Our Aging Kidneys

2017-09-08 23:00:59 Patty Shirley

Most of us have two kidneys, but some individuals only have one, for various reasons.  Amazing to think that our kidneys function day in and day out, with us having little awareness of them or their function, typically.  Our kidneys are part of a system which includes our urethra, ureters and bladder called the renal system or urinary system.  Our kidneys are bean-shaped organs, regulating fluid balance, electrolytes and organic substances in our bodies, acting as a filter for our bodies through the excretion of urine.  This system allows our bodies to reabsorb needed substances such as red blood cells and protein and rid itself of waste materials.

But the culmination of a number of factors contribute to the functionality or dysfunction of this vital organ, as we age.  The amount of punishment we have inflicted upon our kidneys throughout our lifetime or the familial genetic makeup, meaning the kidneys that our parents birthed us with, contribute a great deal toward the health or demise of our kidneys.  And without proper care and awareness of reducing risk factors, especially as we age, our kidneys can become infected, can lead to acute or chronic kidney infections, causing permanent damage and potentially leading to kidney failure or sepsis, a potentially life-threatening bloodstream infection.

Our kidneys function most efficiently when fully hydrated from an abundant water supply.  But as we age, our thirst sensation can be altered and we no longer feel thirsty or recognize the need to drink water to hydrate ourselves, thus leading to dehydration.  A number of other factors should be considered when looking at dehydration, including the consumption of various other beverages, including coffee, highly sweetened beverages or alcohol, none of which provide the adequate hydration our bodies need.  Without the proper degree of hydration or because of build-up of excessive amounts of salt or toxic substances that need to be eliminated, our bodies will temporarily economize on water, producing a more concentrated urine.  This can place greater stress on our kidneys.  Dehydration, kidney stones and kidney infections can also lead to flank pain, a discomfort in the upper abdomen or back and sides that can become severe if the condition causing the pain isn’t treated.  Dehydration and poor kidney function can also lead to constipation in the older population, being another factor that can lead to complications in good health for a myriad of reasons.  Dehydration can also lead to weakness, and cognitive impairment such as delirium or what is referred to as an acute confusional mental state.  This confused state can be due to fluid and electrolyte imbalance, infection, kidney dysfunction or the interaction of multiple medications.

Many individuals of our current older adult population thoroughly indulged the 1960s and '70s in the use of substances.  For some, this trait has continued into the late stages of their lives.  Often their drugs of choice have turned from illicit or experimental drugs to alcohol or prescription pills, at times obtained through their primary care physicians.  And yet some will continue throughout their lifespan using illicit substances.  This continued substance abuse and the addictive traits are one of our nation’s fastest growing health problems, which often goes unidentified, undiagnosed and untreated.  Many in the health care field are turning a blind eye to the fact that the older adult population can be substance users or abusers, which is ageism.  Is it hard to imagine a granddad or grandma perpetuating in their alcohol, meth, cocaine, oxycontin or marijuana use later in life?  It’s currently happening more than our society wants to admit or notice and is complicating the ability to provide health care to this older generation.

As our bodies age, how our medications, substances and alcohol are metabolized and digested can change drastically, often leading to unwanted results.  Substance and alcohol use also contribute to diminished rational thinking, sensory decline and cognitive decline, with individuals under- or over-dosing on multiple medications, potentially leading to multi-drug interactions and a toxic cocktail.

Substance use and alcohol consumption also can contribute to poor nutrition and other factors potentially leading to malnutrition.  Deficiencies of vitamin D in the diet, due to limited sources of vitamin D in older adult’s diets, less exposure to the sun, decreased ability to synthesize vitamin D through their skin and a decreased capacity of the kidneys to convert vitamin D into its active form, has been shown to lead to neurological and other chronic conditions such as osteoporosis.  Alcohol consumption can also lead to dehydration and low blood glucose levels often referred to as low blood sugar.  Low blood sugar can interfere with the liver’s ability to release stored glucose into the bloodstream.  Signs of low blood sugar often appear as weakness, lightheadedness, dizziness, nervousness, anxiety, or irritability, lack of coordination, chills, clammy skin, and sweating but these warning signs aren’t often as prevalent in an older adult.  A sign of low blood sugar often missed in an older adult, is an increase in appetite.  This increase in appetite can be a potential warning sign that something is amiss with the kidneys or renal system such as an urinary tract infection (UTI).

Older adults are more susceptible to UTIs for various reasons such as weakening of the muscles of the bladder and pelvic floor.  Signs of a UTI can include cloudy, dark, bloody, strong or foul-smelling urine, frequent need to urinate, pain or burning when urinating, feelings of pressure, low-grade fever, night sweats, shaking or chills.  Often older adults respond differently to infections.  They don’t always present with the same symptoms or signs of an UTI that someone younger might.  Or they may not express any discomfort to their caregivers.  These warning signs may go unnoticed or misunderstood.  Signs of an UTI in an older adult may look like the early stages of dementia or Alzheimer’s disease, demonstrated by confusion, delirium, paranoia, excessive worry, agitation, hallucinations, unusual behavioral changes, poor motor skills, dizziness, loss of coordination and increased falling.

Being an older adult doesn’t necessarily mean that your kidneys will fail or even that you have to experience poor health.  Keeping yourself well hydrated with water, knowing the signs of infection or decreased kidney function, reducing modifiable factors such as alcohol and substance use, hypertension or hypoglycemia, and knowing your family history of medical conditions, can all add up to better overall health and kidney function.  Seeking good health can be more challenging as we age, but knowing ways to safeguard the health of your kidneys, as well as warning signs when ill-health should arise, can go a long way toward maintaining the health of this vital organ, our kidneys.