You can take steps to improve your kidney health. These include lifestyle changes like increasing your intake of fluid, eating a healthier diet, losing excess weight, and 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 spine, the kidneys help ensure that the body’s systems remain in homeostasis (stable and in balance) to function normally.
Here is a list of nine things you can do to improve kidney health, whether you have kidney disease, are at risk of kidney disease, or simply want to keep your kidneys healthy over the long run.
1. Regular, Consistent 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 sodium, calcium, phosphorus, and potassium) remain at the ideal concentration. Without the correct balance, nerves, muscles, and other tissues in your body may not work normally.
If you are chronically dehydrated, there 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 myoglobin, which can clog the kidneys’ filtering units, called nephrons.
To avoid this, you need to drink enough fluids throughout the day—ideally water—to maintain optimal blood volume.
How much water you need depends on your age, body weight, and other factors. Water needs can also increase when you sweat a lot in hot weather or while exercising.
But generally speaking, the 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 kidneys, keeping blood vessels flexible. It also increases sensitivity to insulin, lowering 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 sessions, so 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.
If You Have Chronic Kidney Disease
If you have CKD, it is important to speak with a healthcare provider to ensure you exercise safely. While moderate-intensity exercise can be beneficial to people with CKD, high-intensity exercise can lead to muscle breakdown and myoglobin-related kidney damage.
3. Eat a Healthy, Balanced Diet
You are more likely to have kidney disease if you have high blood pressure, diabetes, or 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 vegetables, fruits, and whole grains
- Eating moderate portions of fish, poultry, beans, nuts, and fat-free or low-fat dairy
- Limiting foods high in saturated fat, including fatty meat, full-fat dairy, and tropical oils like coconut, palm kernel, and 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 greater, obesity increases your risk of CKD and your risk of CKD complications, such as anemia, gout, and bone disease.
Compared to people of healthy weight, people with a BMI between 30 and 34.9 are at a threefold higher risk of kidney disease. With a BMI of 35 and greater, the risk increases by as much as sevenfold.
To this end, the best way to avoid kidney disease is to achieve and maintain a healthy weight. If you need to lose weight, you 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 plan, incrementally increasing in duration and intensity
- Learning to swap high-fat, high-calorie food with healthier alternatives
- Steaming, broiling, or baking foods rather than frying them
- Finding healthy, low-calorie snacks, such as air-popped popcorn or apple slices
- Eating slower, which may help you eat less overall
If You Have Chronic Kidney Disease
If you have moderate to severe CKD, never embark on a weight loss plan without first consulting a healthcare provider. Rapid weight loss can lead to a greater loss of lean muscle mass compared to body fat. This can speed up the progression of CKD rather than slow it down.
5. Watch Your Blood Sugar
Diabetes is the leading cause of CKD. According to the National Institute of Diabetes and Digestive and Kidney Diseases, no less than 1 out of 3 adults with diabetes in the United States has kidney disease.
Diabetes contributes to diabetic nephropathy, a condition in which persistently high blood sugar levels cause severe and possibly irreversible damage to the kidneys. Even with treatment, diabetic nephropathy remains the most common cause of end-stage kidney disease.
With that said, having diabetes does not mean that you are destined to have CKD. To avoid this. you need to:
Even if you don’t have diabetes, you should watch your sugar intake, as a high-sugar diet can increase the risk of insulin resistance (a precursor to prediabetes and type 2 diabetes).
To keep your kidneys healthy, limit 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.
Can a Kidney Cleanse Help?
A kidney cleanse or “detox” is the practice of removing “toxins” from your kidneys with special supplements, substances, or diets. The National Center for Complementary and Integrative Health (NCCIH) advises that no evidence supports the use of detox diets to eliminate toxins from your body.
Moreover, some substances used for detoxification (such as spinach, beets, and other foods high in oxalate) can be harmful to the kidneys and lead to kidney stones when taken to excess or not balanced with other nutrients.
6. Maintain a Healthy Blood Pressure
Hypertension (high blood pressure) is the second leading cause of CKD. In the United States, nearly one of every two adults—roughly 108 million people—meet the diagnostic criteria for hypertension.
Hypertension places extreme stress on blood vessels, causing them to narrow and stiffen. When the blood vessels of the kidneys are affected, they are less able to remove excess water from your blood. This, in turn, increases the volume of water in your blood vessels, further raising your blood pressure. This vicious cycle can continue, eventually leading to kidney failure.
The same healthy lifestyle choices used to prevent diabetes and heart disease can also you achieve and maintain normal blood pressure, today 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 meditation, guided imagery, and 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 aspirin, Advil (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 overused, the inhibition of prostaglandins can prevent vasodilation. This, in turn, can 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 this, OTC drugs are especially worrisome because they can be used without control.
To protect the kidneys, never 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 NSAID, use the drug exactly as prescribed.
If You Have Chronic Kidney Disease
Certain medications safe for most people may be less safe for people with CKD. These include antibiotics, which may require a dose adjustment to avoid kidney injury.
Caution should also be exercised with contrast dyes used for diagnostic imaging like magnetic resonance imaging (MRI) and computed tomography (CT) scans. Laxatives containing sodium phosphate (used for bowel prep in advance of colonoscopy) can also cause injury in people with CKD.
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 kidneys, destroying nephrons at even relatively low doses. To make matters worse, cadmium can accumulate in the kidneys and persist for years or even decades, causing progressive damage.
In contrast, quitting cigarettes for just three months can lower cadmium concentrations to where the damage can be slowed and possibly stopped.
While quitting cigarettes can be difficult, numerous smoking cessation aids are available to help. These include counseling and support groups, oral drugs like Chantix (varenicline) and Zyban (bupropion), and nicotine-replacement gums, patches, inhalers, lozenges, and nasal sprays.
How to Get Free or Low-Cost Treatment
The Affordable Care Act (ACA) requires most health insurance plans to cover some level of smoking cessation treatment. Under the ACA, the following are covered for people with Medicare, Medicaid, Marketplace health insurance, and employer-sponsored health insurance:
- Four sessions of individual, group, or phone counseling
- 90 days of all FDA-approved smoking cessation medications
- Two quit attempts per year
9. Consider a Kidney Function Test
Of the 35.5 million people living with CKD in the United States, 90% 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 CDK, including those with diabetes, hypertension, heart disease, a family history of kidney disease, or 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 3, and many are nonspecific and easily attributed to other causes. These include persistent fatigue, foamy urine, dry or itchy skin, trouble sleeping, lower back pain, or urinating more or less than usual.
If caught early, medical and lifestyle changes may help slow or prevent CKD progression.
Common Types of Kidney Disease and Problems
Kidney diseases comprise a constellation of diseases, both acute and chronic, that affect different parts of the kidneys in different ways. Some are infectious, while others are metabolic, autoimmune, or congenital (meaning something you are born with). In rare cases, cancer may be involved.
If the results of your renal function test are abnormal, your healthcare provider may order additional tests to narrow the possible causes, including:
Summary
Chronic kidney disease affects over 35 million people in the United States, most of whom have no idea that they have the disease.
You can keep your kidneys healthy by drinking plenty of water, exercising regularly, eating a healthy diet, and maintaining a healthy weight. You can also mitigate the risks by quitting cigarettes, controlling your blood pressure and blood sugar, and avoiding the overuse of NSAIDs like Advil or Aleve.
Even if you aren’t at risk of CKD, these practices can help keep your kidneys healthy over the long term. If you are at risk, ask your healthcare provider for a renal function test so that you can act early if kidney disease is found.
