Kidney disease can be difficult to notice, especially in older adults. It often develops slowly, and many people do not feel sick until their kidneys have already lost a significant amount of their ability to work.
The kidneys are two small organs that perform several important jobs. They remove waste and extra water from the blood, help control blood pressure, balance important minerals, and make hormones that support red blood cell production and bone health.
Kidney function naturally tends to decline with age, but aging alone does not always mean a person has kidney disease. Chronic kidney disease, or CKD, happens when the kidneys are damaged or do not work properly for at least several months.
High blood pressure and diabetes are two major causes of CKD. Both conditions can slowly damage the tiny blood vessels inside the kidneys, making it harder for these organs to clean the blood properly.
One possible warning sign is a change in urination. A person may need to urinate more often, especially during the night, or may notice that they are producing less urine than usual.
Urine may also look unusually foamy or bubbly. Persistent foam can sometimes happen when the kidneys allow too much protein to escape into the urine, while blood in the urine can also be a sign that needs medical attention.
Swelling is another possible warning sign. When damaged kidneys cannot remove enough salt and fluid, extra fluid may collect in the legs, ankles, feet, hands or around the eyes.
Unusual tiredness and weakness may also occur. Healthy kidneys help the body make red blood cells, so advanced kidney disease can contribute to anemia, a condition that reduces the amount of oxygen carried around the body.
Some people develop poor appetite, nausea or vomiting as kidney disease becomes more severe. Waste products that would normally leave the body can build up in the blood, making food less appealing and sometimes changing the way it tastes.
Sleep can also become more difficult. People with kidney disease may experience itching, restless legs or other problems that make it harder to get comfortable and sleep through the night.
Dry and itchy skin can sometimes be linked to kidney problems as well. The kidneys help keep minerals and other substances in the blood balanced, and severe kidney disease can disturb this balance.
In more advanced cases, a buildup of waste in the blood may affect concentration and mental alertness. An older person may have trouble thinking clearly or become unusually confused, although these symptoms have many other possible causes and should always be medically assessed.
The difficult part is that none of these symptoms proves that someone has kidney disease. Swelling, tiredness, sleep problems and changes in urination can be caused by many other conditions, and early CKD often causes no symptoms at all.
That is why testing is so important, particularly for people with diabetes, high blood pressure, heart disease or other risk factors. Doctors can use a blood test to estimate how well the kidneys are filtering blood and a urine test to look for protein or other signs of kidney damage.
Finding CKD early can give people more time to protect their remaining kidney function. Treatment may include controlling blood pressure and diabetes, reducing salt, staying active, stopping smoking when relevant, and taking medicines prescribed to protect the kidneys.
Older adults should not assume that new changes in energy, urination or swelling are simply part of getting older. Checking these symptoms with a doctor can help identify kidney disease or another health problem before it becomes more serious.
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