Month: September 2015

What to Know About the Kidneys As We Get Older

Portrait of senior African American couple

Growing old is a compulsory process in life. As we age certain things weaken. The brain, our muscles, our joints age. Our kidneys get old too and their function reduces sometimes to a level that causes important problems requiring the attention of a doctor or kidney specialist.

As we get older, there are a number of changes that happen to our bodies that we can not avoid. Our memory weakens, our strength in our muscles and joints fall over time. Our energy levels reduce. The same thing happens to our kidneys too. The kidneys loose function as we age even though we might be healthy. This makes added problems such as high blood pressure, high blood sugar, heart problems, urine infections, taking medications at the wrong dose or wrong frequency problems we should avoid because they damage the kidneys even further and put our older people at high risk for kidney failure and premature death.

This post is meant to empower the older among us as well as to make family members of our older population more aware of the changes that happen in the kidney as we get older and the things that can be done to reduce additional damage to the kidney.

What happens to the kidneys as we get older?

As we age, the filtering units of the kidney called the glomeruli get scarred over and we loose some of the filtering units every year from the age of 40 or so. There is also a thickening of the blood vessels supplying the kidney leading to a reduction of blood flow to the kidney. Reducing filtering units and reduced blood flow to the kidney together lead to reductions in overall function of the kidney. In fact, approximately 2-3 our of every 10 elders over the age of 70 years old are believed to have only 60% or less of their kidney function left. In some clinical studies, it has been observed that about 1% of kidney function is lost every year we get older after the age of 40 years although it is not entirely clear if the loss of kidney function is due to age or diseases like high blood pressure, high blood sugar or other problems.

Why is it important to be aware of changes in kidney function as we age?

  • Kidney disease can progress faster if a new problem such as diabetes develops.
  • There are no proven treatments to stop or reverse age-related decreases in kidney function. Any treatment aimed at improving kidney function by causing the remaining functional kidney to work more may actually be harmful rather than beneficial to the kidney.
  • Increased risk for sudden kidney injury from even mild events such as dehydration or exposure to usual amounts of pain medication such as aspirin, naproxen, indocin, ibuprofen and other similar drugs.
  • Toxic accumulation of some medications that are cleared by the kidney may occur. Patients with disease or age-related decreases in kidney function may require medication dose adjustments. For example the dose of the drug may need to be reduced significantly or the frequency of the dosing reduced as well.
  • With the increase in number of living kidney donor transplants, we need to be aware that even healthy older people may not be appropriate candidates for kidney donation.

How are Nigerians aging, what are the most important causes of death and what has this information got to do with kidney disease?

Life expectancy refers to the average length of time people can expect to live. It provides summary information of the death rates and health of a nation, an area, or a group of people. In the last 100 years, the global average life expectancy has more than doubled but there remains marked difference between countries with the highest and lowest life expectancy (Japan 82.1 years versus Angola 38.2 years)

Overall, Nigerians rank 183rd in life expectancy among 194 countries based on 2013 WHO statistics. The life expectancy at birth for a Nigerian in 1960 was about 37 years. By 2013, this had risen appreciably to 52.5 years. Other analyses show that a 60 year old Nigerian person is expected to live till about the age of 75. This means that an increasing number of elders will have to contend with problems related to kidney disease simply by aging even if they do not have any known medical problems. The problems older people have with kidney disease may be accelerated however if they develop other medical conditions such as high blood pressure, high blood sugar or heart disease.

Pneumonia, HIV infection, stroke and heart disease are the leading causes of death in Nigeria. While kidney disease is not a top cause of death, about 20,000 people were estimated to have died from kidney disease in 2013- greater than all the people that died from Asthma and appendicitis combined.

Therefore, as Nigerians get older, more people will have kidney problems to pay attention to and these kidney problems can become a real and large cause of expense, suffering and death. In support of these statements, In many parts of the world, the fastest growing population of patients on dialysis or getting a transplant due to kidney failure are patients over the age of 65 years.



The death rate per 100,000 deaths in Nigeria due to kidney disease is estimated at about 17.4. Nigeria ranks 58th in the world in death rates due to kidney disease. Worse than Ukraine with the lowest death rates due to kidney disease in the world by 2013 WHO data. South Africa ranks 11th in the world with a higher death rate per 100,000 due to kidney disease of 26.6

Thanks for reading this short post. Share the information you learn with others and if you have any questions feel free to ask them in the form below


Frequently asked questions about kidney disease

Based on popular demand, we have compiled answers to many common questions asked by patients and their families about kidney disease.

Enjoy the read. If you have a question that is not answered here, send us a message and we will be happy to provide some answers that might help you.


What do kidneys look like and where are they located in the body?

The kidneys in an adult are about the size of a closed hand. Most people have 2 of kidneys and a few people are born with one kidney. The kidneys are located in the belly region close to the back and each kidney is connected by a tube called the ureter to the bladder.

What is the function of the kidney?

The main purpose of the kidneys is to separate urea, mineral salts, toxins, and other waste products from the blood. In addition, the kidneys also control blood pressure, conserve water, salts, and electrolytes and produce the signals for the body to make blood. Simply put, the kidneys filter the bloodstream in order to get many toxins out of your body, and also regulate body fluids and blood content. The waste and toxins removed by the kidneys pass out of the body eventually in the urine.

What is kidney disease?

Kidney disease is also called renal disease. This is a condition where the functions of the kidney are lost. This can happen either suddenly or very slowly over time depending on the cause. Kidney disease is often irreversible and worsens over time but at times, kidney disease can be reversible or remain stable for long periods of time. Kidney disease has to be identified early or it might be too late to reverse and stop from progressing to complete loss of kidney function.


Myth No 1 – Kidney disease is rare. Answer- False. As many as half of people between age 30-49 could develop kidney disease in their lifetime.

Myth 2: You will know if you have kidney disease. Answer- False. By the time you have symptoms you have lost over 80% of kidney function.

Myth 3: Tests for kidney disease take a long time & are costly. Answer- No. Tests need a small sample of blood & urine and are inexpensive. The results can be available within 24 hours

Myth 4: There is nothing you can do to avoid kidney disease. Answer- false. Healthy living & regular checkups could prevent kidney disease.

Myth 5: The cause of kidney disease is unknown. Answer-False. High blood pressure, diabetes, expired drugs & traditional herbal concoctions can cause kidney disease

Myth 6: The only treatment for kidney disease is dialysis. Answer- False. Not all cases of kidney disease need dialysis.


What are the tests for kidney disease?

There are a number of simple tests for kidney disease. The most important tests involve tests of small amounts of blood and the urine that help the doctor know if there is a problem and how severe the problem may be. Depending on what the results of these tests are, the doctor may recommend additional tests of the kidney such as taking special pictures by x-ray, by ultrasound or even by CT scan or MRI. These pictures can tell if there is any abnormality of the kidney such as a kidney stone, a cyst or some cancer involving the kidney. Before doing any tests of the kidney or its function, talk to your doctor first. Get a yearly checkup and tests if you are-

1) A personal or family history of kidney disease, 2) Over the age of 40 years, 3) A person with a history of high blood pressure or high blood sugar


What are the causes of kidney disease?

The most common causes of kidney disease and kidney failure in African settings are diabetes, hypertension, toxins from herbal medicines or expired medications or infectious diseases ranging from bacteria to viruses such as HIV, Hepatitis B and Hepatitis C. Some kidney diseases may be inherited and run in families. One of the most common of these inherited kidney diseases is polycystic kidney disease. Kidney disease can also be caused by cancers of the kidney tissue. Kidney stones if large enough to cause obstruction to the flow of urine or complicated by infection can also cause kidney disease.

How do I know if I have kidney disease?

Kidney disease can sometimes progress to an advanced and concerning stage with only mild symptoms or it may develop without you developing significant symptoms. If your kidney disease progresses, you will eventually develop symptoms and signs that include tiredness, loss of appetite, difficulty thinking, difficulty  sleeping, breathing problems, muscle pain and muscle cramps, swelling of legs or eyes and dry itchy skin. You are at increased risk for kidney disease if you are black, have high blood pressure, diabetes, a family member with kidney disease or are older.

How do I prevent progression of kidney disease?

You can reduce the risk of developing kidney disease or having progressive kidney disease by:

  • Eating a healthy balanced diet
  • Getting regular exercise (at least 3 times a week)
  • Avoiding becoming  overweight
  • Having regular checkups with your doctor to check for common causes of kidney disease such as high blood pressure and high blood sugar. If you are found to have any of these problems you must religiously and properly take the medications prescribed to treat these conditions
  • Avoiding ingestion of unknown herbal medications and expired drugs
  • Quick treatment of infections
  • Avoiding excess alcohol and tobacco.

My doctor told me I have kidney failure. What does that mean?

Kidney failure occurs when there is loss of most (90% or more) kidney function. Failure can occur suddenly or slowly and may last only a short time or be permanent depending on the cause and the severity of kidney injury. If kidney failure is severe and prolonged, it is often associated with problems like severe lack of energy, leg and eye swelling, difficulty breathing, confusion, difficulty sleeping, itching and depression. At this point your doctor may prescribe dialysis treatment or recommend kidney transplantation for you to support your bodily function while he or she continues to search for and/or treat the cause of the kidney problem.

Is kidney failure or kidney disease reversible?

Kidney disease or failure MAY  be reversible depending on the cause, severity and duration. When the kidney damage has been severe and prolonged, kidney disease is not reversible and often leads to kidney failure that requires transplantation or life long dialysis to support life. Very often, your doctor needs some time and repeated testing to know if the kidney problem is reversible

What medications are needed to treat patients with kidney disease or kidney failure?

Patients with kidney disease or failure may need to be on medications for controlling their blood pressure and on medicine like iron and erythropoietin for increasing their blood levels because of low blood levels caused by kidney disease. To avoid the need for blood transfusions, your kidney doctors will prescribe erythropoietin (also called EPO) and iron to help build up your blood levels. Patients with kidney disease also develop problems with their bones that require special treatments including regular dialysis treatments if they choose dialysis over transplantation. If your kidney failure has been treated by kidney transplantation, you must take your medication carefully and continually to prevent rejection.

What are the treatment options for kidney failure?

The major treatments for kidney failure are Kidney Transplantation and Dialysis.

Kidney Transplantation is a procedure where a kidney from another person is put into you to restore your kidney function. Kidney transplantation has been successfully performed around the world for over 50 years. You will need testing and treatments to determine if you are a candidate for kidney transplantation.  If you are then considered a candidate for transplant, you will need a kidney donor. This donation can be from a person who has recently died or from a living person that does not have to be related to you. In Nigeria at the moment, donation is only possible from a living donor. The potential donor will have to be tested to ensure they are free of kidney or other disease and can withstand the surgery for donation. After successful transplant surgery, you will need to be on powerful medication to prevent rejection of the donated kidney and will need to frequently follow up with your kidney transplant doctors. To learn more about kidney transplantation in Nigeria, visit our blog post by clicking here.

If you are not a candidate for kidney transplantation or do not wish to get a transplant, Dialysis is an option for you.

What is dialysis?

Dialysis is a medical procedure that has been provided safely and successfully to patients for over 70 years. There are 2 main kinds of dialysis- hemodialysis and peritoneal dialysis. The most common type of dialysis is hemodialysis delivered through a blood vessel in your arm, neck or  but a number of patients can be managed on peritoneal dialysis. Peritoneal dialysis is delivered through a tube placed in your belly. Ask your doctor on what options are available best for you.

Hemodialysis is done at a dialysis center or at home. People can live long normal lives if they get enough dialysis. You need this kind of dialysis at least 3 times a week if your kidney failure is not reversible or you can not get a kidney transplant

Peritoneal dialysis is another form of dialysis. You perform this kind of dialysis every day which you can do at home. A special tube is placed in your belly and through this tube a special solution is placed to help draw out all the toxins in your system. You drain after some hours.

What about kidney transplantation?

Kidney transplantation is the best option for patients with end stage kidney failure. Not all patients can be safely transplanted. Kidney transplant requires a serious involvement by the patient, their family and friends. It also requires a smart kidney specialist that knows how to care for such patients. Not all kidney doctors know how to care for transplant patients. To learn more about getting a successful kidney transplant, visit our blog at

How do I prepare for dialysis?

When your doctor determines that you will need dialysis, you should ask questions regarding when such treatments will start, what schedule you will be on, how long you may need to be on dialysis and what types of dialysis options are available to you. You may be on dialysis for a short time, a long time or for the rest of your life if you can not get a kidney transplant. It might take some time before your doctor knows if you will be on dialysis for a long time or not. You should inform your close family and friends if they do not know already as you will need their support to be successful on dialysis. You may also need to inform your employer so that arrangements for time off  and any financial support can be arranged. In order to be successful on dialysis you will need what is called an access. For hemodialysis, access can be in the form of a catheter placed in the neck, chest, arm, forearm or upper thigh. A safer and more reliable access is in the form of a fistula or graft. A fistula is made by a doctor during a surgical operation and is made by connecting your own vein to your own artery. A graft is a type of access also made by a doctor during a surgical operation but in this case, an artificial tubing is placed usually in your forearm or arm. For peritoneal dialysis, the access is in the form of a tubing placed in your belly through which the dialysis will be performed.

What is life like on dialysis?

When you initially start dialysis, you will feel ill, tired, with a poor appetite and depressed. You may also notice other symptoms of kidney disease or kidney failure mentioned above like tiredness, vomiting, loss of apettite, leg or eye swelling, difficulty breathing, itching of the skin and maybe chest pain. You will need to visit the doctor very often at least initially. Over time and if you get enough dialysis, you will begin to feel better and many patients can return to their life before dialysis if they get enough dialysis. Many patients that get enough dialysis and follow all other instructions from their doctor and dialysis nurse will be able to return to work and lead productive lives. Getting enough dialysis is very important and the truth is that once or twice a week dialysis is often not enough to truly return you to a high level of function. To get the best out of dialysis, the ideal number of treatments is 3 times a week. You will be prescribed some medications as mentioned above to help control your blood pressure and improve your blood levels. You will need to have frequent lab tests to determine if you are getting enough dialysis and sometimes you may need to receive a blood transfusion. Try not to miss dialysis appointments, take the medications prescribed and follow other instructions your healthcare team will advice you to follow. There will be good days and some bad days on dialysis. Anytime you are having a bad day, do not hesitate to contact your doctor or dialysis nurse and tell them how you feel so they can figure out how best to help you.