Improving Life Expectancy With Kidney Disease: What Matters Most?

Medically reviewed by Walead Latif, D.O.
Posted on October 6, 2023

  • Your life expectancy with kidney disease is influenced by several factors, including your kidney function, the type of kidney disease you have, and your treatment.
  • Most people with kidney disease die from heart disease, not kidney failure.
  • You may be able to improve your life expectancy by closely following your treatment plan.

A person in the United States can expect to live, on average, 76 years. If you have kidney disease, you may worry that your life expectancy could be lower. Kidney disease can shorten your life for many reasons, including increasing your risk of heart disease.

This article will review the most important factors that influence life expectancy in kidney disease and what you can do to improve it.

What Factors Influence Life Expectancy With Kidney Disease?

When you have kidney disease, your life expectancy can be influenced by your age, sex, and kidney function, as well as other medical conditions.

Age and Sex

A 2012 study analyzed the life expectancy of more than one million adults with kidney disease in Alberta, Canada. The researchers found that younger adults with kidney disease had a longer life expectancy than older people.

Findings from the United Kingdom Renal Registry show that a person who starts dialysis between the ages 25 and 29 can expect to live about 18.5 more years. A person starting dialysis between 65 and 74 can expect to live about five more years.

Reduced kidney function shortens life expectancy in general, but women tend to be less affected compared with men of the same age with the same kidney function, according to the journal Nephrology Dialysis Transplantation.

Kidney Function

Kidney function can be evaluated by calculating an estimated glomerular filtration rate (eGFR). This is commonly done by measuring the levels of a blood protein called creatinine. Your eGFR helps your doctor determine your stage of chronic kidney disease.

The stages of chronic kidney disease and the associated eGFR levels are as follows:

  • Stage 1 — 90 percent or higher
  • Stage 2 — 60 percent to 89 percent
  • Stage 3a — 45 percent to 59 percent
  • Stage 3b — 30 percent to 44 percent
  • Stage 4 — 15 percent to 29 percent
  • Stage 5 — Less than 15 percent

Stage 5 chronic kidney disease is also known as end-stage renal disease (ESRD) or end-stage kidney disease.

Life expectancy is significantly affected when eGFR falls below 60 milliliters per minute per 1.73 square meters (stages 3a, 3b, 4, and 5). For example, life expectancy falls by about 20 percent in men ages 30 to 44 with stage 3a chronic kidney disease, according to findings published in the journal Pediatric Nephrology, by about 50 percent in stage 3b, and by 65 percent in stage 4.

Talk to your doctor to find out what your eGFR is and how it might affect your life expectancy.

Other Medical Conditions

Other medical conditions that commonly occur with kidney disease can also influence your life expectancy. High blood pressure and diabetes are common in people who have kidney disease. High blood pressure in a middle-aged person can reduce life expectancy by two to three years, and diabetes can decrease life expectancy by seven to eight years, according to Nephrology Dialysis Transplantation.

How Does the Type of Kidney Disease Influence Life Expectancy?

Diabetes and high blood pressure are the most common causes of kidney disease. However, several other conditions can cause renal dysfunction that influences your life expectancy.

IgA Nephropathy

Immunoglobulin (IgA) nephropathy is a condition in which an immune system protein called IgA damages your glomeruli (filtering units in your kidney) and causes kidney disease. People with IgA nephropathy often progress to kidney failure within 10 to 15 years after diagnosis.

A 2018 study in the southeastern United States found that life expectancy in people with IgA nephropathy decreased by about 10 years. In a 2019 population-based study from Sweden, researchers found that people with IgA nephropathy died about six years earlier than people without the disease.

Complement 3 Glomerulopathy

With complement 3 (C3) glomerulopathy, part of your immune system — called the complement system — becomes too active and causes kidney damage. Kidney health usually gets worse over time. About 70 percent of children and 30 percent to 50 percent of adults with C3 glomerulopathy progress to ESRD within 10 years of diagnosis. If you have ESRD, you will likely have a shorter life expectancy.

Lupus Nephritis

Lupus nephritis is a kidney disease caused by an autoimmune disease called systemic lupus erythematosus (SLE). This common subtype of lupus can affect many parts of the body, but when it damages the kidneys, life expectancy is significantly decreased. A 2013 study found that people with SLE who had kidney disease had a life expectancy 15 years shorter than that of the general population, and people with kidney damage had a life expectancy of almost 24 years shorter.

Polycystic Kidney Disease

Polycystic kidney disease occurs when fluid-filled cysts grow on the kidneys. The average life expectancy for people with polycystic kidney disease is estimated to be from 53 to 70 years, depending on their subtype.

How Does Kidney Disease Treatment Affect Life Expectancy?

The type of treatment for your kidney disease can also influence your life expectancy.

For people with ESRD, dialysis is associated with living longer compared with more conservative therapy. A person starting dialysis can expect to live about 5 to 10 years, according to the National Kidney Foundation. However, many people have lived much longer — 20 to 30 years — while on dialysis treatment.

A kidney transplant is the best available treatment for ESRD. People who get a kidney transplant typically live 10 to 15 years longer than they would have if they’d stayed on dialysis, according to Beth Israel Deaconess Medical Center.

How Can You Improve Life Expectancy?

The higher risk of death in people with kidney disease is strongly linked to an increased risk of cardiovascular (heart) disease.

Manage Complications of Kidney Disease

You may be able to improve your life expectancy by preventing further kidney damage and heart disease. Kidney diseases can cause complications that not only worsen the condition itself but also increase your risk of heart disease, such as high blood pressure and high cholesterol.

You and your health care team will develop your personal treatment plan that will help you prevent kidney disease from getting worse or causing complications. Possible complications you may experience with kidney disease include:

  • Blood vessel problems
  • High blood pressure
  • Anemia (low levels of red blood cells)
  • Bone and mineral disease caused by extra calcium and phosphorus in your blood
  • Poor nutrition
  • Acute kidney injury (when kidney function suddenly worsens)
  • High cholesterol (high levels of fat in blood)

Several of these complications are also risk factors for heart disease. Medications can help you manage these risk factors and treat other health conditions, like diabetes. It’s important to take your medications exactly as your doctor prescribes. High blood pressure medications, such as ACE inhibitors and angiotensin-receptor blockers, can help keep kidney disease from getting worse.

If your immune system is causing kidney damage — such as in IgA nephropathy, C3 glomerulopathy, or lupus nephritis — your treatment plan may include immunosuppressive drugs. These drugs can help calm your immune system and prevent further kidney damage.

Talk to your health care team to find out what complications you may be at risk for and the best way to manage them.

Prevent Heart Disease

Most people with kidney disease die from heart disease, not kidney failure. It isn’t possible to prevent many types of kidney disease, such as IgA nephropathy and C3 glomerulopathy. However, you can take actions like these to prevent heart disease:

  • Follow your doctor’s advice to keep your blood pressure below 140/90 millimeters of mercury (mm Hg) and achieve healthy cholesterol levels.
  • If you have diabetes, keep your blood sugar levels under control.
  • Maintain a healthy weight.
  • Stay active, logging about 30 minutes of physical activity on most days.
  • Eat nutritious, well-balanced foods that fit with your renal diet.
  • Limit the amount of sodium (part of salt) you eat — most people should get less than 2,300 milligrams each day.

Talk to your nephrologist and other members of your health care team to learn more about what you can do to improve your life expectancy.

Talk With Others Who Understand

At MyKidneyDiseaseCenter, the site for people with kidney disease and their loved ones, people come together to gain a new understanding of different kidney diseases and share their stories with others who understand life with kidney disease.

What are you doing to improve your outlook while living with kidney disease? Share your experiences in the comments below.

References
  1. Life Expectancy in the U.S. Dropped for the Second Year in a Row in 2021 — Centers for Disease Control and Prevention
  2. Key Points: Living With Stage 4 Kidney Disease — National Kidney Foundation
  3. Chronic Kidney Disease and Life Expectancy — Nephrology Dialysis Transplantation
  4. Why Do Young People With Chronic Kidney Disease Die Early? — World Journal of Nephrology
  5. Estimated Glomerular Filtration Rate (eGFR) — National Kidney Foundation
  6. End-Stage Renal (Kidney) Disease — Cleveland Clinic
  7. Life Expectancy With Chronic Kidney Disease: An Educational Review — Pediatric Nephrology
  8. Chronic Kidney Disease (CKD) — National Kidney Foundation
  9. IgA Nephropathy — National Kidney Foundation
  10. Long-Term Outcomes in IgA Nephropathy — Clinical Journal of the American Society of Nephrology
  11. Life Expectancy for Patients From the Southeastern United States With IgA Nephropathy — Kidney International Reports
  12. Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study — Journal of the American Society of Nephrology
  13. C3 Glomerulopathy — MedlinePlus
  14. C3 Glomerulopathy — Understanding a Rare Complement-Driven Renal Disease — Nature Reviews. Nephrology
  15. Lupus and Kidney Disease (Lupus Nephritis) — National Institute of Diabetes and Digestive and Kidney Diseases
  16. Effect of Renal Disease on the Standardized Mortality Ratio and Life Expectancy of Patients With Systemic Lupus Erythematosus — Arthritis and Rheumatism
  17. Polycystic Kidney Disease — National Kidney Foundation
  18. Should Patients With Autosomal Dominant Polycystic Kidney Disease Be Screened for Cerebral Aneurysms? — American Journal of Neuroradiology
  19. Long-Term Outcomes Among Patients With Advanced Kidney Disease Who Forgo Maintenance Dialysis: A Systematic Review — JAMA Network Open
  20. Dialysis — National Kidney Foundation
  21. A Comparative Analysis of Survival of Patients on Dialysis and After Kidney Transplantation — Clinical Kidney Journal
  22. The Benefits of Kidney Transplant Versus Dialysis — Beth Israel Deaconess Medical Center
  23. IgA Nephropathy (Berger Disease) — Mayo Clinic
  24. Managing Chronic Kidney Disease — National Institute of Diabetes and Digestive and Kidney Diseases
  25. Complement 3 Glomerulopathy (C3G) — National Kidney Foundation
  26. Complement 3 Glomerulopathy (C3G) — Cleveland Clinic
  27. Heart Disease & Kidney Disease — National Institute of Diabetes and Digestive and Kidney Diseases

Posted on October 6, 2023
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Walead Latif, D.O. is a board-certified nephrologist and an assistant clinical professor at Rutgers New Jersey Medical School. Learn more about him here
Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here

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