Chronic Kidney Disease in Older Adults
Plain-language information about chronic kidney disease (CKD) in older adults. This page is for older Canadians and their caregivers. It does not replace advice from your own health-care provider.
1. What is chronic kidney disease?
Chronic kidney disease (CKD) means your kidneys are not working as well as they used to over a period of months or years.
What healthy kidneys do
Remove waste and extra fluid from the blood
Help regulate your blood pressure levels
Help keep bones and blood chemistry balanced
With CKD, waste and fluid can slowly build up in the body. You may feel more tired, have swelling, or notice changes in urine over time.
Did you know?
In early stages, many people have no symptoms and only find out from blood and urine tests. This is why regular check-ups are important.
2. Why chronic kidney disease matters more in older adults
CKD is more common in older adults and often occurs together with:
In older adults, CKD can:
- Make people more sensitive to many medications
- Increase the risk of side effects from common drugs (pain medicines, some diabetes or blood pressure pills)
- Worsen quickly if there is dehydration, infection, or certain medication use
- Increase the risk of anemia (low blood count), bone problems, and heart disease
Regular monitoring
Because of these risks, kidney function often needs regular monitoring in older adults through blood and urine tests.
3. How doctors usually treat chronic kidney disease
Health-care providers often consider:
- The stage of kidney disease (based on blood tests such as eGFR and urine tests)
- The cause (such as diabetes, high blood pressure, or another kidney disease)
- Other conditions (heart disease, anemia, bone problems)
- All medications you are taking
Treatment usually includes:
Blood pressure & blood sugar control
Avoiding harmful medications & contrast dyes
Safe doses for your kidney function
Food, fluids, blood pressure, not smoking
In advanced stages
Planning for possible dialysis or other supportive care may be discussed, depending on age, overall health, and your personal goals. This website does not tell you whether you need dialysis – only your kidney specialist (nephrologist) or primary provider can decide that with you.
4. Common medicines in older adults with kidney disease
Health-care providers may:
Blood pressure medicines (ACE inhibitors or ARBs)
Used to protect the kidneys and heart
Adjusted diabetes medications
Changed to be safer for lower kidney function
Anemia treatments
If blood counts are low due to kidney disease
Bone health medicines
To protect bones affected by kidney disease
Medications to avoid or limit
NSAIDs (such as ibuprofen, naproxen, Advil, Aleve) can harm kidneys. Always ask your provider before taking these.
Important reminder
Many drugs need dose adjustments in CKD, including some antibiotics, pain medicines, heart medicines, and others. Always tell every health-care provider and pharmacist that you have kidney disease and ask if new medications are safe for your kidneys.
5. Possible side effects older adults may notice
Things to watch for and report include:
Sudden changes
If you notice sudden changes, especially in how much you are urinating or in swelling or breathing, contact your provider promptly.
Do not stop medications
Do not stop or change your medications on your own. Some medicines help protect the kidneys and heart even when numbers look worse at first. Only your provider can interpret your tests.
6. Habits and lifestyle that may help
Many kidney and heart guidelines suggest that certain daily habits may help support kidney health along with medical care. What is safe and realistic is different for each person and each stage of CKD.
Food and drink
Your provider may suggest:
- Limiting salt (sodium) to help control blood pressure and reduce swelling
- Choosing fewer very salty processed foods (many canned soups, deli meats, packaged snacks)
- Choosing fresh or lightly processed foods more often when possible
In more advanced CKD, you may also need to adjust:
- Protein intake – too much or too little can be an issue, depending on stage
- Potassium – found in bananas, oranges, potatoes, tomatoes
- Phosphorus – found in dairy, nuts, processed foods
A renal dietitian can provide specific advice tailored to your lab results, stage of kidney disease, and other conditions.
Fluids
- Some people with CKD need to limit how much fluid they drink; others do not
- Recommendations depend on your stage of CKD, heart function, and swelling
Never change your fluid intake sharply without checking what is safe for your kidneys and heart.
Medications and over-the-counter products
Use caution with:
Ibuprofen, naproxen, Advil, Aleve – ask provider first
May strain the kidneys – check with pharmacist
Some can be harmful – ask before taking
Always ask first
Always ask your doctor, nurse practitioner, or another health professional what food, fluid, and medication changes are safe for you. Do not make major changes without checking first.
7. When to call your doctor, nurse practitioner, or pharmacist
(Non-urgent)
Contact your health-care provider or pharmacist if:
- You notice more swelling, especially in your legs, ankles, or around your eyes
- You are more short of breath with your usual activities
- Your urination pattern changes significantly (much more or much less than usual)
- You are starting a new prescription or over-the-counter medicine and are not sure if it is safe
- You are unsure how much fluid or what foods are safe for you at your stage of CKD
8. When to call 911 or go to the emergency department
Call 911 immediately if:
- You have severe shortness of breath, especially if it started suddenly
- You have chest pain or pressure that does not go away
- You notice no urine output for many hours and feel unwell
- You have severe confusion, extreme drowsiness, or are difficult to wake
If possible, do not drive yourself. Ask someone to call for you or call an ambulance.
9. Questions to ask your doctor or nurse practitioner
You can print these questions and bring them to your next appointment: