kidney in older adults

Overview

Kidneys are two bean-shaped organs in your lower back that filter waste and extra water out of your blood. As people get older, kidney function naturally goes down a little. This is normal, but some older adults develop chronic kidney disease (CKD), a condition where the kidneys lose their ability to filter blood well over time. Most people with early kidney disease do not feel sick, and with the right care, it can be managed to keep you feeling your best.

Yes, it's very common. About one in three adults over the age of 65 has some degree of chronic kidney disease, but many people don't know it because they have no symptoms.

It mostly affects people over the age of 60, especially those with diabetes, high blood pressure, or a history of heart disease. It can also be more likely if you are overweight or have a family history of kidney disease.

Symptoms

Common symptoms

• No symptoms in early stages
• Feeling more tired than usual
• Swelling in your feet, ankles, or hands
• Needing to urinate more often, especially at night
• Foamy or bubbly urine
• Blood in the urine (pink, red, or brown)
• Dry, itchy skin
• Poor appetite

Symptoms in children

• Kidney problems in children have different causes and warning signs than in older adults. This article focuses on older adults. If you are concerned about a child's kidney health, talk to your pediatrician.

Symptoms in older adults

• Older adults may not have classic symptoms. Instead, they might notice confusion or trouble thinking clearly, feeling very tired, losing interest in food, swollen legs or feet, urinating less than usual, or getting up at night to urinate more often.
• Sometimes there are no symptoms at all, which is why regular check-ups are important.

Causes

Main causes

• High blood pressure — it can damage the tiny blood vessels in your kidneys over time
• Diabetes — high blood sugar damages the kidney filters
• The natural aging process — kidney function slowly declines with age
• Infections or kidney stones
• A blockage, such as an enlarged prostate in men
• Long-term use of certain pain relievers called non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, especially without a doctor's supervision

Risk factors

• Being over 60 years old
• Having diabetes or high blood pressure
• Having a family history of kidney disease
• Being overweight or obese
• Smoking
• Drinking too much alcohol
• Having heart disease or a stroke
• Taking certain pain medicines for a long time

When to see a doctor

See a doctor urgently if:

• If you have blood in your urine, severe pain in your back or side, or a high fever, seek medical care the same day.
• If you suddenly stop urinating, have trouble breathing, or feel confused, call your local emergency number right away.

Book a routine appointment if:

• If you have diabetes or high blood pressure, ask your doctor for a kidney function test at least once a year.
• If you notice swelling in your legs, feeling extra tired, or changes in how often you urinate, speak to a doctor.
• If you are over 60 and have not had your kidney function checked recently, mention it at your next check-up.

Diagnosis

Kidney problems are found with simple tests. Your doctor or nurse will take a small blood sample and a urine sample to check how well your kidneys are filtering waste.

Tests that may be done

• Blood test — measures a waste product called creatinine. This is used to calculate your estimated glomerular filtration rate (eGFR), which tells how well your kidneys are filtering
• Urine test — checks for a protein called albumin. Leaking protein is a sign that your kidney filters are damaged
• Blood pressure check — high blood pressure can both cause and be a result of kidney disease
• Ultrasound — uses sound waves to look at the size and shape of your kidneys, if needed

What to expect at your appointment

No special preparation is usually needed. You will have a blood test and provide a urine sample. The results come back in a few days. Your doctor will explain the numbers and what they mean for your health and will discuss next steps if anything looks abnormal.

Treatment

Treatment for kidney disease in older adults focuses on slowing down further damage, managing any other health conditions (especially high blood pressure and diabetes), and helping you feel as well as possible. In early stages, this is often done with lifestyle changes and regular monitoring.

Self-care at home

• Stay hydrated — ask your doctor how much fluid is best for you
• Keep your blood pressure in a healthy range by reducing salt in your diet and taking any prescribed medicines
• If you have diabetes, keep your blood sugar well controlled
• Avoid smoking and limit alcohol
• Stay active at a level that feels comfortable — walking is a great option
• Do not take anti-inflammatory pain relievers (like ibuprofen or naproxen) without checking with your doctor, as they can harm kidneys
• Attend your medical appointments and take medicines as prescribed — never stop or change your medication on your own

Medical treatments

Doctors may prescribe medicines to control blood pressure, lower blood sugar, or reduce strain on your kidneys. These are usually started based on your test results and health history. In more advanced stages, you might need dialysis (a treatment that filters your blood using a machine) or a kidney transplant. A kidney specialist, called a nephrologist, will talk with you about the best options for your situation.

When is surgery considered?

Surgery might be considered if there is a blockage causing kidney damage (for example, an enlarged prostate that is not relieved by other treatments) or if a kidney transplant is recommended for advanced kidney failure. Your healthcare team will explain the risks and benefits and will only recommend surgery if it is likely to help you.

Living with this condition

Living with kidney disease means staying on top of your routine: take your medicines exactly as prescribed, monitor your blood pressure at home if your doctor advises it, keep your appointments, and watch for any new or worsening symptoms like swelling, tiredness, or changes in urination. Tell your doctor about any changes you notice.

Lifestyle tips

• Eat a balanced diet with less salt and processed food
• Limit alcohol to recommended amounts or as advised by your doctor
• Avoid smoking and secondhand smoke
• Exercise regularly — even a short daily walk helps your heart and kidneys
• Get enough sleep and try to reduce stress
• Keep your weight in a healthy range

Diet and exercise

A kidney-friendly diet is usually lower in salt, processed foods, and sometimes potassium or phosphorus. Ask your doctor for a referral to a dietitian who can help you plan meals that taste good and support your kidneys. Exercise is safe and helpful for most people — start slowly and check with your doctor if you are unsure what activity level is right for you.

Mental health and emotional wellbeing

A kidney diagnosis can feel overwhelming and worrying. You might feel anxious, low, or angry at times. This is completely normal. Talking to family, friends, or a counsellor can help. If you feel persistently sad, hopeless, or anxious, reach out to your healthcare provider. Your emotional well-being matters just as much as your physical health.

Prevention

You cannot always prevent kidney disease, especially with aging, but you can lower your risk. Keep your blood pressure and blood sugar in check, eat well, stay active, avoid smoking, limit alcohol, and avoid long-term use of pain relievers that can harm the kidneys without medical supervision.

Vaccines

People with kidney problems are at higher risk of infections. Ask your doctor or local pharmacy about flu, pneumonia, and COVID-19 vaccines. Keeping your vaccinations up to date is an important part of staying healthy with kidney disease.

Screening programmes

If you have diabetes, high blood pressure, or a family history of kidney disease, regular kidney function tests are important. Your doctor can tell you how often you should be screened — often it is once a year.

Complications

If left untreated

• Kidney failure, which would require dialysis or a transplant
• Heart disease and stroke
• Anaemia (low red blood cells, causing fatigue and weakness)
• Weak bones that break easily
• Fluid buildup in the lungs, making it hard to breathe
• Uncontrolled high blood pressure

Long-term outlook

Many older adults with kidney disease live full, active lives for many years. The key is early detection and working with your healthcare team to manage things like blood pressure and diabetes. If kidney function gets severely low, there are treatments like dialysis and transplant that help people live longer, but not everyone needs them. You are more than your kidney numbers, and there is always hope and help available.

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