The kidney is a metabolically active organ that requires energy to drive processes such as tubular reabsorption and secretion, and shows a decline in function with advancing age. Various molecular mechanisms, including genomic instability, telomere attrition, inflammation, autophagy, mitochondrial function, and changes to the sirtuin and Klotho signalling pathways, are recognized regulators of individual lifespan and pivotal factors that govern kidney ageing. Thus, mechanisms that contribute to ageing not only dictate renal outcomes but also exert a substantial influence over life expectancy. Conversely, kidney dysfunction, in the context of chronic kidney disease (CKD), precipitates an expedited ageing trajectory in individuals, leading to premature ageing and a disconnect between biological and chronological age. As CKD advances, age-related manifestations such as frailty become increasingly conspicuous. Hence, the pursuit of healthy ageing necessitates not only the management of age-related complications but also a comprehensive understanding of the processes and markers that underlie systemic ageing. Here, we examine the hallmarks of ageing, focusing on the mechanisms by which they affect kidney health and contribute to premature organ ageing. We also review diagnostic methodologies and interventions for premature ageing, with special consideration given to the potential of emerging therapeutic avenues to target age-related kidney diseases.

肾脏是一个代谢活跃的器官，需要能量来驱动肾小管重吸收和分泌等过程，并且随着年龄的增长，其功能会下降。各种分子机制，包括基因组不稳定性、端粒磨损、炎症、自噬、线粒体功能以及sirtuin和Klotho信号通路的变化，被认为是个体寿命的调节因子和控制肾脏衰老的关键因素。因此，导致衰老的机制不仅决定肾脏结果，而且对预期寿命产生重大影响。相反，在慢性肾脏病（CKD）的背景下，肾功能障碍会加速个体的衰老轨迹，导致过早衰老以及生物学年龄和实际年龄之间的脱节。随着 CKD 的进展，虚弱等与年龄相关的表现变得越来越明显。因此，追求健康老龄化不仅需要管理与年龄相关的并发症，还需要全面了解系统性衰老的过程和标志物。在这里，我们研究衰老的特征，重点关注它们影响肾脏健康和导致器官过早衰老的机制。我们还回顾了过早衰老的诊断方法和干预措施，特别考虑了针对与年龄相关的肾脏疾病的新兴治疗途径的潜力。