Measures to Improve Kidney Function in Elderly

Introduction:

Kidney functions may deteriorate as age advances. It is attributed to many reasons which include both genetic and lifestyle factors. People above the age of 60 are at a higher risk of getting kidney disease. Other risk factors include diabetes, hypertension, smoking, and metabolic acidosis. Kidney disease can lower the quality of a person's life and may even be fatal in some cases.

What Are the Age-Related Changes in the Kidney?

• The amount of kidney tissue decreases.

• The number of nephrons (functional unit of the kidney) decreases.

• Blood vessels in the kidney may get hardened which slows down the filtration process.

• Decrease in glomerular filtration rate.

• Decrease in blood flow in the kidney.

What Are the Age-Related Diseases Associated With the Kidney?

Common kidney diseases in older people are;

1. Chronic Kidney Disease (CKD): CKD is a highly prevalent disease among older people. Diabetes and hypertension are considered the major causes of chronic kidney disease. Obesity, smoking, cardiovascular diseases, metabolic acidosis, are the other causes. The range of CKD extends from normal glomerular filtration rate (GFR) to kidney failure.

2. Polycystic Kidney Disease: It is an inherited condition where numerous cysts or fluid-filled sacs of various sizes are formed within the kidneys which eventually leads to the impairment of kidney function. Common symptoms are back pain, increased size of the abdomen, blood in urine, frequent kidney infections.

3. Kidney Stone: Kidney stone or renal calculi occurs due to the accumulation of crystals of minerals like calcium, oxalates, and uric acid. It is very common in older adults, especially males above the age of 75 years. The symptoms of kidney stones include pain and burning sensation while urinating, blood in urine, cloudy urine, lower back pain.

4. Glomerulonephritis: It is the inflammation of the glomerulus or tiny filters in the kidney. It can be caused due to bacterial infection, exposure to toxins, or other diseases like lupus, Wegener’s disease. In older people, it is caused mainly due to impaired immune systems. High blood pressure, edema, foamy urine, less frequent urination are common symptoms.

5. Acute Kidney Injury: It is the sudden stoppage of kidney function and occurs as a complication of other serious diseases. The main causes of acute kidney injury are lack of blood flow to the kidneys, infections, medications, and autoimmune diseases.

What Causes Kidney Diseases in the Elderly?

• Diabetes: Diabetes is the most common cause of kidney diseases in the elderly. Increased blood glucose levels can damage blood vessels and nephrons (functional unit of the kidney) in the kidney which leads to diabetic nephropathy. In some cases, diabetic nephropathy can progress to kidney failure.

• Urinary Tract Infections (UTI): If left untreated UTIs may cause kidney scarring, kidney stones, and eventually chronic kidney disease. However, urinary tract infections are treatable in most cases. But, an individual has to be cautious if UTI recurs frequently.

• Hypertension: The blood vessels in the kidney may get weaker or narrower due to hypertension. This affects the kidney’s ability to filter out the waste materials in the body.

• Smoking: Smoking can decrease the blood flow to the kidneys which may increase the risk of kidney dysfunction.

• Obesity: The pressure inside the glomerulus or tiny filters in the kidney gets increased in obesity which may give rise to chronic kidney disease.

What Are the Symptoms of Kidney Disease?

Most of the symptoms of kidney disease won't appear unless 90 % of the damage has occurred. Hence, kidney disease is a type of ‘silent disease’. Following are the common signs and symptoms of kidney diseases in the elderly;

• Blood in Urine: It is a very common symptom of many diseases like renal stones, glomerulonephritis, malignancies in the urinary tract. It presents commonly as pink or cola-colored urine.

• Foamy or Cloudy Urine: Urine may have excessive bubbles which makes it appear foamy or cloudy due to the excess presence of a protein called albumin.

• More Tired and Trouble Concentrating: As kidney disease reduces the filtration of waste materials, more toxins get accumulated in the blood which makes the person tired and difficult to concentrate.

• Difficulty in Sleeping: Due to the excessive amount of toxins in blood, the sleep of the person also gets affected.

• Decreased Appetite: This also occurs as a result of toxin accumulation in the blood.

• Puffiness in Feet and Ankles: Kidney disease increases sodium retention which leads to edema or swelling in feet and ankles.

• Muscle Cramps: Severe pain or cramping in muscles happens due to electrolyte imbalance.

Other common symptoms of kidney symptoms are;

• Changes in urination frequency.

• Halitosis or bad breath in the mouth.

• Metallic taste in my mouth.

• Puffiness around eyes.

• Lower back pain.

• Itching.

• Nausea and vomiting.

• Shortness of breath.

How to Treat Poor Kidney Functions in the Elderly?

As poor kidney function occurs due to different causes, it is important to treat the cause and then manage the symptoms. Even though there is no permanent cure for diseases like chronic kidney disease, its symptoms can be managed based on the stage of the disease. However, doctors may prescribe the following medications and methods to treat poor kidney functions in older people:

• Reducing Proteinuria: Increased protein can cause increased pressure inside the glomerulus. Hence, it is important to reduce protein in urine and it can be done through diabetic medication and weight management.

• Providing Additional Electrolytes: Electrolyte-infused water, sugarless coconut water, bananas, watermelon, avocados, fruit juice, can replenish electrolytes in the body.

• Intake of Iron Pills: Oral iron supplements are found to be beneficial for kidney patients with iron deficiency anemia.

• Intake of Vitamin D Supplements: Kidneys play a key role in converting vitamin D absorbed from food and sunlight into active vitamin D. So in the cases of kidney dysfunctions the levels of active vitamin D get reduced which requires additional supplementation of vitamin D.

• Medications: Following medications are prescribed in cases of poor kidney functioning.

1. Diuretics: Diuretics can help in urination and removes extra sodium and water from the body. Furosemide and Torsemide are commonly used diuretics for kidney disease

2. Angiotensin-Converting Enzyme (ACE) inhibitors: ACE inhibitors such as Captopril, Enalapril, and Fosinopril can improve blood flow in the kidney and increase sodium removal from the body.

3. Phosphate Binders: In kidney dysfunction, the amount of phosphorus filtered by the kidney gets reduced which leads to phosphorus accumulation that can weaken bones. Phosphate binders can remove excess phosphorus from the body.

4. Erythropoiesis Stimulating Agents: It is an injection that is used to treat anemia. It is beneficial for kidney patients who are anemic.

• Dialysis: It helps in removing excess waste accumulated due to kidney dysfunction and is indicated in kidney failure.

• Kidney Transplantation: It is a surgical procedure of replacing a damaged kidney with a healthy kidney from a donor. Kidney transplantation is indicated in the final stage of chronic kidney disease or renal failure and tumors in the kidney.

What Are the Measures to Improve Kidney Function in the Elderly?

1. Drink plenty of water.

2. Cut excess sugar and salt in food.

3. In the case of diabetes and hypertension, it is important to manage them with medications and a healthy lifestyle.

4. Limit the intake of alcohol and avoid smoking.

5. Maintain a healthy weight.

6. Exercise at least 30 minutes a day.

7. Get a urine and blood test every year.

Conclusion:

Kidney disease commonly affects people above 60 years. Due to various reasons, many people during old age experience impairment of kidney functions which may even end up in chronic and fatal kidney diseases. However, many treatment modalities have been developed to treat and manage kidney diseases. By following a healthy lifestyle and modifying risk factors, kidney diseases can be prevented during old age.