| Anatomic |
| Decrease in renal mass, mostly from cortex |
| Increased renal fat and fibrosis |
| Sclerosis of cortical nephrons with longest loops of Henle |
| Functional |
| Decreased renal blood flow |
| Impaired vasodilation in response to dopamine |
| Decreased creatinine clearance |
| Impaired sodium excretion and conservation |
| Decreased potassium excretion and conservation |
| Decreased concentrating and diluting capacity |
| Impaired excretion of acid loads |
| Decreased serum renin and aldosterone |
| Altered intrarenal nitric oxide actions |
| Increased dependence on renal prostaglandins to maintain intrarenal perfusion |
| Decreased vitamin D activation |
| Increased vulnerability to dye, ischemia, or other insults |
| Impaired recovery after insults |
