"Old age" and the issue of "kidneys" are not far from oneself

As Thailand enters an increasingly aging society, data from the Department of Older Persons indicates that there will be a population aged 65 and over accounting for 10% or more than 7 million people. It is also predicted that by 2021, the proportion of elderly people will increase to 20-30%, meaning that out of every 100 people, there will be 30 elderly individuals. The important issue to watch out for is health problems and various chronic diseases, with kidney disease being a common condition found in the elderly.

“Assoc. Prof. Dr. Natthapon Aponsujaritkul, Organ Transplant Surgeon” stated that elderly people and kidney disease are not distant issues. Older adults are at risk of kidney disease caused by kidney degeneration. Many elderly people require treatment including medication, dialysis, and even “kidney transplantation.” Kidney transplantation in the elderly may carry risks due to health conditions, underlying diseases, and slower physical recovery compared to other age groups. Therefore, elderly individuals need to be closely monitored if they require kidney transplantation.

Are elderly people really at higher risk of kidney disease than other age groups?

Generally, people over 35 years old experience a 1% decline in kidney function per year, which continues progressively. Therefore, as age increases, even those who take care of their health will experience normal age-related kidney decline. Hence, elderly people are at risk of kidney disease caused by kidney degeneration.

What causes the risk of kidney disease in the elderly?

Actually, all age groups are at risk of kidney disease. The main factor for Thai people is salty food, which comes from cooking with excessive salt beyond the World Health Organization’s recommended limit. Salty food means food containing sodium salt beyond the recommended amount. Thai food is prepared to be delicious, and in that deliciousness, sodium content is higher than the body should receive. You may have heard campaigns to reduce salt and sodium intake. This is the root cause of kidney disease, especially elderly people with kidney degeneration who consume very salty food are at higher risk than other age groups.

What precautions should be taken for kidney transplantation in the elderly?

Currently, even elderly patients over 70 years old, if physically strong and ready, can undergo kidney transplantation despite having kidney failure.

Mostly, elderly people have risks from underlying diseases such as diabetes, hypertension, and heart disease, so doctors must conduct a thorough health assessment. Importantly, heart function must be evaluated. Therefore, before every kidney transplantation procedure, a detailed patient evaluation is necessary. Only if all criteria are met can the patient undergo kidney transplantation.

How should elderly patients prepare before and after kidney transplantation?

The important thing before kidney transplantation is to maintain good health and undergo thorough health examinations and assessments, including regular dialysis as per the treatment plan. Preparation before kidney transplantation includes:

1. Maintain good health, get enough rest, and be mentally prepared at all times to enhance treatment effectiveness.
2. Refrain from eating and drinking, including water, for 1 day immediately before surgery.
3. Blood and urine tests at the laboratory.
4. Clean the nose and throat.
5. Electrocardiogram (ECG).
6. Chest X-ray.
7. Body cleansing with special soap.
8. Intravenous fluid administration.
9. Dialysis as per the doctor’s discretion.
10. Taking immunosuppressive drugs.
11. Signing consent forms before surgery.

After kidney transplantation, infection must be closely monitored because patients must take immunosuppressants to reduce rejection of the transplanted kidney, which increases the risk of infection. Post-transplant care includes:

1. Strictly taking immunosuppressive drugs as prescribed by the doctor.
2. Taking medication at the same time every day.
3. If any abnormalities are noticed, record the details with date and time and inform the attending doctor at the next appointment.
4. Always carry a list of current medications.
5. Attend all scheduled doctor appointments.
6. If new side effects from medication or emergency complications occur, contact the doctor and hospital immediately.
7. Light exercise is allowed to build strength but must be under the doctor’s discretion.
8. Eat a balanced diet with all five food groups and consume cooked food.
9. Avoid alcohol and smoking.
10. Drink at least 2 liters of clean water daily.
11. Avoid crowded places with many people.
12. Most importantly, be cautious of infections in the early post-transplant period by maintaining daily hygiene and emphasizing cleanliness.

Know before getting sick: How should elderly people maintain healthy kidneys to avoid the risk of kidney disease?

1. Take care of diet by avoiding salty foods, reducing soup consumption, and avoiding strong-flavored foods.
2. Manage health conditions such as diabetes and hypertension to keep them well controlled.
3. Exercise regularly.
4. Drink at least 8-10 glasses of clean water daily.
5. Avoid smoking as it reduces kidney function efficiency.
6. Avoid long-term use of medications such as anti-inflammatory drugs and herbal medicines; importantly, consult a doctor before using any medication.

The best way is to take care of your kidneys starting today by reducing salt intake and lowering the risk of kidney disease.