Feeling unusually tired, waking up several times at night to use the bathroom, or noticing swollen ankles might seem like ordinary parts of getting older. However, these seemingly minor changes can sometimes indicate something more serious: declining kidney function. The problem is that kidney disease often develops quietly, leaving many older adults unaware that anything is wrong until significant damage has occurred.
According to the Centers for Disease Control and Prevention (CDC), approximately 34% of Americans ages 65 and older have chronic kidney disease, and an estimated 87% of adults with the condition don’t know they have it. That’s especially concerning because early detection and treatment can help slow kidney damage and prevent complications. Recognizing potential signs of kidney trouble is important, particularly for people with diabetes, high blood pressure, or a family history of kidney disease. Here are nine warning signs older adults shouldn’t automatically dismiss as normal aging.
1. You’re Feeling Exhausted Even After Sleeping
Everyone experiences occasional fatigue, but persistent exhaustion that interferes with everyday activities deserves attention. According to the National Kidney Foundation, declining kidney function can allow waste products to accumulate in the bloodstream, contributing to weakness and fatigue. Kidney disease can also interfere with the production of erythropoietin, a hormone that helps the body make red blood cells, potentially causing anemia.
Someone who previously enjoyed gardening or walking around the neighborhood might suddenly struggle to complete those activities without resting. Although fatigue has many possible causes, unexplained exhaustion is one of the signs of kidney trouble worth discussing with a healthcare provider.
2. Your Feet or Ankles Are Swelling
Swollen ankles aren’t always caused by standing too long or eating salty foods. When kidneys cannot adequately remove excess sodium and fluid, swelling may develop in the feet, ankles, legs, hands, or face. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) identifies fluid retention as a possible symptom of chronic kidney disease, particularly in more advanced cases.
You might notice that your shoes feel unusually tight in the evening or that your socks leave deeper impressions around your ankles. Because swelling can also indicate heart or circulation problems, persistent or worsening symptoms should be evaluated rather than treated with over-the-counter diuretics.
3. You’re Urinating More or Less Frequently
Changes in bathroom habits can provide important clues about kidney health. Some people with kidney disease notice increased nighttime urination, while others experience reduced urine production as kidney function worsens. According to the American Kidney Fund, changes in urination frequency can be among the symptoms associated with declining kidney function. However, frequent nighttime urination can also result from prostate enlargement, diabetes, medications, or an overactive bladder. If your bathroom habits change noticeably, especially alongside other signs of kidney trouble, ask your doctor whether kidney testing is appropriate.
4. Your Urine Looks Foamy or Bubbly
Occasional bubbles in the toilet aren’t necessarily a reason to worry, but persistent foam deserves a closer look. Foamy urine can indicate protein leaking through damaged kidney filters. Healthy kidneys normally prevent significant amounts of protein from entering the urine, so ongoing protein leakage can signal kidney damage. Some people describe the appearance as similar to the foam that develops when pouring beer into a glass. A simple urine albumin-to-creatinine ratio test can help determine whether protein loss is occurring and whether additional evaluation is necessary.
5. Your Skin Itches Without an Obvious Reason
Dry skin becomes more common with age, but persistent itching that doesn’t improve with moisturizer can sometimes indicate an underlying medical problem. As kidney disease advances, changes in mineral balance and the accumulation of waste products may contribute to uncomfortable itching.
The National Institutes of Health identifies itchy skin among the possible symptoms of more advanced chronic kidney disease. The itching may be widespread, interfere with sleep, or occur without a noticeable rash. Because allergies, medications, and ordinary skin conditions are more common explanations, persistent unexplained itching should prompt a medical evaluation rather than an assumption of kidney disease.
6. You’ve Lost Your Appetite or Feel Nauseated
An occasional upset stomach isn’t unusual, but repeatedly feeling nauseated or losing interest in meals can signal a larger problem. When kidney function declines significantly, waste products can accumulate in the bloodstream and affect digestion and appetite.
Nausea, vomiting, and appetite loss can develop as chronic kidney disease becomes more advanced. An older adult who starts skipping meals, losing weight unintentionally, or complaining that food no longer tastes appealing should mention those changes to a healthcare professional. These symptoms have numerous possible causes, but they shouldn’t be dismissed simply because someone is getting older.
7. You’re Experiencing Frequent Muscle Cramps
Muscle cramps can happen after exercise, dehydration, or prolonged sitting, but recurring cramps may also indicate an underlying health issue. Kidneys help regulate important minerals and electrolytes, including potassium, calcium, and phosphorus, which play roles in normal muscle function. The American Kidney Fund lists muscle cramps among the symptoms that can occur with advanced kidney disease.
Someone who begins experiencing frequent nighttime leg cramps alongside fatigue or swelling should consider whether these symptoms might be connected. Avoid starting potassium or other mineral supplements without medical guidance because excessive amounts can be dangerous when kidney function is impaired.
8. Your Blood Pressure Is Becoming Harder to Control
High blood pressure is both a major cause of kidney damage and a potential consequence of declining kidney function. The CDC estimates that approximately 21% of adults with high blood pressure also have chronic kidney disease. When kidneys struggle to regulate fluid balance and blood pressure, existing hypertension can become more difficult to manage.
For example, someone whose blood pressure was previously controlled with medication might begin seeing consistently higher readings at home or during routine appointments. If your blood pressure changes unexpectedly, ask your healthcare provider whether kidney function testing should be part of the evaluation.
9. You’re Having Trouble Concentrating or Thinking Clearly
Occasional forgetfulness doesn’t necessarily indicate a serious problem, but noticeable changes in concentration or mental clarity shouldn’t be ignored. Advanced kidney disease can contribute to cognitive difficulties through anemia, metabolic disturbances, and the accumulation of waste products.
The NIH identifies trouble concentrating and confusion among symptoms that may occur as kidney function deteriorates. Family members might notice that an older relative seems unusually distracted, struggles with familiar tasks, or has difficulty following conversations. Sudden confusion requires urgent medical attention because it can indicate a stroke, infection, medication reaction, or another emergency rather than chronic kidney disease alone.
Kidney Disease Can Also Take a Serious Toll on Retirement Savings
Kidney disease doesn’t just threaten your health; it can also create significant financial pressure through specialist appointments, prescription medications, hospital stays, and potentially expensive long-term treatment. According to the United States Renal Data System’s 2025 Annual Data Report, annual Medicare Parts A and B spending averaged $23,438 for older beneficiaries with chronic kidney disease in 2023, compared with $11,219 for those without the condition.
Although those figures represent Medicare expenditures rather than what patients personally paid, they demonstrate how costly managing kidney disease can become. Medicare may cover medically necessary kidney function testing and treatment, but deductibles, coinsurance, and other out-of-pocket expenses depend on your coverage, making it important to understand your benefits before problems develop.
Asking your healthcare provider about appropriate kidney testing, particularly if you have diabetes or high blood pressure, could help identify problems earlier and potentially reduce the risk of complications that threaten both your health and retirement budget.
Don’t Wait for Symptoms to Ask About Kidney Testing
One of the most important things older adults should understand is that kidney disease can develop without obvious warning signs, particularly in its early stages. According to the NIDDK, two important tests are the estimated glomerular filtration rate (eGFR), which measures how effectively kidneys filter blood, and the urine albumin-to-creatinine ratio (UACR), which checks for kidney damage.
People with diabetes, high blood pressure, heart disease, or a family history of kidney failure should discuss appropriate testing with their healthcare providers, even when they feel perfectly healthy. Recognizing possible signs of kidney trouble early may help prevent expensive hospitalizations, serious complications, and further loss of kidney function, although symptoms alone cannot establish a diagnosis.
Have you or someone in your family experienced unexpected kidney problems, and were there warning signs you initially overlooked? Share your experience in the comments.
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