If you would like to discuss your kidney diagnosis with our trained members of staff, ring our free-to-call number. The NKF Helpline is available Monday to Thursday 08:30 am - 5:00 pm Friday 8.30 am – 12.30 pm on 0800 169 09 36 or email [email protected]

Living with kidney disease as we get older

There are more people than ever living with kidney disease. Research shows that the number of people living with chronic kidney disease (CKD) increases with age and that more than 3 in 10 people with advanced CKD are living with frailty. 

There are many reasons for this. Kidney disease can impact all parts of the body and kidney patients are at higher risk of poor nutrition, muscle loss, memory changes and experiencing other illnesses. These all can contribute to frailty. 

Frailty is important to address because there are things we can do to prevent it from occurring or progressing. Getting the right information and support early on means we have a better chance of keeping well and maintaining a good quality of life.

What is frailty?

Frailty is a term used in healthcare which is often misunderstood as it has a different meaning in everyday language. In healthcare, frailty means that a person’s recovery from an illness or injury may take longer. Frailty is more common with age, although younger people can live with frailty too, especially if they live with long-term health conditions like chronic kidney disease. 

Whilst people with frailty can live independently in their homes, those with more severe frailty may require help with their day-to-day activities. Importantly, people living with frailty tend not to “bounce back” as quickly when they become ill or fall and are more likely to experience admissions to hospital with longer hospital stays, more difficulties with everyday activities and worse quality of life.

Common symptoms include:

Factors that can contribute to frailty include:

Some of these things can be prevented or improved with the correct information and support. Early identification of frailty symptoms means early action to support people living and ageing well. 

If you are starting to experience any of these symptoms, talk to your doctor or another healthcare professional involved in your care. It is good to speak to family or friends too. Having someone to talk to can help ease worries and stress and get you the support/care you need.

How is it assessed?

There are various tools to help healthcare professionals identify frailty. In the UK, many healthcare professionals use the Clinical Frailty Scale, a nine-point scale that summarises a person’s frailty status. The Clinical Frailty Scale prompts healthcare professionals to consider a person’s energy and activity levels, symptoms, mobility and physical function when assessing frailty. It may be a bit of a shock to hear your frailty score, however being aware of frailty means you can be supported to prevent and manage it better.

Prevention: What can I do to age well? 

The good news is that there is a lot we can do in our day-to-day lives to age well and improve/prevent frailty. Our daily habits have a big impact on our health and wellbeing, and small, manageable and consistent changes over time can make a big difference. 

Keeping Physically Active

The benefits of keeping fit and active are endless! Most importantly, it helps being able to do day to day activities independently now and as you get older. People living with kidney disease can often feel tired and may be less active. But the less you do, the less you’ll feel able to do – even small amounts of movement can be effective. 

You don’t need to be fit to get started. You can start by making small changes like walking instead of taking the bus, taking the stairs instead of the lift and breaking up your day so you are not sitting for extended periods of time.

The recommended level of activity is 30 minutes five times a week of cardiovascular exercise (e.g. walking or swimming) and twice a week of muscle-strengthening and balance exercises (e.g. bodyweight exercises, Pilates or Yoga), but it is important to do a mixture. Always speak to a healthcare professional if you have any concerns with being more active.

Keeping Mentally Active

Just like our bodies, our minds need to be kept active too. Memory changes can be scary and frustrating, however there are lots of things we can do to keep our minds sharp:

• Learn something new! Take up a hobby, whether it be a language, instrument or skill. Find something that interests you – learning is a lifelong experience!
• Do activities that challenge and engage your brain such as games (e.g. puzzles, Sudoku, digital apps/games, trivia) or reading
• Connect socially and have regular conversations with people – whether it be your friends, family, neighbours, social groups or people in the community
• Keep active, keep on top of your health conditions, get your eyes and ears checked regularly, and ensure you are eating and sleeping well as these all have an impact on your brain function and health

Keep connected!

Strong social connections are a key part of ageing well. There is a large amount of research that shows the positive impacts of social interaction on health and well-being. Engaging in conversations, feeling connected to people, groups or communities, and interacting with others (whether in-person or virtually) helps us feel good, improves our emotional skills and brain health, and reduces social isolation and loneliness. This is particularly important because social isolation and loneliness are linked to health problems such as dementia, heart disease, stroke, more hospital admissions and earlier death. 

There are many opportunities to connect with others out there. If you are finding it difficult, you can speak to a healthcare professional who may be able support and signpost you to what is available in your community.

Here are just a few examples of ways to keep connected:

• Call, text or video chat with loved ones
• Connect with neighbours
• Volunteering
• Exercise classes
• Social clubs or groups (e.g. Ramblers Wellbeing Walks, gardening clubs, reading groups)
• Hobby classes (e.g. art classes)
• Visit your local library or community centre – they often have host events and have lots of information about what’s on in the area
• Be-friending services

Psychological Support

Frailty does not just affect your body – it can also affect you mentally and emotionally. The combined impact of living with frailty and kidney disease can influence how you think and feel about yourself and your health, and it can affect how you cope with life in general. You are not alone if you experience:

• Changes in confidence as activities that once felt very simple have now become increasingly tiring or unmanageable
• Different fears and worries about many things including being admitted to hospital, falling, becoming more dependent on others or worry about how you will cope
• Mood changes and frustration as you compare life to before or feel overwhelmed with the types of changes that are occurring
• Isolation and loneliness as you feel no one understands your situation or you have no one to speak to about your experiences

Everyone will have their own coping strategies but here are just some ways that can help you feel better mentally and emotionally:

 

• Social connection. Maintaining strong relationships with your family, friends and your wider community can make it easier to cope with any changes or challenges.
• Join support groups and/or peer support. Connecting with others who share similar experiences can reduce loneliness and provide reassurance, hope and practical tips. Some hospitals have organised peer support programmes. The NKF is run by kidney patients, for kidney patients and is there to support you throughout your kidney journey.
• Speak to a kidney psychologist or counsellor. You may find it helpful to speak to someone who understands the challenges of kidney disease and frailty. They may offer you one-to-one therapy or group sessions and can offer techniques to help feel mentally and emotionally well. 
• Do things that bring meaning and purpose to your day, set small goals and move your body! These are all things that can help our mood and improve our confidence.

Falls Prevention

Our risk of falls increases as we age and with frailty. There are many reasons for this, including taking lots of medications, other health conditions, loss of strength and changes in balance and function. Having a fall can have a big impact on your health, independence and quality of life so it is helpful to understand the reasons why you may be at risk and take preventative action. 

If you have had a previous fall, you are at higher risk of further falls and it is important you ask your doctor for a review, as there may be medical reasons for falling. You can reduce your falls risk with balance and muscle-strengthening exercises, maintaining bone health, regular eyesight and medication reviews and fall-proofing your home. The Chartered Society of Physiotherapy in the UK has a good guide for falls prevention and keeping fit that may be helpful: CSP: A Guide to Staying Steady

Top Tips to fall-proof your home
Lighting	Living Area	Kitchen/Bathroom
Ensure adequate lighting around your home and stairs	Replace worn-out or frayed rugs/carpets	Rearrange your cupboards so that frequently used items are within easy reach
Avoid long cables from lamps that could trip you	Check all rugs have a non-slip underlay	Clear up spills straight away
Use a bedside light when getting up at night	Clear away any clutter	Use a non-slip mat in the bath/shower
If you regularly use the bathroom at night, keep a landing light on	Organise any jumble wires or trailing extension leads	Install grab rails in the bathroom and check features such as banisters to make sure they are solid and may be relied on to help you move safely

Having a Balanced Diet

When managing kidney disease and the risk of frailty, your diet can make a difference. Eating varied, fresh and whole foods is important for your body and mind. If you are looking for a place to start, the Mediterranean diet, celebrated for its heart-healthy benefits, offers an excellent balanced foundation. It includes olive oil, whole grains for fibre and gut health, dairy, fresh vegetables for vitamins and minerals, and lean protein from poultry, fish or plants for muscle repair and strength. Vitamin D plays a crucial role in bone strength and immune support, especially for those with limited sun exposure, so fortified foods or supplements may be needed.

Some might need to be careful with potassium and phosphate-rich foods, but that doesn’t mean you need to compromise on having a delicious healthy diet that provides all the nutrients you need; a kidney dietitian can help to guide you.  If food preparation is tricky, then pre-prepared meals and frozen vegetables have their place – just opt for lower-salt versions where possible.

If you would like further information on diet and kidney disease, NKF have a range of resources available online: https://www.kidney.org.uk/diet-and-food

Stop Smoking

Smoking speeds up the loss of kidney function and can worsen frailty too. Stopping smoking can improve your kidney function as well as your overall health. You will have more energy, less trouble with your breathing and be less at risk of infections or developing other health problems. It’s never too late to stop and even small steps towards quitting brings health benefits. If you smoke, talk to your healthcare team about support, stop-smoking medicines and local support services that can help. 

National Centre for Smoking Cessation and Training: https://www.ncsct.co.uk/

Fatigue Management

Fatigue is one of the most common symptoms reported by people living with kidney disease; it is also one of the early symptoms of frailty and can lead to other health problems. It is the feeling of extreme exhaustion that is not relieved by sleep or rest, and it can have significant impacts on activity levels, mood and quality of life. While fatigue cannot be “cured,” it can often be better managed through making small changes to lifestyle and habits. The NKF have a leaflet on fatigue and kidney disease which may be of use if you are struggling with fatigue.

Medications

It is important to take medications that you are prescribed by your doctor. However, we know that taking lots of different medications can increase your risk of falls, functional or mental decline and hospitalisation. You can ask your doctor or pharmacist to review your current medications and let them know your goals for care and your preferences; communicating this to them may help your care team to make your medication regimen as simple and effective as possible.

Support for family, friends and carers

If you are a carer or provide care support for someone living with frailty and kidney disease, there is support available nationally and locally to help prevent burnout, improve health, maintain quality of life and provide essential tools to manage the responsibilities of caring for someone with health conditions. 

• Carers UK: https://www.carersuk.org/
• Carers Trust: https://carers.org/
• Carers Kidney Information Network: https://www.kidneyinfonet.org/kin/carers-kin/
• Age UK: https://www.ageuk.org.uk/services/in-your-area/carers-support/
• Local Council: Speak to your local authority for a carer’s assessment and local support services

Future Planning

We hope to stay as well as possible for as long as possible but know that things can become more difficult with time, especially if we experience a serious illness or injury. 

It is important to prepare for this - making your wishes known can help ensure the care you receive if you become unwell is the care that you want. Planning like this is sometimes called advance care planning. Speak to your doctor or another healthcare professional involved in your care to discuss your wishes about your future care. It can also be helpful to discuss this with family and/or friends too. Mywishes.co.uk is a free website that can help you make future plans. 

You may also want to consider setting up Lasting Powers of Attorney (LPA) with someone who you trust while you are able to do so. There are two distinct types – one for Health and Welfare and one for Property and Financial Affairs. The person you appoint for each of these allows them to make decisions on your behalf and are activated only if you are no longer able to make these decisions for yourself. Putting this into place ahead of time can make life easier for both you and those close to you. You can access forms and information at https://www.gov.uk/power-of-attorney.

Future planning may include thinking ahead with things like accessing your property and managing your home. There are often modifications and supports that can be put into place to help keep you living at home, but it can be useful to think ahead as these decisions may be a part of discussing whether you need to move to live with relatives or into a residential or care home. Health professionals such as an occupational therapist or social worker can often support with this – you can usually request a home assessment from your GP or online via your local council website (varies by council).  

You can also tell your healthcare team if you find coming up to hospital for follow up visits increasingly difficult. There are sometimes options to reduce frequencies, have a telephone follow-up or attend a clinic closer to your home.

A final word...

Frailty is common in people living with kidney disease, but it is not inevitable. There is a great deal you can do to stay well, independent and active. By recognising early signs and making small, consistent changes, you can reduce risks, improve your health and maintain a good quality of life.

Resources

National Kidney Federation – Frailty Webinar

https://www.youtube.com/watch?v=qFWW01lXaBU 

Age UK: Act Now, Age Better leaflet

https://www.ageuk.org.uk/siteassets/documents/act-now-age-better/act-now-age-better-leaflet-by-age-uk.pdf 

Chartered Society of Physiotherapy – Get Up and Go! A Guide to Staying Steady

https://www.csp.org.uk/system/files/get_up_and_go_0.pdf 

Men’s Sheds UK

Encourages people to come together to make, repair and repurpose, supporting projects in their local communities. Improving wellbeing, reducing loneliness and combatting social isolation.

https://menssheds.org.uk/

 Kidney Kitchen

Healthy recipes that are very carefully analysed and approved by the British Dietetic Association Kidney Dietitian Specialist Group (KDSG).

https://kidneycareuk.org/get-support/healthy-diet-support/kidney-kitchen/ 

National Academy for Social Prescribing

https://socialprescribingacademy.org.uk/ 

National Centre for Smoking Cessation and Training
https://www.ncsct.co.uk/ 

National Kidney Federation – Fatigue Management information

https://www.kidney.org.uk/living-with-fatigue-fatigue-management-for-people-with-kidney-disease 

National Kidney Federation – Diet and Kidney Disease

https://www.kidney.org.uk/diet-and-food 

Re-engage: Reducing loneliness in later life

Re-engage provides vital, life-enhancing social connections for older people at a time in their lives when their social circles are diminishing.

https://reengage.org.uk/ 

University of the Third Age

UK-wide movement of locally run interest groups that provide a wide range of opportunities to come together to learn for fun.

https://www.u3a.org.uk/ 

UK GOV - Lasting Power of Attorney

Registering an LPA (either for Health and Welfare, or Property and Finance) can be done through this website: https://www.gov.uk/power-of-attorney   

Volunteering Matters

https://volunteeringmatters.org.uk/ 

Future Planning

https://www.mywishes.co.uk

Written February 2026
Next review February 2029

Authors:

Sarah Afuwape, consultant health psychologist

Lisa Ancliffe, occupational therapist

Michelle Chody, physiotherapist

Elyssa Grief, occupational therapist

Clarissa Murdoch, geriatrician

Andrew Nixon, nephrologist

Ida Rebello, dialysis matron / frailty lead nurse

Emily White, kidney specialist dietician

Download this Information in PDF

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.