Most kidney disease starts after 65 – here’s how to help prevent it

Most of us don’t give much thought to our kidneys — until we have to. Chronic kidney disease (CKD) affects an estimated 35.5 million Americans, with older adults facing the highest risk. According to current estimates, people ages 65 and older account for 34% of total chronic kidney disease cases. And yet as many as 9 in 10 adults with CKD don’t even know they have it.¹

There are simple steps you can take to minimize your odds of developing kidney damage. And diagnosing CKD early makes it easier to treat, notes nephrologist George Hart, M.D., chief medical officer of Interwell Health, a kidney care management company. 

Understanding what causes CKD, how to prevent it and your treatment options are a good way to start protecting your health.

Your kidneys are fist-sized organs found behind the abdomen, just under the ribcage, on both sides of your spine. They perform several jobs, from helping regulate blood pressure, to contributing to bone health and of most vital importance: They reclaim solutes and clear waste products in regulating fluid volume and excrete excess fluid from your body as urine.²

CKD, also known as chronic kidney disease, is the gradual loss of kidney function over time. It develops when your kidneys become damaged and can no longer filter waste from your blood as well as they should. If left untreated, kidney disease can cause toxic electrolytes, waste and extra fluid to build up in the body. That may lead to high blood pressure, heart disease, stroke and early death.¹

Kidney disease tends to start later in life because it’s typically caused by health problems that have damaged your kidneys gradually over many years, says nephrologist Silas Norman, M.D., M.P.H., chair-elect of the American Kidney Fund board of trustees. 

Moreover, many of the health conditions that damage the kidneys generally appear later in life. Dr. Norman points to diabetes and high blood pressure (hypertension) as the leading culprits. In fact, the Centers for Disease Control and Prevention (CDC) estimates that approximately 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure may also have chronic kidney disease.³

However, kidney disease can also be caused by autoimmune diseases such as lupus, Dr. Norman says.²

According to the National Kidney Foundation, these are some signs you may have kidney disease:⁴

• You have low energy and are having trouble concentrating. A decrease in kidney function can lead to a buildup of toxins and impurities in the blood, contribute to anemia, all of which can cause you to feel tired and weak.
• You’re having trouble sleeping. When the kidneys aren’t filtering properly, toxins stay in the blood rather than leaving the body. This can make it difficult to sleep.
• You have dry and itchy skin. Kidneys maintain the right amount of minerals and nutrients in your blood. Dry and itchy skin can be a sign that the kidneys are no longer able to keep the proper balance.
• You feel the need to urinate more often. When the kidneys’ filters are damaged, it can cause an increase in the urge to urinate.
• There’s blood in your urine. When the kidneys’ filters are damaged, blood cells can start to appear in the urine.
• Your urine is foamy. Excessive bubbles in the urine — especially when you need to flush several times before they go away — indicate protein in the urine, which is a sign of kidney damage.
• Your ankles and feet are swollen. Decreased kidney function can lead to sodium retention, causing swelling in your feet and ankles.

Diet and lifestyle changes can help prevent kidney disease and slow its progression. Here are several tips from the CDC to keep your kidneys healthy:⁵

• Exercise. Physical activity can help you manage your weight, blood pressure and blood sugar, which can help prevent and control diabetes and high blood pressure. Managing and preventing chronic conditions can keep your whole body healthy, including your kidneys. So, aim to be active for at least 30 minutes per day, Dr. Norman says. Pick an activity you enjoy and add it to your calendar to help yourself stay on track. (Talk with your doctor before significantly increasing your activity level. Ask about the amounts and types of activities that may be best for you.)
• Manage chronic conditions. If you have diabetes, high blood pressure or heart disease, it’s important to follow your treatment plan closely to prevent kidney damage. This includes taking any medications as prescribed and keeping blood pressure, blood sugar and cholesterol levels within your target range. 
• Quit smoking. Cigarette smoking can worsen kidney disease and interfere with medication that lowers blood pressure. It also increases your chances of having a heart attack or stroke. Talk to your doctor about options for quitting. 
• Choose healthy foods. Making healthy food choices may help prevent kidney disease by improving blood pressure, heart disease and diabetes, Dr. Hart says. Opt for plenty of fruits, vegetables, low-fat dairy products, whole grains, fish, poultry, beans, seeds and nuts. “Your diet should also be low in sodium, added sugars, fat and red meat,” Dr. Hart adds. Aim for less than 2,300 milligrams of sodium per day.^6,7

To check for kidney disease, your doctor will take blood and urine tests to see how well your kidneys work. If tests reveal that you have kidney disease, your doctor will discuss treatment options.

There are a number of medications that can help limit kidney damage. “Some help lower blood pressure, protect the kidneys and slow progression of kidney disease,”⁷ says nephrologist Bassem Mikhael, M.D., M.B.A., senior vice president of clinical enterprise at Somatus, a kidney care company. “Other, newer, medications help manage blood sugar levels and have a protective effect on the kidneys over time,⁸ Dr. Mikhael says. Your doctor may also recommend a water pill (known as a diuretic) to help your body get rid of excess fluid.

By priortizing your kidney health, you may be able to avoid developing CKD. Go for regular check-ups and try to stay ahead of or manage any health conditions such as diabetes or high blood pressure. And most importantly, listen to your body: If you’re having symptoms, don’t ignore them. Talk to your doctor — because early detection is key.