This blog explores the unique complexities of Chronic Kidney Disease management in older adults—ranging from polypharmacy to mobility and cognitive limitations—and underscores the pivotal role nurses play in early detection, patient education, and psychosocial empowerment. By fostering prevention and supporting self-management, nurses can significantly improve health outcomes and quality of life for older individuals living with Chronic Kidney Disease.
Chronic Kidney Disease (CKD) remains a persistent concern for the older population in the United Kingdom. Because of the insidious nature of CKD, the disease often progresses slowly without overt symptoms, with no evidence of its presence until kidney function is severely compromised. CKD, if left unmanaged, progresses to kidney failure and requires either dialysis or transplant, each leading to significant impairment of quality of life. In view of the ageing population and high prevalence of comorbid conditions like diabetes, hypertension, and cardiovascular diseases, CKD represents an important public health challenge in geriatric medicine (Reis da Silva, 2024a).
Difficulty of management of CKD in older adults pertains to several factors. This would include the normal process of ageing, whereby in otherwise healthy adults, renal function is slowly reduced. For older adults who may have some predisposing conditions, such as diabetes or hypertension, major risk factors for CKD, renal function decline accelerates. Additionally, because old age is generally marred by multiple chronic diseases, management of CKD, combined with other conditions, becomes difficult. Care complexity is enhanced by polypharmacy, or the use of many medications, and some actually contribute to deterioration in renal function. In addition, many older adults have limited mobility or have cognitive impairments limiting adherence to complicated treatment regimens (Reis da Silva, 2024b).
Nurses can make significant contributions to early detection and management in older adults with CKD. As they are the major caregivers in most healthcare settings, they tend to be the first to note minimal changes in their patients' health, such as oedema, tiredness, or changes in urination patterns-all symptoms that may be associated with the kidney losing its function. Routine blood pressure and blood sugar check-ups should be conducted on all patients, especially those presenting with risk factors, to allow for early interference. Nurses educate regarding life changes that would slow the progression, such as a low-sodium, kidney-friendly diet, hydration, and weight management (Reis da Silva, 2024c).
Nursing interventions in this regard are also not confined to clinical care but extend to psychosocial empowerment of the older adults. Educating them on the aspect of risk factors and strategies for self-management provides them with the opportunity to make informed choices regarding their condition, which further enhances compliance and improves outcomes. By adopting a proactive attitude regarding renal health, it would be easy for nurses to contribute significantly to the prevention of disease development of CKD and lessen the impacts related to kidney failure among the elderly population. Their early interventions followed by constant follow-ups make nurses crucial in the early stages of helping aged individuals maintain their renal functions and their overall health.
External Links:
Reis da Silva TH (2024) Understanding body fluid balance, dehydration and intravenous fluid therapy. Emergency Nurse. doi:10.7748/en.2024.e2201
Reis da Silva, T.H. (2024). Chronic kidney disease in older adults: nursing implications for community nurses. Journal of Kidney Care. 9(4). 174-179. https://doi.org/10.12968/jokc.2024.9.4.174
Reis da Silva, T.H. (2024) Pharmacokinetics in older people: an overview of prescribing practice. Journal of Prescribing Practice. 6 (9). 374-381. https://doi.org/10.12968/jprp.2024.6.9.374
