How to keep your kidneys working well

Learn about the vital role of your kidneys in filtering waste and maintaining overall health. Find out the risks and consequences of chronic kidney disease and how to protect your kidneys for a healthy future.

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Story courtesy of Consumer Reports

Think of your kidneys as your body’s sanitation department — and then some. They filter waste, toxins and extra fluid from your blood. They also balance minerals in your body and release hormones that help create red blood cells, keep your blood pressure in check and strengthen your bones.

Chronic kidney disease (CKD) is a condition in which the kidneys can no longer effectively filter blood. This can increase your risk of cardiovascular disease, other health problems and even death. More than a third of people 65 and older have CKD, and it’s quickly becoming more common. Although kidney damage can’t be reversed, there are a number of effective lifestyle steps and treatments that can help keep CKD in check.

Eat right, exercise and hydrate

The risk of developing CKD generally increases with age. “This is often due to a longer exposure to medical conditions or medications that can harm the kidney function,” says Laura Maursetter, a nephrologist and associate professor at the University of Wisconsin School of Medicine and Public Health. Diabetes, high cholesterol and high blood pressure are all known risk factors for kidney disease, as is long-term use of over-the-counter NSAIDs such as ibuprofen and naproxen. Research also indicates that people who regularly use proton pump inhibitors — such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) — for frequent heartburn are more than 28 times as likely to have CKD as those who use histamine-2 receptor antagonists (Pepcid and Zantac).

Maintaining a diet that’s low in salt and sugar can help keep all these conditions in check, which in turn can protect your kidneys, says Sumeska Thavarajah, an assistant professor of medicine in the division of nephrology at the Johns Hopkins University School of Medicine. And a diet that’s high in unprocessed foods such as fruits, vegetables, eggs, fish and nuts can help you maintain a healthy weight, which Thavarajah says will reduce the work your kidneys have to do.

Physical activity also plays a positive role. “Exercise helps with diabetes control and blood pressure control, which can help protect your kidney health,” says Sylvia E. Rosas, director of the Latino Kidney Clinic and a physician at the Joslin Diabetes Center in Boston. The Centers for Disease Control and Prevention says to aim for 150 minutes of moderate-intensity exercise each week (think brisk walking) or about 30 minutes most days. People with CKD who did aerobic or strength training three times a week for 12 weeks reported improvements in symptoms, according to a study published in 2019 in Clinical Kidney Journal.

Dehydration can affect kidney function, so keep an eye on your fluid intake, too. Hydrating regularly throughout the day helps support healthy body function, says Thavarajah, who adds, “If you’re working outside and sweating a lot or working out, increase your fluid intake.”

Get screened

Because CKD is often symptomless, it’s often undiagnosed. Screening tests are critical — at least once a year if you’re older than 60 or have high blood pressure or diabetes, Thavarajah suggests.

A routine blood test can measure levels of creatinine, a waste product from your muscles, to determine how well your kidneys are functioning. These test results can be combined with factors such as age, race and gender to determine your glomerular filtration rate (GFR). The lower it is, the more likely it is that you have CKD. Your doctor may also order a urine test to screen for a protein (albumin), which can be an early sign of declining kidney function, Thavarajah says — sometimes before anything shows up on a blood test.

People who do have CKD symptoms may experience feet and ankle swelling, frequent nausea, vomiting, appetite loss and shortness of breath.

Take care of kidney disease

If your lab tests show a decline in kidney function for more than three months in a row, you might be diagnosed with CKD and referred to a nephrologist.

Dietary modifications (such as avoiding alcohol and choosing heart-healthy foods low in sugar and salt), exercise and quitting smoking can help control CKD. And there’s increasing evidence that diabetes medications called SGLT-2 inhibitors can slow the progression of CKD and decrease the risk of cardiovascular complications and other problems. People who take blood pressure or diabetes drugs should talk to their doctors about how medications will affect CKD.

In severe cases where the kidneys are failing, Rosas says that dialysis or a kidney transplant may be necessary. That’s why prevention through lifestyle steps and routine screening are so important. “There are many things we can do if chronic kidney disease is caught early,” Rosas says.

Kidneys, filtration, waste, toxins, blood pressure, red blood cells, bones, chronic kidney disease, cardiovascular disease

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