Kidney Disease in Older Adults

More than 37 million Americans, one in seven adults, have chronic kidney disease, according to the National Kidney Foundation. More than 98,000 Americans are on the national organ transplant waitlist. As reported by researchers at Johns Hopkins University, it is estimated that more than 50 percent of seniors, whose age is over 75, are believed to have kidney disease. In comparison to the general population, kidney disease is more prevalent in those over 60. Older adults or seniors are at more risk of developing kidney diseases.

Aging changes a person’s bladder and kidneys. Some changes encountered in the bladder are weakening of bladder muscles, the bladder not holding as much urine as before, and the urethra becoming partially or totally blocked. Some changes encountered in the kidneys are that the number of filtering units (nephrons) decreases, blood vessels that supply the kidney become hardened, which slows down the filtering of blood, and a decrease in nephrons, which filters waste material from the blood. 

TYPES OF AGE-RELATED KIDNEY DISEASE

Kidney disease is more likely to develop in people with the following health concerns or issues. 

• Inflammation or swelling of the kidneys

Inflammation can be caused by conditions such as glomerulonephritis, where the blood filters of the kidneys become scarred and inflamed. 

• Renovascular Disease

Renovascular disease is the most common cause of kidney failure in older adults or the elderly. The renal artery narrows or is blocked due to the fatty deposits, cholesterol, calcium, and other substances that are deposited in the inner lining of the arteries. It results in reduced kidney function and high blood pressure. 

• Urinary Tract Infection

Urinary Tract Infection (UTI) is common and may spread into the kidneys if not treated. It is important to consult a doctor if it is suspected to be a kidney infection.

• Urinary Incontinence

Urinary incontinence is the uncontrolled leaking of urine from the bladder and heightens the risk of urinary tract infection. It is recommended to have it checked with a doctor to know whether or not it indicates a more serious kidney problem. 

• Hereditary Kidney Disease

Hereditary Kidney Disease includes polycystic kidney disease, which causes fluid-filled cysts in the kidneys. 

• Diabetes

Diabetes is one of the most common causes of kidney disease in Americans. Even if the diabetes is managed, the damage can still occur to nerves and blood vessels. According to the National Institute of Diabetes and Digestive and Kidney Diseases, 1 in 3 people with diabetes has kidney disease. 

• High Blood Pressure

Untreated High Blood Pressure can increase the risk of stroke and loss of vision, heart attack, and kidney damage. It is also one of the most common causes of kidney disease in Americans, where 1 in 5 people with high blood pressure have kidney disease. 

People with age-related kidney disease are two to three times more likely to have a heart attack. Those at every stage of the chronic kidney disease are at more risk of it, especially with the highest risk for those in the later stages. 

SYMPTOMS OF KIDNEY DISEASE

According to the National Kidney Foundation, most people with early kidney disease have no symptoms. When the symptoms have appeared, the kidney disease may have already advanced. The following are the ten possible signs of kidney disease.

• Difficult and painful urination

• Increased thirst

• Increased need to urinate (especially at night)

• Fatigue, weakness (feeling tired)

• Foamy urine

• Pink, dark urine (blood in urine)

• Nausea

• Trouble concentrating

• Puffy eyes

• Swollen face, hands, abdomen, ankles, feet

You can also ask your primary-care health professional to get tested. It can be a blood pressure test, urine albumin-to-creatinine ratio (UACR) test, or the estimated glomerular filtration rate (eGFR) test. 

Ideally, 140/90 is a good blood pressure for most people. Below 130/80 is better if the person received a kidney transplant or has a chronic kidney disease. Below 130/80 is considered best. It is important to take a blood pressure test because it is the second-leading cause of kidney failure. For the UACR test, a good score is ideally less than 30 mg of albumin per gram of urinary creatinine. Regular amounts of albumin and/or other proteins in urine may indicate kidney damage. The eGFR test measures how well the kidneys are filtering the blood. Over 90 indicates good kidney function, while 60-89 needs to be monitored. A consistent reading of below 60 for three months could indicate kidney disease. For CKD diagnosis, a person must have an eGFR over 60 and a UACR of 30 or greater, or other evidence of kidney damage, persisting for three months or more.

HEALTHY HABITS TO PROTECT KIDNEYS

1. Follow a balanced diet

Make or choose foods that are composed of fresh or frozen vegetables, whole grains, fresh fruits, and fat-free or low-fat dairy products. Cut back on salt and aim for less than 2,300 milligrams of sodium per day. Reduce the intake of added sugar and ensure to consume less than 10 percent daily intake. Aside from cutting back on salt and added sugar, moderate your protein consumption. Making healthy choices can be cooking foods using spices instead of salt, eating foods made from whole grains, baking or broiling instead of frying, choosing foods with little or no added sugar, serving foods without added fats, and choosing veggie toppings. 

2. Be physically active and maintain a healthy weight

Make physical activity part of your routine by exercising moderately for at least 30 minutes each day. Physical activity in general can improve your mood, health, and quality of life. Coordinate with a dietitian or health care provider to create a realistic weight-loss plan if you have obesity or are overweight. 

3. Manage diabetes, high blood pressure, and heart disease

Check your blood sugar level and high blood pressure. Keep the numbers close to your goal and take all medicines prescribed by your healthcare provider. Remember to be careful of over-the-counter painkillers and avoid the regular use of nonsteroidal anti-inflammatory drugs or NSAIDs, which can damage your kidneys. For those with heart disease, keep your cholesterol levels in the target range. 

4. Get annual physical check-ups

Get an annual check-up and stay updated with all vaccinations. It is also important to know your family medical history and consult with a health care provider. You can ask key questions about your blood pressure, glomerular filtration rate (GFR), blood glucose, and urine albumin. You can also ask questions about maintaining healthy habits to protect your kidneys. 

5. Stop smoking and limit alcohol intake

Quit smoking or using tobacco products for your overall health. Limit alcohol intake to two drinks per day for men and one drink per day for women. Not limiting your alcohol intake can increase blood pressure and add extra calories, resulting in weight gain. One drink is 1.5 ounces of liquor, 12 ounces of beer, and 5 ounces of wine. 

The first step in preventing kidney disease is awareness. People do not realize they have a kidney until it is in its advanced stage. When it can be recognized early, the risk of complications can be managed. It is recommended for those over 60 to be screened annually for early signs of kidney disease. Aging well requires taking care of your overall health and maintaining a lifestyle.

To know more about kidney health, visit the National Kidney Foundation website.