The elderly are a fast growing population in the world, and they have a high prevalence of chronic kidney disease. The function of the kidney changes markedly with age. The glomerular fi ltration rate falls progressively, independent of overt pathology. Declining renal function with age has important implications, not only for individual homeostasis but also for the use of drug therapy and for the receipt and donation of organs for transplantation. Aging is associated with structural and functional changes in the kidney. The adaptive capacity of kidney to stress and disease in the elderly is restricted. The clinician should be aware of these alterations in order to anticipate and better treat the clinical conditions that occur in great frequency in elderly. Age-related changes has been reviewed in this manuscript.