Patient 1. An 87-year-old woman was admitted to the emergency room of the AIcalá de
Henares Hospital after a fall at home. She had a long-standing history of hypertension,
which was well controlled with nifedipine and indapamide. A hysterectomy had been
performed 30 years ago. Evaluation at the emergency room revealed a femoral neck
fracture, and she was prepared for an internal fixation under epidural ancsthesia. Pre-
operatoiy evaluation disclosed no significant metabotic alterations, the plasma creatinine …

The aging kidney is characterized by reduced glomerular filtration rate, loss of tubular
volume, and narrowed homeostatic control of water and electrolyte balance. It is unclear
whether these physiologic changes represent normal aging or subclinical disease. With
aging, there is an increased risk of hyper-or hypovolemia. Sluggish control of potassium
concentration also makes hyperkalemia more common, particularly when the patient is
using certain drugs. Water metabolism is particularly vulnerable in older patients, resulting in …