92Tsunoda, K, Abe, K, Goto, T et al. Effect of age on the renin-angiotensin-aldosterone system in normal subjects: simultaneous measurement of active and inactive renin, renin substrate, and aldosterone in plasma. J Clin Endocrinol Metab 1986; 62: 384–89.Google Scholar
93Grymonpre, RE, Mitenko, PA, Sitar, DS, Aoki, FY, Montgomery, PR. Drug-associated hospital admissions in older medical patients. J Am Ceriatr Soc 1988; 36: 1092–98.Google Scholar
94Fichman, MP, Vorherr, H, Kleeman, C, Telfer, N. Diuretic-induced hyponatremia. Ann Intern Med 1971; 75: 853–63.Google Scholar
95Andreasen, F, Hansen, U, Husted, SE, Jansen, JA. The pharmacokinetics of furosemide are influenced by age. Br J Clin Pharmacol 1983; 16: 391–97.Google Scholar
96Andreasen, F, Hansen, U, Husted, SE, Mogensen, CE, Pedersen, EB. The influence of age on renal and extrarenal effects of furosemide. Br J Clin Pharmacol 1984; 18: 6574.Google Scholar
97Wilson, TW, McCaulay, FA, Waslen, TA. Effects of aging on responses to furosemide. Prostaglandins 1989; 38: 675–87.Google Scholar
98Macias Nunez, JF, Garcia, Iglesias C, Bondia, Roman A et al. Renal handling of sodium in old people: a functional study. Age Ageing 1978; 7: 178–81.Google Scholar
99Ceruso, D, Squadrito, G, Quartarone, M, Rarisi, M. Comportamente della funzionalita renale e degli electtroliti ematice ed urinari dopo aldosterone in soggietti anziani. G Gerontol 1970; 18: 862.Google Scholar
100Macias Nunez, JF, Garcia, Iglesias C, Tabernero Romo, JM, Roderiquez Commes, JL, Corbacho, Becerra L, Sanchez Tomero, JA. Renal management of sodium under indomethacin and aldosterone in the elderly. Age Ageing 1098; 9: 165–72.Google Scholar
101Lewis, WH, Alving, AS. Changes with age in the renal function in adult men. Am J Physiol 1938; 123: 500–15.Google Scholar
102Lindeman, RD, Van Buren, C, Raisz, LG. Osmolar renal concentrating ability in healthy young men and hospitalized patients without renal disease. N Engl J Med 1960; 262: 1306–309.Google Scholar
103Rowe, JW, Shock, NW, DeFronzo, RA. The influence of age on the renal response to water deprivation in man. Nephron 1976; 17: 270–78.Google Scholar