Abstract
Background: Human aging is associated with a number of unexplained changes in renal function, including a diminished capacity to excrete water and sodium loads and an increased susceptibility to acute renal failure. PGE2 and dopamine are intrarenal autocrine factors important in diuresis, natriuresis and also serve to protect against ischemic renal injury. Responses of these autocoids to provocative maneuvers such as water loading have not previously been studied in the elderly. Methods: Five healthy young (25±1 yrs) and five healthy elderly (70±1 yrs) women underwent a 20 ml/kg oral water load in the Clinical Research Center. Results: Urinary PGE2 and dopamine excretion were lower in the elderly. Urinary PGE2 and dopamine rose significantly during water diuresis only in the young subjects but remained essentially unchanged in the elderly (p<0.05, ANOVA). Minimum urine osmolality was lower in young than old (61±3 vs 83±9 mOsm/L, p<0.05). Old had less brisk diuresis and a greater decline in serum sodium than young (p<0.05, ANOVA). Conclusion: The defect in PGE2 and dopamine excretion in the elderly demonstrated here during water diuresis may have more general implications, relating to the susceptibility of the aged to hyponatremia and acute renal failure.
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