Kidneys - age-related problems

Your kidneys can be affected or damaged by a wide range of diseases and conditions. As you get older, you become more likely to develop kidney problems. Kidney disease can be serious, but early detection and good management can extend the working life of your kidneys.

Kidney disease is often called a “silent disease” because it is not always accompanied by warning signs. People may lose up to 90 per cent of their kidney function before noticing any symptoms.

If you have one or more risk factors for kidney disease, it is recommended that you have a kidney health check (blood test, urine test and blood pressure check) from your doctor at least every two years, and every year if you have diabetes or high blood pressure.

Types of age-related kidney disease#

Several conditions that affect the kidneys and urinary tract become more common with age. They include:

• Diabetes - one of the most common causes of kidney disease. Persistently high blood sugar can damage the small blood vessels in the kidneys, even when diabetes is otherwise well managed.
• High blood pressure - a leading cause of kidney failure in older people. If left untreated, high blood pressure can also increase the risk of heart attack, stroke and loss of vision.
• Urinary tract infections - a urinary tract infection can spread to the kidneys. It is important to see a doctor if a kidney infection is suspected, because lasting damage can occur if it is left untreated.
• Renovascular disease - fatty deposits, cholesterol, calcium and other substances build up in the inner lining of the arteries, narrowing or blocking the renal artery. This reduces blood supply to the kidneys, affects their filtering and can lead to high blood pressure and reduced kidney function.
• Inflammation of the kidneys, such as glomerulonephritis.
• Hereditary kidney diseases, including polycystic kidney disease.
• Scarring of the kidneys caused by urinary reflux, where urine flows backward from the bladder into the kidneys. This mainly affects young children.

Urinary tract infections are very common, particularly in women and with increasing age. Urinary incontinence (uncontrolled leaking of urine from the bladder) can increase the risk of these infections. Your doctor should check any problems linked to passing urine, as they may point to more serious kidney problems or other conditions, such as an enlarged prostate in men.

Symptoms of kidney disease#

The first signs of kidney disease are often general and may include:

• high blood pressure
• changes in how much and how often urine is passed (for example, at night)
• changes in the appearance of urine, or blood in the urine
• puffiness of the legs and ankles
• pain in the kidney area
• tiredness and difficulty sleeping
• loss of appetite
• nausea and vomiting
• headaches and lack of concentration
• itching
• shortness of breath
• bad breath or a metallic taste in the mouth

A reduction in kidney filtration is common in older people, but it can also indicate kidney damage and should be checked by your doctor.

Risk factors#

You are more at risk of developing kidney disease if you:

• are over 60 years of age
• have diabetes
• are overweight or obese
• have high blood pressure
• have established heart problems (heart failure or a past heart attack) or have had a stroke
• are a smoker
• have a family history of kidney failure
• have a history of acute kidney injury

Some populations are also at higher risk and may benefit from earlier and more regular kidney checks.

Kidney disease and your heart#

Kidney problems can increase the risk of other conditions, including cardiovascular (heart and blood vessel) disease. People with chronic kidney disease are two to three times more likely to have a heart attack. Cardiovascular disease remains a leading cause of death for people on dialysis and those with a transplanted kidney. The risk rises at every stage of chronic kidney disease and is highest in the later stages.

Keeping your kidneys healthy#

There are several things you can do to protect your kidneys:

• Manage diabetes. If you have diabetes, aim for good blood sugar control and follow your doctor’s advice about medicines, diet, physical activity and monitoring your blood sugar.
• Control high blood pressure. Have your blood pressure checked regularly. Medicines that lower blood pressure, such as ACE inhibitors or angiotensin blockers, can slow the development of kidney disease.
• Have regular kidney health checks if you have any risk factors.
• Treat urinary tract infections promptly.
• Control blood cholesterol with diet and, if necessary, medication.
• Eat well. Drink plenty of water and choose foods that are low in sugar, fat and salt but high in fibre. Stick to moderate serving sizes.
• Stay at a healthy weight for your height and age, and exercise moderately for at least 30 minutes a day.
• Do not smoke, and limit alcohol.

Key points#

• Older people are more at risk of some kidney and urinary tract diseases.
• Diabetes and high blood pressure are among the most common causes of kidney disease.
• See a doctor if a kidney infection is suspected, because lasting damage can occur if it is left untreated.
• People may lose up to 90 per cent of their kidney function before getting any symptoms.
• Early detection and good management can increase the working life of your kidneys.

Where to get help#