Chronic kidney disease (CKD) and acute kidney injury (AKI) are more common in elderly individuals owing to ageing-related changes in the kidney. Renal disease in the elderly will in future form an increasing proportion of the workload of nephrologists, specialists in internal medicine and general practitioners because of the ageing of the general population. AKI in elderly people can often be anticipated and prevented. Published guidelines concerning the management of CKD in younger adults may not be universally implementable in the elderly, and may ignore complications and challenges specific to this age group.