Kidneys - age-related problems

Your kidneys can be affected or damaged by a variety of diseases and conditions. As you get older, you are more likely to suffer from kidney and urinary tract problems. Kidney problems can also increase the risk of other conditions such as cardiovascular (heart and blood vessel) disease.

Kidney diseases can be serious, but early detection and good management can increase the life of your kidneys.

Kidney disease is not always accompanied by warning signs. If you have one of the 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.

Types of age-related kidney disease

Older people are more at risk of some kidney and urinary tract diseases. These include:

• inflammation or swelling of the kidneys – this can be caused by conditions such as glomerulonephritis
• diabetes – this is the most common cause of kidney disease in Australia. Damage can occur to blood vessels and nerves, even when the diabetes is well managed
• urinary tract infections – if left untreated, a urinary tract infection may spread into 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. Urinary tract infections are very common, particularly in women and with increasing age
• urinary incontinence – this is uncontrolled leaking of urine from the bladder, which can increase the risk of urinary tract infections. Your doctor should check any problems linked to passing urine, as they may indicate more serious kidney problems or other conditions, such as an enlarged prostate in men
• renovascular disease – fatty deposits, cholesterol, calcium and other substances are deposited in the inner lining of the arteries, causing narrowing or blockage of the renal artery. This affects the kidneys’ filters and reduces the blood supply to the kidneys, resulting in high blood pressure and reduced kidney function. This is the most common cause of kidney failure in the elderly
• high blood pressure – if left untreated, high blood pressure can increase the risk of heart attack, stroke and loss of vision, and cause kidney damage
• hereditary kidney diseases – including polycystic kidney disease.

Scarring of the kidneys mainly affects young children and is caused by a condition called ‘urinary reflux’. In this condition, there is a backflow of urine from the bladder into the kidneys.

Symptoms of kidney disease

Kidney disease is called a ‘silent disease’ as there are often no warning signs. People may lose up to 90 per cent of their kidney function before getting any symptoms. The first signs of kidney disease may be general and can include:

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

Risk factors for age-related kidney disease

Some conditions that affect the kidneys and urinary tract are more common as people get older. You are more at risk of developing kidney disease if you:

• are over 60 years of age
• have diabetes
• are obese
• have high blood pressure
• have established heart problems (heart failure or 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
• are of Aboriginal or Torres Strait Islander origin and 18 years and older.

Age-related kidney disease can affect your heart

People with chronic kidney disease are two to three times more likely to have a heart attack, and cardiovascular disease remains the leading cause of death for people on dialysis and those who have a transplanted kidney.

People at every stage of chronic kidney disease are at more risk of cardiovascular disease, although those in the later stages have the highest risk.

Keeping your kidneys healthy

There are a number of things you can do to keep your kidneys healthy, including:

• If you have diabetes, make sure that your blood sugar control is excellent. Follow your doctor’s advice about insulin injections, medicines, diet, physical activity and monitoring your blood sugar.
• Control high blood pressure. Have your blood pressure checked regularly. Medications used to lower blood pressure (anti-hypertensive medications), such as ACE inhibitors or angiotensin blockers, can slow the development of kidney disease.
• If you have one of the risk factors for kidney disease, have a kidney health check (blood test, urine test and blood pressure check) at least every two years (every year if you have diabetes or high blood pressure).
• Treat urinary tract infections immediately.
• Control blood cholesterol levels with diet and medications if necessary.
• Drink plenty of water and choose foods that are low in sugar, fat and salt, but high in fibre. Stick to moderate serving sizes.
• Do not smoke.
• Drink alcohol in moderation only.
• Stay at a healthy weight for your height and age.
• Try to exercise moderately for at least 30 minutes a day.

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

Where to get help

• Your GP (doctor)
• Kidney Health Australia helpline Tel. 1800 454 363
• Kidney Health Australia - Keeping your kidneys healthy factsheet