Comprehensive management of chronic kidney disease in the old population

Chronic kidney disease (CKD) is a global issue that raises inflammation and heightens the risk of progressing to advanced CKD, requiring renal replacement therapy. It also significantly increases the likelihood of cardiovascular and vascular diseases, hospitalizations, functional decline, and reduced quality of life, particularly in older adults. CKD prevalence rises with age, affecting 25-30% of older adults. Despite that, the fact is that CKD is underdiagnosed in this population. Diagnosing CKD in older patients is difficult because accurate tests are limited, common serum creatinine-based formulas depend on muscle mass (often low in this group), and age-related renal function decline further complicates assessment. Comprehensive management can help achieve therapeutic goals in the old population with CKD through assessments and care plans. This care includes a combination of lifestyle changes, cardiovascular risk factors control, the use of drugs with proven renal and cardiovascular benefits, as well as the adequate management of specific clinical conditions, including the general clinical comorbidities, renal-related conditions and recognition of geriatric syndromes, helping patients manage their condition and involving them in decisions about their care. In this narrative review, the epidemiology, clinical profile and management of CKD in the old population are updated.