Heart and kidney failure in the elderly

Q: What happens when you have kidney failure and heart failure?

When the kidneys dont work well, more stress is put on the heart. When someone has CKD, their heart needs to pump harder to get blood to the kidneys. This can lead to heart disease, the leading cause of death in the United States. Change in blood pressure is also a CKD complication that can lead to heart disease.

As you age, your kidneys begin losing function. While kidney disease, also known as chronic kidney disease or CKD, can develop during any stage of life, your chances greatly increase over the age of 60. In fact, researchers from John Hopkins University found that more than 50% of seniors over the age of 75 are believed to have kidney disease. It’s one of the leading causes of death in the U.S., but 90% of adults with kidney disease don’t know they have it. So, what can you do?

Table of Contents Show

What are the Causes?
Know the Symptoms
How to Prevent Kidney Disease
When to seek care
From Mayo Clinic to your inbox
Risk factors
Complications
How long can you live with heart and kidney disease?
What happens when you have kidney failure and heart failure?
What are signs of kidneys shutting down in elderly?
What are the symptoms of heart and kidney failure?

Kidney disease means your kidneys are losing the ability to filter your blood to keep you healthy. In the early stages of the disease, many people do not experience symptoms, which is why the disease often goes undiagnosed for a long time. But as the disease worsens, you may develop other problems such as high blood pressure, anemia, weakened bones, and nerve damage. Because the kidneys are vital to so many of the body’s functions, kidney disease also increases your risk of heart disease.

These problems can lead to kidney failure, suddenly and without warning. If your kidneys fail, dialysis or a kidney transplant is required to stay alive.

What are the Causes?

There are two main causes of kidney disease: diabetes and high blood pressure. These conditions were the cause of 76% of kidney failure cases between 2015-2017. Over time, high blood sugar from diabetes can damage blood vessels in the kidneys, causing them to not work as well as they should. About 1 in 3 adults with diabetes have kidney disease, and around 1 in 3 seniors (aged 65 and older) have diabetes.

On the other hand, high blood pressure can constrict and narrow the blood vessels, reducing blood flow. This damages and weakens them throughout the body, including the kidneys. When your kidneys’ blood vessels are damaged, they are no longer able to remove waste and extra fluid from your body like they’re supposed to. Around 63% of seniors (aged 60 and older) have high blood pressure.

Smoking, obesity, heart disease, frequent use of medications that can damage the kidneys, having a family history of kidney disease, and being Black, Native American, or Asian American all increase your risk.

Know the Symptoms

The signs and symptoms of kidney disease often develop slowly, over many years. Loss of kidney function can cause a buildup of fluid or body waste. Depending on how severe it is, loss of kidney function can cause:

Nausea and vomiting
Loss of appetite
Fatigue and weakness
Sleep problems
Urinating more or less frequently
Decreased mental sharpness
Muscle cramps
Swelling of feet and ankles
Dry, itchy skin
Shortness of breath
Chest pain

Many of these symptoms are nonspecific to kidney disease and can be caused by other illnesses or conditions as well. Because of this, you may not develop signs until irreversible damage has occurred. If you experience any of these symptoms, call your doctor right away.

How to Prevent Kidney Disease

Taking preventative measures is the best defense against kidney disease since it often shows no distinct symptoms. There are several things you can do to keep your kidneys healthy.

If you have diabetes, closely monitor your blood sugar.
Get your blood pressure checked regularly.
Get a kidney health check (blood test, urine test, and blood pressure check) at least every two years.
Treat urinary tract infections immediately.
Drink plenty of water.
Do not smoke.
Exercise for at least 30 minutes each day.
Eat a diet that is low in sugar, fat, and salt, and high in fiber.
Maintain a healthy weight.
Get screened for kidney disease.

Talk to your doctor about your risk of kidney disease.

Overview

End-stage renal disease, also called end-stage kidney disease or kidney failure, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys no longer work as they should to meet your body's needs.

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When your kidneys lose their filtering abilities, dangerous levels of fluid, electrolytes and wastes can build up in your body.

With end-stage renal disease, you need dialysis or a kidney transplant to stay alive. But you can also choose to opt for conservative care to manage your symptoms — aiming for the best quality of life during your remaining time.

How kidneys work

One of the important jobs of the kidneys is to clean the blood. As blood moves through the body, it picks up extra fluid, chemicals and waste. The kidneys separate this material from the blood. It's carried out of the body in urine. If the kidneys are unable to do this and the condition is untreated, serious health problems result, with eventual loss of life.

Symptoms

Early in chronic kidney disease, you might have no signs or symptoms. As chronic kidney disease progresses to end-stage renal disease, signs and symptoms might include:

Nausea
Vomiting
Loss of appetite
Fatigue and weakness
Changes in how much you urinate
Chest pain, if fluid builds up around the lining of the heart
Shortness of breath, if fluid builds up in the lungs
Swelling of feet and ankles
High blood pressure (hypertension) that's difficult to control
Headaches
Difficulty sleeping
Decreased mental sharpness
Muscle twitches and cramps
Persistent itching
Metallic taste

Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys can make up for lost function, signs and symptoms might not appear until irreversible damage has occurred.

When to seek care

Make an appointment with your health care provider if you have signs or symptoms of kidney disease.

If you have a medical condition that increases your risk of kidney disease, your care provider is likely to monitor your kidney function with urine and blood tests and your blood pressure during regular office visits. Ask your provider whether these tests are necessary for you.

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Causes

Kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years. For some people, kidney damage can continue to progress even after the underlying condition is resolved.

Diseases and conditions that can lead to kidney disease include:

Type 1 or type 2 diabetes
High blood pressure
Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis) — an inflammation of the kidney's filtering units (glomeruli)
Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney's tubules and surrounding structures
Polycystic kidney disease or other inherited kidney diseases
Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back up into your kidneys
Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis)

Risk factors

Certain factors increase the risk that chronic kidney disease will progress more quickly to end-stage renal disease, including:

Diabetes with poor blood sugar control
Kidney disease that affects the glomeruli, the structures in the kidneys that filter wastes from the blood
Polycystic kidney disease
High blood pressure
Tobacco use
Black, Hispanic, Asian, Pacific Islander or American Indian heritage
Family history of kidney failure
Older age
Frequent use of medications that could be damaging to the kidney

Complications

Kidney damage, once it occurs, can't be reversed. Potential complications can affect almost any part of your body and can include:

Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart's ability to function and may be life-threatening
Heart disease
Weak bones and an increased risk of bone fractures
Anemia
Decreased sex drive, erectile dysfunction or reduced fertility
Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
Decreased immune response, which makes you more vulnerable to infection
Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium)
Pregnancy complications that carry risks for the mother and the developing fetus
Malnutrition
Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival

Prevention

If you have kidney disease, you may be able to slow its progress by making healthy lifestyle choices:

Achieve and maintain a healthy weight
Be active most days
Limit protein and eat a balanced diet of nutritious, low-sodium foods
Control your blood pressure
Take your medications as prescribed
Have your cholesterol levels checked every year
Control your blood sugar level
Don't smoke or use tobacco products
Get regular checkups

Oct. 12, 2021

How long can you live with heart and kidney disease?

Demographic factors and patient characteristics, of cardiac function parameters and renal parameters were recorded longitudinally. Main results: CHF patients progressing to dialysis- dependent renal failure had a grave prognosis: median survival time was 95 days, mean survival 444 days.

What happens when you have kidney failure and heart failure?

When the kidneys don't work well, more stress is put on the heart. When someone has CKD, their heart needs to pump harder to get blood to the kidneys. This can lead to heart disease, the leading cause of death in the United States. Change in blood pressure is also a CKD complication that can lead to heart disease.