By Alicia Schwartz, MSN-ED, BSN, RN, PCC, CCM, VNSNY CHOICE Health Plans

As we age, it is not uncommon to experience kidney problems, but for some people talking about symptoms even to a doctor can be a challenge. According to the National Center for Chronic Disease Prevention and Health Promotion, the risk for chronic kidney disease increases after age 50 and is most common among adults older than 70. It is important to understand the causes of kidney disease, and to take steps to maintain good kidney health at any stage of life.

Two of the biggest causes of kidney failure are Type 2 diabetes and high blood pressure. When these conditions are controlled, kidney functions often improve and further disease can be prevented or slowed down. Older adults who are overweight, have diabetes or other risks for kidney disease can should speak with their doctors about how to maintain a healthy blood pressure range, for most people the target is less than 140/90 mm Hg.

If you’re diabetic, watch blood glucose and cholesterol levels carefully, and stay in your target range. Be sure to follow your doctor’s instructions for taking all medications. Some blood pressure medicines work to protect your kidneys and it’s especially important to take them as directed. It’s important too to reduce salt and add heart-healthy fruits and vegetables to your diet and stay physically active.

These guidelines are certainly not new, but they are effective—and worth reviewing. As a Registered Nurse (RN) with VNSNY CHOICEHealth Plans, I coordinate care for many seniors who are challenged by kidney conditions. If left untended, kidney problems can lead to kidney failure, cardiovascular disease, asthma, hypertension, cognitive impairment, and even death. But old habits can be hard to break, so to keep the seniors I coordinate care for moving in the right direction, I often share inspiring stories about people like Juan who’ve learned to take better care of themselves and have turned their health around.

A 75-year-old gentleman from Cuba, Juan’s diabetes had a tendency to swing out of control. He had grown accustomed to take-out dinners in front of the TV most every night, and even though he’d been active and athletic in his youth, he was now suffering from a host of chronic issues related to weakened kidneys, arthritis and inactivity. After a few emergency room scares, Juan’s doctor recommended dialysis, which sent Juan into a depression. The VNSNY CHOICE care team coordinated with Juan’s physician and together they presented him with a challenge: get your weight and blood levels back in line, and the surgery is off.

Juan took the challenge and started by substituting one TV show for 20 minutes of walking in the neighborhood in the late afternoon. Within a week, he was feeling more energetic. He was able to stay on track with the exercise routine his physical therapist mapped out for him and while he grumbled about it at first, he cut way back on alcohol and began eating a heart healthy diet that his home health aide helped him prepare. When four weeks were up, Juan had made such astonishing progress that the doctor agreed to take dialysis completely off the table. Juan is no longer a hermit, tethered to his TV, he walks through the entire neighborhood with a smile on his face, and even takes the train to visit his family nearby.

When Juan took responsibility for his own health, he immediately began to feel better and was able to avoid surgery. It’s amazing what someone can accomplish when they realize how simple self-care actions add up.

For more information about VNSNY CHOICE Health Plans from the not-for-profit Visiting Nurse Service of New York, please call 1-888-867-6555 or visit