9 Ways to Keep Your Kidneys Healthy

You can take steps to improve your kidney health. These include life changes like increasing your intake of fluideating a healthier dietlosing excess weightand controlling your blood pressure. You can also prevent kidney damage by quitting cigarettes and avoiding the overuse of nonsteroidal anti-inflammatory drugs (NSAIDs).

The kidneys are two bean-shaped organs whose primary functions are filtering waste from the blood and maintaining the optimal fluid balance in your body. Located on the back of the abdominal wall on both sides of the spinethe kidneys help ensure that the body's systems remain in homeostasis (stable and in balance) to function normally.

1. RegularConsistent Water Intake

One of the primary functions of your kidneys is to remove extra fluid from the body in the form of urine. This ensures that the acid and electrolyte levels in your blood (including sodiumcalciumphosphorusand potassium) remain at the ideal concentration. Without the correct balancenervesmusclesand other tissues in your body may not work normally.

If you are chronically dehydratedthere will not be enough water in your body to dilute acid or eliminate wastes from your blood. This can lead to the breakdown of muscles and the release of a protein called myoglobinwhich can clog the kidneys' filtering unitscalled nephrons.

To avoid thisyou need to drink enough fluids throughout the day—ideally water—to maintain optimal blood volume.

How much water you need depends on your agebody weightand other factors. Water needs can also increase when you sweat a lot in hot weather or while exercising.

But generally speakingthe National Institutes of Health recommends drinking an average of:

• 9 cups of fluids a day for adult females
• 13 cups of fluid a day for adult males

If you have kidney disease or take medications that promote urination (like diuretics)you may need to drink more even than this. Speak with your healthcare provider.

2. Stay Active

Good physical health is linked to good kidney health. This is especially true if you have chronic kidney disease (CKD)a progressive condition that affects at least one in seven adults in the United States.

Exercise reduces two primary risk factors for CKD: high blood pressure and diabetes. High blood pressure is a problem because it causes the progressive narrowing of blood vessels (including those of the kidneys)while high blood sugar directly damages nephrons.

Exercise helps by increasing circulation through the kidneyskeeping blood vessels flexible. It also increases sensitivity to insulinlowering blood sugar.

People with and without CKD are advised to engage in at least 150 minutes of moderate-intensity exercise per week. Exercise can be broken into 25- to 30-minute sessionsso you work out most days of the week.

Exercise is moderate-intensity when you are breathing harder than normal and can talk but not sing during exercise.

3. Eat a HealthyBalanced Diet

You are more likely to have kidney disease if you have high blood pressurediabetesor heart disease. Diet plays an important role in mitigating these risks.

Some experts recommend the DASH diet (Dietary Approach to Stop Hypertension diet) as the foundation by which to adjust your eating habits if you have or are at risk of developing CKD.

This would involve:

• Eating larger portions of vegetablesfruitsand whole grains
• Eating moderate portions of fishpoultrybeansnutsand fat-free or low-fat dairy
• Limiting foods high in saturated fatincluding fatty meatfull-fat dairyand tropical oils like coconutpalm kerneland palm oils
• Restricting sweets and sugar-sweetened beverages
• Keeping your sodium intake to less than 2,300 milligrams (mg) per day

4. Manage Your Weight

Having obesity is associated with all three main risk factors for kidney disease. Defined as a body mass index (BMI) of 30 or greaterobesity increases your risk of CKD and your risk of CKD complicationssuch as anemiagoutand bone disease.

Compared to people of healthy weightpeople with a BMI between 30 and 34.9 are at a threefold higher risk of kidney disease. With a BMI of 35 and greaterthe risk increases by as much as sevenfold.

To this endthe best way to avoid kidney disease is to achieve and maintain a healthy weight. If you need to lose weightyou can better achieve these goals by:

• Working with a healthcare provider to determine your daily calorie intake
• Logging the calories of all the foods you eat and drink each day
• Creating a sustainable exercise planincrementally increasing in duration and intensity
• Learning to swap high-fathigh-calorie food with healthier alternatives
• Steamingbroilingor baking foods rather than frying them
• Finding healthylow-calorie snackssuch as air-popped popcorn or apple slices
• Eating slowerwhich may help you eat less overall

5. Watch Your Blood Sugar

Diabetes is the leading cause of CKD. According to the National Institute of Diabetes and Digestive and Kidney Diseasesno less than 1 out of 3 adults with diabetes in the United States has kidney disease.

Diabetes contributes to diabetic nephropathya condition in which persistently high blood sugar levels cause severe and possibly irreversible damage to the kidneys. Even with treatmentdiabetic nephropathy remains the most common cause of end-stage kidney disease.

With that saidhaving diabetes does not mean that you are destined to have CKD. To avoid this. you need to:

• Talk with your healthcare provider about the blood glucose range that is healthy for you.
• Regularly monitor your blood sugar with a glucometer as directed by your provider,
• Take your diabetes medicationssuch as insulinas prescribed.
• Control your blood pressure.
• Work with a dietitian to develop a diabetes meal plan.
• Aim for seven to eight hours of sleep per night.

Even if you don't have diabetesyou should watch your sugar intakeas a high-sugar diet can increase the risk of insulin resistance (a precursor to prediabetes and type 2 diabetes).

To keep your kidneys healthylimit your sugar intake to no more than 36 grams (9 teaspoons) per day if you are male and 25 grams (6 teaspoons) per day if you are female.

6. Maintain a Healthy Blood Pressure

Hypertension (high blood pressure) is the second leading cause of CKD. In the United Statesnearly one of every two adults—roughly 108 million people—meet the diagnostic criteria for hypertension.

Hypertension places extreme stress on blood vesselscausing them to narrow and stiffen. When the blood vessels of the kidneys are affectedthey are less able to remove excess water from your blood. Thisin turnincreases the volume of water in your blood vesselsfurther raising your blood pressure. This vicious cycle can continueeventually leading to kidney failure.

The same healthy life choices used to prevent diabetes and heart disease can also you achieve and maintain normal blood pressuretoday defined as a systolic (upper) reading of less than 120 mm Hg (millimeters of mercury) and diastolic (lower) reading of less than 80 mm Hg.

If you have been diagnosed with hypertension (defined as a systolic reading of 130 or more or a diastolic reading of 80 or more)medications like angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and diuretics (water pills) can help bring your blood pressure under control.

Stress management can also help. A 2021 review of studies reported that mindfulness-based stress reduction is especially useful in lowering your diastolic blood pressure. This includes practices like meditationguided imageryand diaphragmatic ("belly") breathing.

7. Avoid Taking OTC Pain Medication Too Often

Certain medications can harm the kidneys. Chief among these are nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirinAdvil (ibuprofen)and Aleve (naproxen)which can damage the kidneys if overused.

NSAIDs work by blocking hormone-like compounds called prostaglandins that trigger inflammation and pain in the body. Prostaglandins also trigger vasodilation (the widening of blood vessels)which the body uses to regulate blood pressure.

If NSAIDs are overusedthe inhibition of prostaglandins can prevent vasodilation. Thisin turncan decrease blood flow to the point where acute kidney failure can occur.

While over-the-counter (OTC) and prescription NSAIDs (like indomethacin and mefenamic acid) can both cause thisOTC drugs are especially worrisome because they can be used without control.

To protect the kidneysnever take OTC NSAIDs for more than 10 consecutive days for pain or three consecutive days for fever. Always use the lowest possible dose. If given a prescription NSAIDuse the drug exactly as prescribed.

8. Stop Smoking

Cigarettes are linked to an increased risk of CKD and a faster progression to end-stage kidney disease.

Tobacco smoke contains a metal called cadmium that is especially toxic to the kidneysdestroying nephrons at even relatively low doses. To make matters worsecadmium can accumulate in the kidneys and persist for years or even decadescausing progressive damage.

In contrastquitting cigarettes for just three months can lower cadmium concentrations to where the damage can be slowed and possibly stopped.

While quitting cigarettes can be difficultnumerous smoking cessation aids are available to help. These include counseling and support groupsoral drugs like Chantix (varenicline) and bupropionand nicotine-replacement gumspatchesinhalerslozengesand nasal sprays.

9. Consider a Kidney Function Test

Of the 35.5 million people living with CKD in the United States90% have no idea that they have it.

Because CKD is often asymptomatic (without symptoms)the disease may only become apparent when the kidneys are irreversibly damaged or when a routine panel of tests—called a renal function test—is performed for another reason.

The renal function test consists of blood and urine tests that evaluate how well your kidneys are functioning. These include:

• Estimated glomerular filtration rate (eGFR): This blood test measures how well your kidneys are filtering blood based on how much creatinine (a waste product created by the normal breakdown of muscles) is found in your blood.
• Urine albumin-creatinine ratio (uACR): This urine test measures how well your kidneys are functioning based on how much albumin (a protein normally retained by the kidneys) is found in a sample of urine,

The National Kidney Foundation and other leading health authorities recommend renal function testing in all people at risk of CDKincluding those with diabeteshypertensionheart diseasea family history of kidney diseaseor a personal history of acute kidney failure.

What Happens When Kidney Function Gets Worse?

Chronic kidney disease occurs in stages during which there will be a gradual decline in kidney function over the course of years.

The five stages are based on eGFR test results measured in milliliters per minute (mL/min):

• Stage 1: Normal kidney function (eGFR over 90 mL/min)
• Stage 2: Mild CKD (eGFR 60-89 mL/min)
• Stage 3: Moderate CKD (eGFR 30-59 mL/min)
• Stage 4: Severe CKD (eGFR 15-29 mL/min)
• Stage 5: End-stage kidney disease (eGFR under 15 mL/min)

Symptoms generally only develop during stage 3and many are nonspecific and easily attributed to other causes. These include persistent fatiguefoamy urinedry or itchy skintrouble sleepinglower back painor urinating more or less than usual.

If caught early, medical and life changes may help slow or prevent CKD progression.

Common Types of Kidney Disease and Problems

Kidney diseases comprise a constellation of diseasesboth acute and chronicthat affect different parts of the kidneys in different ways. Some are infectiouswhile others are metabolicautoimmuneor congenital (meaning something you are born with). In rare casescancer may be involved.

If the results of your renal function test are abnormalyour healthcare provider may order additional tests to narrow the possible causesincluding:

• Diabetic nephropathy
• Fanconi syndrome
• Goodpasture syndrome
• Glomerulonephritis
• Interstitial nephritis
• Kidney cysts
• Kidney stones
• Lupus nephritis
• Nephrotic syndrome
• Polycystic kidney disease (PKD)
• Pyelonephritis (kidney infection)
• Renal artery stenosis
• Renal cell carcinoma (RCC)
• Renal vein thrombosis