HOW TO KEEP YOUR KIDNEYS HEALTHY

 

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.1

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, 

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:3

• 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.4

Centers for Disease Control and Prevention. Chronic kidney disease in the United States, 2023.

Exercise reduces two primary risk factors for CKD: high blood pressure and diabetes.5 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.6

Exercise helps by increasing circulation through the kidneys, keeping blood vessels flexible. It also increases sensitivity to insulin, lowering blood sugar.6

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.5

Exercise is moderate-intensity when you are breathing harder than normal and can talk but not sing during exercise.7

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.6

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.8

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.8

This would involve:8

• 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

If You Have Chronic Kidney Disease

Additional changes may be needed if your kidney function is decreasing. This may include restricting sodium to less than 1,500 mg per day, avoiding alcohol, limiting foods high in potassium or phosphorus, and reducing your protein intake.9

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.10

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.10

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:11

• 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.12

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.13

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.14

With that said, having diabetes does not mean that you are destined to have CKD. To avoid this. you need to:13

• 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 medications, such as insulin, as 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 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).15

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.16

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.17

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.17

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.18

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.18

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.19

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.18

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.20

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.21

NSAIDs work by blocking hormone-like compounds called prostaglandinsthat trigger inflammation and pain in the body. Prostaglandins also trigger vasodilation (the widening of blood vessels), which the body uses to regulate blood pressure.21

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.21

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.21

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.22 If given a prescription NSAID, use 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.26

Lang SM, Schiffl H. Smoking status, cadmium, and chronic kidney disease. Ren Replace Ther. 2024;10(17). doi:10.1186/s41100-024-00533-3

Tobacco smoke contains a metal called cadmium that is especially toxic to the kidneys, destroying nephrons at even relatively low doses.26 To make matters worse, cadmium can accumulate in the kidneys and persist for years or even decades, causing progressive damage.27

In contrast, quitting cigarettes for just three months can lower cadmium concentrations to where the damage can be slowed and possibly stopped.26

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.