Kidney disease is a major problem for older adults because the kidneys naturally lose function as they age. However, if this decline is more severe, it can lead to chronic kidney disease (CKD), a disease in which kidney function declines over time. Recognizing these symptoms early is essential to treating kidney disease and preventing further complications.

Common Signs and Symptoms of Kidney Disease

1. Fatigue– A decrease in the kidneys' ability to filter waste products from the blood can lead to feelings of tiredness and weakness, which can be confused with general aging.
2. Swelling (edema) – Fluid accumulation, especially in the legs, ankles, and feet, is a common sign of decreased kidney function. This occurs when the kidneys are unable to maintain adequate fluid balance.
3. Changes in urination– Older adults with kidney disease may notice increased or decreased frequency of urination, foamy or bloody urine, or difficulty urinating.
4. Shortness of breath – Impaired kidney function leads to excess fluid in the lungs, which can make it difficult to breathe.
5. Nausea and vomiting– A buildup of toxins in the body can lead to digestive issues, including nausea and vomiting.
6. Confusion or difficulty concentrating– A buildup of waste products in the blood can negatively affect brain function and cause confusion or difficulty concentrating.
7. High blood pressure – The kidneys play a vital role in regulating blood pressure. As kidney function declines, blood pressure may rise and worsen kidney damage.
8. Persistent itching – Poor kidney function can lead to mineral imbalances, causing toxins to build up in the blood, which can cause itchy skin.

IgA Nephropathy (IgAN) and Kidney Disease

IgA Nephropathy (IgAN) is a rare but serious kidney disease. IgAN occurs when the protein immunoglobulin A (IgA) builds up in the kidneys, causing inflammation and damage to kidney tissue. Although IgAN progresses slowly, it is a leading cause of kidney failure. In severe cases, patients may need dialysis or a kidney transplant to manage the disease, as the loss of kidney function is permanent.

Kidney Disease May Be More Common Than You Think

According to the National Kidney Foundation, an estimated 35.5 million Americans have kidney disease and approximately 808,000 Americans have kidney failure. Kidney disease is increasing at an alarming rate, currently affecting more than one in seven (or 14%) American adults. These figures underscore the importance of early detection and treatment to manage the disease and prevent further complications. CKD is more common in people aged 65 and older.

Available Treatment Options for Kidney Disease

There are a variety of treatments available to treat kidney disease, each tailored to the patient's specific needs and stage of disease. These options range from medications that target the underlying cause to those that help preserve kidney function, allowing for a treatment plan tailored to an individual's health status.

Jynarque (tolvaptan) - Jynarque is a vasopressin receptor antagonist that slows the progression of kidney disease by reducing cyst growth in patients with autosomal dominant polycystic kidney disease (ADPKD). By reducing fluid buildup in the kidneys, the goal is to preserve kidney function for a longer period of time.

• Pros:Jynarque can significantly slow the decline in kidney function in people with ADPKD, potentially delaying the need for dialysis or transplantation.
• Cons: Can cause liver damage, requires regular monitoring of liver function, and is only indicated for certain types of kidney disease, limiting its use.

Filspari (sparsentan) – Filspari is a dual endothelin-angiotensin receptor antagonist designed to preserve kidney function in patients with IgA nephropathy by reducing proteinuria (excess protein in the urine). This medication works by reducing protein loss in the urine, which is critical to slowing the progression of this type of kidney disease.

• Pros:Filspari targets IgA nephropathy and helps reduce proteinuria and slow the progression of kidney damage in a specific patient population.
• Cons: Filspari is primarily effective in patients with IgA nephropathy and may cause side effects such as edema and hypotension, requiring careful monitoring of patients.

Farxiga (dapagliflozin) – Farxiga is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that helps slow the progression of kidney disease by lowering blood sugar levels and blood pressure. This medication is often used in patients with chronic kidney disease (CKD) and may also be beneficial in patients with heart failure.

• Pros: Farxiga's mechanism is beneficial for a variety of conditions, including CKD, because it promotes better blood sugar control and blood pressure regulation.
• Disadvantages: May cause side effects such as dehydration, genital infections, and increase the risk of diabetic ketoacidosis in some patients. This limits suitability for some people.

These treatment options offer a targeted mechanism for treating kidney disease and allow healthcare providers to tailor treatment to the specific patient's needs and stage of disease progression.

Conclusion

Kidney disease is a serious health problem for older adults, but early detection and treatment can improve outcomes. Recognizing symptoms and working closely with a healthcare provider to develop a treatment plan can help slow disease progression and maintain quality of life.