Chronic kidney disease (CKD) means that your kidneys are diseased or damaged in some way, or are ageing and not working as well as they once did. Severity can vary but most cases are mild or moderate, often occur in older people, do not cause symptoms and generally do not progress to kidney failure. Although about half of people aged 75 or more have some degree of CKD, most of these people do not actually have diseases of their kidneys; they have normal ageing of their kidneys. People with any stage of CKD have an increased risk of developing heart disease or a stroke. It is important to detect even mild CKD, as treatment may not only slow down the progression of the disease, but also reduce the risk of developing heart disease or stroke.(1) A routine blood test is commonly done to detect kidney disease and monitor people with conditions that can affect the kidneys, such as diabetes or high blood pressure.
There is an age-related decline in kidney function; however, not all individuals will develop chronic kidney disease (CKD) with advancing age. Those who are genetically predisposed and exposed to lifetime cardiovascular risk factors are likely to develop systemic atherosclerosis and CKD. (1)
Why is it Important?
70.9% of people with CKD have hypertension compared with 20.1% of people without CKD (1)
About 1 in 10 people have some degree of CKD and it is more common in women (2)
CKD contributes to poor health through its association with inflammation and oxidative stress (1)
Malnutrition, weight loss and sarcopenia are common in CKD patients, leading to poor outcomes, such as physical and cognitive dysfunction, manifesting as major geriatric syndromes (1)
Frailty is likely to be one of the underlying processes that leads to the clinical manifestations of geriatric syndromes in patients with CKD (1)
Functional outcomes, such as cognition and physical functioning, are more relevant outcomes to older patients with CKD (1)
Renal function declines physiologically with advancing age and pathologically as a result of associated diabetes mellitus and hypertension (1)
Although about half of people aged 75 or more have some degree of CKD, most of these people do not actually have diseases of their kidneys; they have normal ageing of their kidneys (2)
Interventions should be developed and assessed in terms of maintaining quality rather than quantity of life in order to prevent disability (1)
Investigations to exclude treatable kidney disease (e.g. urinary tract infection or obstruction) (2)
Reduce progression of kidney disease (by controlling BP to recommended levels with ACEI or ARB therapy) (2)
Reduce cardiovascular risk, avoidance of nephrotoxic medications and volume depletion, Lipid-lowering treatment, glycemic control (2)
Early detection and management of CKD complications by: avoid renally-excreted medications; adjust medication doses for kidney function and appropriate referral to a nephrologist where indicated (2)
1. Abdelhafiz, A., Ahmed, S., El Nahas, M. & Flint, K. (2011). Is chronic kidney disease in older people a new geriatric giant? Aging Health, October 2011, Vol. 7, No. 5, Pages 749-762. Retrieved March 10, 2014 from: http://www.medscape.com/viewarticle/753447
The Kidney Foundation of Canada is the national volunteer organization committed to reducing the burden of kidney disease by providing funding and stimulating innovative research, providing education and support, promoting access to high quality healthcare, and increasing public awareness and commitment to advancing kidney health and organ donation.
This manual (available in English, French, Chinese, Italian, Punjabi) reviews how the kidneys work, the causes and symptoms of kidney disease and the ways different kidney diseases are treated. It also looks at how kidney diseases may affect diet, emotional and physical health, family and social life. It explores issues related to work life, as well as provides information about finances, legal issues, the roles of the health care team and the services available through The Kidney Foundation of Canada. 168 Pages.
This best practice guideline provides practice, education, organization & policy recommendations, as well as research gaps and future implications for chronic kidney disease. Nurses, other health care professionals and administrators who are leading and facilitating practice changes will find this document valuable for the development of policies, procedures, protocols, educational programs, assessment and documentation tools, etc. 83 Pages