Chronic kidney disease (CKD) is the fastest growing cause of death, expected to become the fifth global cause of death and the third in some countries with long life expectancy, such as Japan and Spain, by 2050. This reflects societal aging, as advancing kidney age is the main risk factor for CKD. The forecasted 140% increase in the death rate from CKD by 2050 is reduced to 33% when adjusted for age. The increasing mortality burden is paralleled by higher personal, healthcare, socio-economic and environmental burdens and the need for kidney replacement therapy to treat kidney failure. To some extent, the higher CKD burden represents the price of success in prolonging longevity by decreasing other causes of death. Now is the time to act to minimize the negative impact of CKD on aging societies through primary prevention and early diagnosis and treatment of CKD. Action aimed at maintaining kidney health and delaying biological kidney aging will contribute to healthy aging, as the kidneys have gerosuppressor functions and CKD has the highest negative impact on body aging among chronic non-communicable diseases. This action should be part of a move towards novel holistic approaches to healthy longevity represented by concepts such as cardiovascular-kidney-metabolic health, geromedicine, gerosuppressors and organ rejuvenation. We discuss a conceptual framework for the present and future of kidney aging and kidney health in the elderly, emphasizing opportunities for intervention that underlie the Japanese Society of Nephrology and European Renal Association call to action on Achieving Kidney Health in Aging/Aged Societies.

Amsterdam Public Health Research Institute Quality of Care Amsterdam The Netherlands

Department of Clinical Studies and Epidemiology University Hospital Würzburg Würzburg Germany

Department of Medicine 3rd Faculty of Medicine Charles University Prague and University Hospital Kralovske Vinohrady Prague Czech Republic

Department of Medicine Universidad Autonoma de Madrid Madrid Spain

Department of Nephrology and Hypertension IIS Fundacion Jimenez Diaz UAM Madrid Spain

Department of Nephrology Graduate School of Medicine Kyoto University Kyoto Japan

Department of Nephrology Juntendo University Faculty of Medicine Tokyo Japan

Department of Nephrology Kumamoto University Graduate School of Medical Sciences Kumamoto Japan

Department of Urology Osaka Metropolitan University Osaka Japan

Division of Kidney Dialysis and Cardiology Department of Internal Medicine Hyogo Medical University Hyogo Japan

Division of Nephrology and Endocrinology University of Tokyo Graduate School of Medicine Tokyo Japan

ERA Registry Department of Medical Informatics Amsterdam UMC location University of Amsterdam Amsterdam The Netherlands

European Renal Association Parma Italy

Kawasaki Medical School Kurashiki Japan

Nephrology Department Fundació Puigvert Institut de Recerca Sant Pau Departament de Medicina Universitat Autònoma de Barcelona RICORS2040 Barcelona Spain

Population Health Sciences Bristol Medical School University of Bristol Bristol UK

Universität des Saarlandes Homburg Germany

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doi: 10.1093/ndt/gfaf087 PubMed

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