What is Kidney Disease in the Elderly?
The kidneys play an important role in our bodies. They filter out water and waste, turning that waste into urine. The kidneys also help to regulate the bodies’ electrolytes and acids. Kidney disease is a condition in which the kidneys become damaged, and their ability to filter out blood is limited. Kidney disease is a condition when the kidneys have reduced in functionality, losing their ability to filter out chemicals and hormones.
What are the Causes of Kidney Disease?
There are many things that can lead to kidney disease. When co-occurring health problems affect the kidney’s ability to filter the blood, it can lead to kidney disease. This can be due to chronic medical conditions or age, with age being one of the most common indicators.
However, it is important to note that while kidney disease is more likely as you age, age alone is not an indicator of kidney disease. The kidney’s functioning begins to decrease after age 35 and can take a drastic decrease after age 60. In fact, about 10% of seniors have chronic kidney disease. Because seniors are more likely to deal with other medical conditions, it is usually the occurrence of these conditions that leads to kidney disease.
Potential causes of kidney disease might include:
- Hormone changes
- Medication usage
- High blood pressure
- Low blood pressure
- Blood vessel disease
- Heart failure
- Untreated urinary tract infection
- Diabetes mellitus
- Interstitial nephritis
- Polycystic kidney disease
- Prolonged obstruction in the kidneys
- Chronic kidney infection
It is also possible for medications to lead to decreased kidney functioning, which can then lead to kidney disease. Patients who have had prior acute kidney injury can also eventually develop chronic kidney disease (CKD). Kidney disease has also been linked to genetics. In addition to certain populations that have an increased chance of developing kidney disease, autosomal dominant genes have been identified in patients who develop kidney disease or who are at an increased risk of it.
Many patients will not notice kidney disease symptoms until the kidney’s functioning has decreased, making it important to seek medical treatment as soon as possible. Although there isn’t a treatment for kidney disease, medical intervention, and frequent monitoring is important in delaying the symptoms.
What are the Symptoms of Kidney Disease?
It is important to note that not all patients will exhibit symptoms when dealing with kidney disease. Because the kidneys play an important role in the bodies’ ability to regulate fluids and chemicals, you might notice the following symptoms with kidney disease:
- Electrolyte imbalance
- Waste build-up
- Fluid retention or edema
- Hypertension or high blood pressure
- Weakened bones
- Frequent cramps
- Frequent nausea
- Weight loss
- Loss of appetite
- Depression or confusion
- Sharp pains in back
These symptoms can be present when kidney function has decreased. Unfortunately, many of these symptoms can also be confused with other medical conditions, making it difficult to diagnose.
How Is Kidney Disease Treated?
While there is not a cure for kidney disease, many of the symptoms can be managed. The treatment will depend on how damaged the kidneys are and what caused the kidney disease. The presence and severity of the symptoms of the elderly patient can also play a role in the treatment.
The goal of kidney disease treatment is to slow down the progression of the disease and to support the functioning of the kidneys. Effective treatment requires a careful evaluation of the existing symptoms. For example, treatment options might include:
- High blood pressure treatment: Hypertension and heart disease are common among elderly patients dealing with CKD.
- Improvement of high cholesterol: High cholesterol levels can lead to a worsening of the kidney disease.
- Diabetes treatment: Diabetes is another medical condition commonly found in elderly patients with CKD.
- Re-balancing electrolytes: Kidney disease can lead to an electrolyte imbalance, which can worsen symptoms.
- Treating high levels of protein: With CKD, the kidneys are unable to filter out certain things, including protein.
- Balancing phosphorus levels: An imbalance of phosphorus levels is also common among the elderly population with CKD.
The type of kidney disease that you have will also dictate your treatment. There are also medications available that can help to support the kidneys’ functioning. You can discuss these medication options with your medical provider to evaluate whether they are a good fit for your needs or not.
If kidney disease leads to kidney failure, then dialysis or a kidney transplant may be needed to resume the functions of the kidneys.
Dialysis treatment options include:
- Hemodialysis: During hemodialysis, there is a medical machine that filters the waste from the blood and then returns it back to the body.
- Continuous ambulatory peritoneal dialysis: During continuous ambulatory peritoneal dialysis, a solution is inserted into the stomach.
Some patients may need to also deal with the effects of kidney stones or frequent urinary tract infections. While treatment is not always needed for these medical concerns, kidney stones that are too large to pass may need medical intervention or to be removed through surgery. Elderly patients will also need to be more aware of chronic urine problems like urinary tract infections.
When to See a Doctor for Kidney Disease
Because kidney disease is not always accompanied by life-changing symptoms, it is important to keep up with your annual exams. During your annual exam, your doctor will check your vitals and take routine blood tests. They might also order a urine test, which can measure the EGFR and GFR levels in the urine.
If they notice any concerning symptoms or lab results that could indicate conditions like diabetes or CKD, they might request that you undergo additional testing.
Once you are diagnosed with kidney disease, it is important to keep up with medical visits. Your doctor will play an important role in your treatment, monitoring your blood and urine levels, and making any adjustments to your medications, as needed. If your condition worsens or you are diagnosed with a severe level of kidney disease, like acute renal failure or advanced kidney disease, then your primary doctor may refer you to a specialist.
Nephrology is the specialized study of the kidneys. Your nephrology specialist will assist you in treating the symptoms of diabetes, hypertension, renal disease, and CKD. Depending on the extent of your symptoms and the progression of your disease, your medical team might consist of your primary doctor, a specialist, a nutritionist, and in some cases, a surgeon or dialysis specialist.
Kidney Disease Diagnosis
If your medical doctor suspects kidney disease, they will complete a series of tests to confirm the diagnosis, while also evaluating the type of kidney disease.
Your doctor may order the following tests:
- Blood: Blood tests will allow your doctor to look for sodium and potassium levels, while also identifying any products of waste. The GFR test measures your glomerular filtration rate, while an EGFT test looks at your estimated creatinine rate.
- Blood pressure: Kidney disease can affect blood pressure. Your doctor may test your current blood pressure levels to assist with diagnosis.
- Urine: An ACR test measures your Albumin to Creatinine ratio, which can determine kidney disease. It also looks for protein in the urine.
- Lipids: Lipid tests look at your cholesterol levels, which can help with the diagnosis of CKD.
- Imaging: Imaging tests like ultrasonography and ultrasound can look at the condition of the kidneys.
- Kidney biopsy: A kidney biopsy might be needed to look at the health of the tissue.
Evaluating these medical tests will not only determine whether or not you have kidney disease, but also the extent of the damage to the kidneys. These tests are necessary for the planning of your treatment.
Medications for Kidney Disease
Medications might be a part of your treatment plan for kidney or renal disease. Common medications used in treatment include:
- Antibiotics: Antibiotics are often used to treat infections of the kidneys, which can lead to kidney disease.
- Heart medication: Blood pressure or heart medication can support heart health, which can prevent further damage to the kidneys. Medications like angiotensin-converting enzymes are often used, which can help to control blood pressure by regulating the fluids in the body.
- Erythropoiesis-stimulating agents (ESAs): ESAs are commonly used in anemic patients whose bodies’ are unable to produce enough erythropoietin (EPO).
- Phosphate binders: Kidney disease can lead to a build-up of phosphates in the blood. Phosphate binders will help to rid your body of phosphates.
- Potassium binders: Similar to phosphate binders, potassium binders help the body to remove built-up potassium.
Over-the-counter supplements might also be used to balance hormones and chemicals in the body. They might include iron or vitamin D supplements.
Kidney Disease Risk Factors
You might be at an increased risk of developing chronic kidney disease if you also have the following co-occurring conditions:
- High blood pressure: Because the kidneys can directly affect blood pressure, having ongoing high blood pressure can be a risk factor.
- Age: While age is not a clear indicator of developing kidney disease, the kidneys do begin to decline in functioning after age 35.
- Ancestry: Studies show that African Americans and Hispanic Americans are at an increased risk of developing chronic kidney disease.
- Diabetes: Diabetes is a strong indicator of developing chronic kidney disease.
- Cardiovascular disease or heart failure: Heart disease is another strong indicator of developing chronic kidney disease.
- Lung disease: Lung disease can also affect kidney functioning.
- High cholesterol: High cholesterol can lead to high blood pressure or a diagnosis of diabetes, which increased the chance of CKD.
- Dementia: Research shows that the same blood vessel findings that lead to dementia can also lead to chronic renal failure.
- Obesity: Obesity and living an unhealthy lifestyle can cause certain medical conditions like diabetes or heart disease in the elderly.
Patients with a previous history of kidney injury or disease are also at an increased risk of developing kidney disease. There are also some medications that can increase the chances of developing CKD. Non-steroidal anti-inflammatory pain medications (NSAIDs) can decrease the functioning of the kidneys over time. Elderly patients who take NSAIDs to manage other medical conditions will require ongoing monitoring of kidney and renal functioning.
Kidney Disease Prevention
Unfortunately, kidney disease cannot always be prevented. It is possible to prevent the condition from rapid progression. Monitoring blood levels, including EGFR and creatinine levels, and medication use are important. Monitoring includes frequent blood labs and urine tests.
You can also prevent the progression of kidney disease by taking care of your kidneys. You can keep your kidneys healthy with the following tips:
- Manage diabetes
- Monitor and control high blood pressure
- Treat urinary tract infections immediately
- Control cholesterol
- Avoid smoking
- Avoid high usage of alcohol
- Maintain a healthy weight
- Frequently exercise
Experts estimate that as many as 50% of seniors over the age of 75 currently have kidney disease and are not aware. One of the most important steps in prevention is keeping up with routine check-ups. The National Kidney Foundation recommends an annual kidney disease screening for anyone over the age of 60.
Special Concerns for Elderly Patient
Many seniors are also dealing with other medical concerns and maybe taking medications to manage symptoms. With kidney disease, the kidneys cannot filter out medications as easily. It is important to monitor kidney function and also to decrease medication dosage as needed.
Another concern with elderly patients is the co-occurrence of dementia. Kidney disease, especially undiagnosed, can lead to the symptoms of dementia, making it more difficult for an accurate diagnosis.
Additionally, elderly patients dealing with dementia and kidney disease may require assistance in keeping up with treatment plans.
The existence of kidney disease can also increase a senior’s chance of developing other medical conditions. It is important for elderly patients to look out for things like malnutrition, osteoporosis, anemia, and high blood pressure. It can also lead to complications of current medical conditions like an increase in fluid retention, weakened bones, anemia, and erectile dysfunction.
Dealing with kidney disease requires working with a medical team that is aware of the patient’s history.
Questions to Ask Your Doctor
By preparing for your upcoming doctor’s appointment, you can ensure that you have all the information you need to manage your symptoms effectively.
Ask your doctor these questions:
- What type of kidney disease do I have?
- What do you think is the cause of my kidney disease?
- Will I need dialysis?
- What are the results of my urine and blood lab tests?
- What dietary changes should I make?
- Will I need a kidney transplant?
- Is it necessary for me to see a renal specialist?
- What can I expect from treatment?
Being involved in your treatment plan, and understanding your symptoms is crucial in understanding your condition.
Managing Kidney Disease
It is possible to manage the symptoms of kidney disease. Through things like dietary changes and medications, seniors can slow down the progression of kidney disease.
It is important to maintain a diet that is minimal in protein and phosphorus when dealing with kidney disease. It can be helpful to work with a nutritionist when determining a kidney-friendly diet. Kidney disease can also lead to electrolyte imbalances. Seniors can manage these imbalances through dietary changes or leveling out certain chemicals that are imbalanced.
For some, managing kidney disease also requires the management of other health conditions. Because kidney disease and heart disease are commonly found together, it is also important to keep up with the routine treatment of heart disease too. This means keeping all medical visits and consistently taking all medications.
How Do You Live With Kidney Disease?
Early diagnosis and treatment of kidney disease can lead to a long and fulfilled life. Seniors can optimize their health and well-being through dietary changes and frequent monitoring of their condition. By keeping up with things like frequent blood work, urine tests, EGFR and GFR tests, and treating symptoms as they come, you can manage life with kidney disease.
How to Help Your Loved One Post Kidney Disease
Monitoring is important when dealing with kidney disease. The requirements for remembering medications and doctor’s appointments can be overwhelming. You can help your loved one after a kidney disease diagnosis by assisting them with these tasks.
Additionally, some seniors will need to spend some time in the hospital or long hours receiving dialysis. Helping them with household tasks or transportation to and from doctor’s appointments can be very useful.
It is also important to consider your health insurance when dealing with kidney disease treatment options. While most insurance will cover the diagnostic and initial treatment available for kidney disease, insurance coverage can change if the disease worsens. For more progressed forms of the disease, such as with renal or kidney failure, insurance might only cover a percentage of treatment.
Some treatments, like dialysis or a kidney transplant, can be expensive, even if the patient is only responsible for a small portion of the payment. Many patients dealing with kidney or renal disease have Medicare, and some will supplement with Medicaid.
For More Information Contact
For more information about kidney disease, you can visit these websites:
- National Institute of Digestive Kidney Diseases
- National Kidney Foundation
- Centers for Disease Control and Prevention
- Centers for Medicare & Medicaid Services
Types of kidney disease
There are multiple types of kidney disease, which can be useful to know as you begin to manage symptoms and consider your treatment plan:
- Chronic kidney disease (CKD): Chronic kidney disease is a kidney condition that lasts for three months or longer. It is divided into five stages and can lead to kidney failure in stage five. CKD is actually very common and is one of the most common types of kidney disease, especially among elderly patients.
- Electrolyte imbalance: Electrolyte imbalances can also lead to kidney disease. When the sodium levels in the body are not normalized, it can make the kidneys work more. This can also lead to dehydration, which can further affect the kidney’s health and functioning.
- Renovascular disease: Renovascular disease is a condition of the kidney’s blood vessels. Most commonly found in seniors who smoke, this disease affects the bodies’ ability to input blood to the liver. The narrowing of the artery that leads to each of the kidneys can also lead to high blood pressure and heart complications.
- Acute kidney failure: Acute kidney failure is a sudden onset type of kidney disease. It is also a common type of kidney disease and can follow an acute kidney injury.
- End-stage renal disease (ESRD): End-stage renal disease is one of the most severe stages of kidney disease and will often require treatment with either a kidney transplant or dialysis.
Kidney disease is a common condition, especially with older adults. Early diagnosis will increase the effectiveness of treatment, reducing the symptoms, and slowing down the progression of the disease.