Understanding Kidney Disease: Signs, Symptoms, and Treatment

Kidneys quietly support nearly every system in the body, filtering blood, balancing fluids and minerals, activating vitamin D, and helping control blood pressure. When they are damaged, waste and fluid can build up, blood pressure may rise, and other organs are affected. Because early kidney damage is often silent, understanding the basics can help with earlier testing, timely treatment, and better long-term health.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What is kidney disease?

Kidney disease refers to a loss of kidney function or structural damage that persists over time. It comes in two main forms: acute kidney injury (AKI), which develops suddenly and may be reversible, and chronic kidney disease (CKD), which progresses over months to years. CKD is typically defined by a reduced estimated glomerular filtration rate (eGFR) and/or signs of kidney damage such as albumin (protein) in the urine persisting for at least three months.

Common causes include diabetes, high blood pressure, glomerular diseases, genetic conditions such as polycystic kidney disease, autoimmune disorders, certain infections, and long-term use of some medications that can affect kidney blood flow. CKD is often staged from 1 to 5, based on eGFR and the level of albuminuria. Early stages may have no noticeable symptoms but still carry increased risk for cardiovascular disease and progression if not addressed.

Testing usually involves blood work to measure creatinine and calculate eGFR, urine tests to detect protein and assess kidney damage, blood pressure measurement, and sometimes imaging to evaluate structure and size. Regular monitoring helps track stability, improvement, or progression.

Kidney disease in seniors

Kidney function naturally declines with age, making CKD more common in older adults. Seniors are also more likely to have diabetes, hypertension, and cardiovascular conditions that affect renal health. Age-related changes in body composition and blood vessels, along with multiple medications, can increase vulnerability to kidney stress and side effects.

Care in older adults often focuses on balancing benefits and risks. Treatment choices may prioritize quality of life, symptom control, and preserving independence. Medication doses frequently require adjustment for kidney function. Some older adults may choose conservative kidney management without dialysis if overall health status or personal goals make intensive treatments less suitable. Regular discussions with healthcare teams help align care plans with individual preferences and evolving health needs.

Signs and symptoms of kidney disease

Early CKD commonly has few or no symptoms. As function declines, people may notice fatigue, swelling in the ankles or around the eyes, muscle cramps, trouble concentrating, decreased appetite, nausea, itchy or dry skin, and changes in urination such as foamy urine (a sign of protein), blood in urine, or needing to urinate more often at night. High blood pressure, shortness of breath from fluid retention, and persistent back or flank discomfort can also occur.

Because these symptoms are nonspecific and can overlap with other conditions, testing is essential for clarity. Lab results that raise concern include a persistent decline in eGFR, elevated creatinine, and repeat urine tests showing albumin. People with diabetes, hypertension, heart disease, a family history of kidney problems, or a history of urinary tract issues benefit from regular screening.

Managing chronic kidney disease

Management aims to slow progression, reduce complications, and support overall well-being. Lifestyle steps include controlling blood pressure, managing blood sugar in diabetes, achieving a healthy weight, staying physically active, quitting smoking, limiting salt, and moderating alcohol intake. Hydration needs vary; in many cases, drinking to thirst is reasonable unless a clinician advises a specific fluid goal.

Medications are often central to care. Blood pressure control is typically targeted using agents such as ACE inhibitors or ARBs, which can also help reduce protein loss in urine. In people with diabetes and CKD, certain glucose-lowering medications (including SGLT2 inhibitors) have shown kidney-protective benefits. Statins may be used to address cardiovascular risk. Depending on lab trends, clinicians may treat complications such as anemia (iron and other therapies), mineral and bone changes (vitamin D analogs, phosphate management), and metabolic acidosis.

Nutrition guidance can be highly individualized. Many people with CKD are advised to moderate sodium and, in some cases, protein intake. A registered dietitian can tailor plans for calorie and protein needs, phosphorus and potassium limits when indicated, and cultural or personal food preferences. Avoiding routine use of non-steroidal anti-inflammatory drugs (NSAIDs) and reviewing all over-the-counter supplements with a clinician can reduce kidney stress.

Planning for advanced CKD includes learning about kidney replacement therapies and supportive options. Dialysis (hemodialysis or peritoneal dialysis) and kidney transplantation are possible pathways for some. Others may opt for conservative kidney management focused on symptom relief, medication optimization, and supportive care. Early education helps individuals and families understand choices, timelines, and practical considerations, including home support and travel.

Monitoring schedules depend on stage and stability. Periodic checks of kidney function, electrolytes, urine protein, and blood pressure guide adjustments. Vaccinations, including protection against influenza, pneumonia, and hepatitis B where appropriate, may be part of preventive care plans. Coordinated follow-up with primary care, endocrinology, cardiology, and nephrology improves consistency and reduces medication conflicts.

Putting it together

Kidney disease ranges from silent early changes to advanced stages affecting daily life. Awareness of risk factors, timely testing, and attention to blood pressure, blood sugar, and lifestyle can slow decline and limit complications. For older adults, individualized goals, careful medication review, and shared decision-making are especially important. With regular monitoring and informed choices, many people living with kidney disease maintain function, comfort, and independence over the long term.