Challenges and Opportunities in Geriatric Nephrology and Urology

Dear Colleagues,

The increase in the average age of the population gives rise to a series of problems at various levels, including health.  In the field of nephrology, it is necessary to acquire specific knowledge that allows us to better deal with the multiple comorbidities of an elderly patient. First of all, however, it is important to understand that the elderly patient is not a “different machine”, with its own special rules, with aspects that magically appear unexpected. From a nephrological point of view, for example, in the elderly, even if they are not specifically affected by kidney disease, two phenomena occur can occur as follows: a "physiological" process of sclerosis causes the number of functioning nephrons to decrease as the age advances, and this not only reduces the performance that the kidneys offer to the body community, but increases the risk of other pathologies, of which renal failure is an independent risk factor. The other phenomenon is the recourse in the elderly patient to the so-called “renal functional reserve”, a mechanism that increases the filtrate of residual nephrons (and therefore preserves the overall renal function in the face of the reduced number of functioning nephrons), thanks to the mediation activating vasodilating prostaglandins, and this explains why, in the elderly, drugs that inhibit prostaglandins and/or tend to induce dehydration have a much more negative effect on kidney function than in young people. All this means that the GFR levels of an elderly patient (and its effects) deserve careful monitoring by clinicians, even in patients who are not strictly nephropathic, and that, in those who are, kidney problems will be intertwined with increasingly complex pictures, pathologies that occur in other organs and systems, and age-related issues. Another aspect is the increase in the average age of both the donors and recipients of a kidney transplant.

It is therefore very important for nephrologists to acquire specific knowledge aimed at this increasingly large group of patients.

Topics will include:

• Renal function in the elderly patients;
• Kidney disease in elderly patients;
• Pharmacological therapies in elderly nephropathic patients;
• Pharmacological therapies in elderly patients with normal renal function;
• Interactions between renal disease and other comorbidities in the elderly patient.

Prof. Dr. Giulio Romano
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• kidney disease
• elderly patient
• epidemiology
• pharmacological therapy
• lifestyle diet