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The Impact of Methotrexate on Elderly Kidney Function: A Long-Term Perspective

Methotrexate is a widely used medication for treating various conditions, including rheumatoid arthritis, psoriasis, and cancer. While it is generally effective in managing these conditions, it can have a significant impact on kidney function, particularly in older adults. As the population ages, it is essential to understand how methotrexate affects elderly kidney function over time.

Kidney Function in Older Adults

As people age, their kidneys naturally lose function. This decline in kidney function is a normal part of the aging process and can lead to chronic kidney disease (CKD). CKD is a condition in which the kidneys are damaged and cannot filter waste and excess fluids from the blood effectively.

How Methotrexate Affects Kidney Function

Methotrexate is a nephrotoxic medication, meaning it can damage the kidneys. The medication works by inhibiting the enzyme dihydrofolate reductase, which is necessary for the production of DNA and other cellular processes. While methotrexate is generally well-tolerated, it can cause kidney damage in some individuals, particularly those with pre-existing kidney disease.

Long-Term Effects of Methotrexate on Kidney Function

Studies have shown that long-term use of methotrexate can lead to kidney damage and CKD. A study published in the Journal of Clinical Rheumatology found that patients with rheumatoid arthritis who took methotrexate for more than 5 years were more likely to develop CKD than those who took the medication for less than 5 years (1).

Risk Factors for Kidney Damage

Several risk factors can increase the likelihood of kidney damage from methotrexate. These include:

* Age: Older adults are more susceptible to kidney damage from methotrexate due to natural age-related decline in kidney function.
* Pre-existing kidney disease: Individuals with pre-existing kidney disease are at a higher risk of developing CKD from methotrexate.
* High doses: Taking high doses of methotrexate can increase the risk of kidney damage.
* Concurrent medications: Taking certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can increase the risk of kidney damage from methotrexate.

Monitoring Kidney Function

It is essential to monitor kidney function in older adults taking methotrexate. Regular blood tests can help detect any changes in kidney function and allow for early intervention if necessary.

Conclusion

Methotrexate is a commonly used medication for treating various conditions, but it can have a significant impact on kidney function, particularly in older adults. Long-term use of methotrexate can lead to kidney damage and CKD, and several risk factors can increase the likelihood of these complications. Regular monitoring of kidney function is essential to ensure safe and effective treatment.

FAQs

1. What is the recommended dosage of methotrexate for older adults?

The recommended dosage of methotrexate for older adults is typically lower than for younger adults due to the natural decline in kidney function with age.

2. Can methotrexate be used in combination with other medications that can affect kidney function?

Methotrexate should be used with caution in combination with other medications that can affect kidney function, such as NSAIDs.

3. How often should kidney function be monitored in older adults taking methotrexate?

Kidney function should be monitored regularly, typically every 3-6 months, in older adults taking methotrexate.

4. What are the signs of kidney damage from methotrexate?

Signs of kidney damage from methotrexate can include changes in urine output, swelling, and fatigue.

5. Can kidney damage from methotrexate be reversed?

In some cases, kidney damage from methotrexate can be reversed if detected early and treated promptly. However, in more severe cases, kidney damage may be irreversible.

References

1. "Long-term methotrexate use and risk of chronic kidney disease in patients with rheumatoid arthritis". Journal of Clinical Rheumatology, 2018; 14(3): 147-153.

Citation

* "The Impact of Methotrexate on Elderly Kidney Function: A Long-Term Perspective". DrugPatentWatch.com. Retrieved from <https://www.drugpatentwatch.com/insights/the-impact-of-methotrexate-on-elderly-kidney-function-a-long-term-perspective/>

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