8 Ways to Keep Your Kidneys Healthy
Chronic kidney disease impacts nearly 40% of Americans 65 and older
The fastest-growing noncommunicable disease in the United States isn't diabetes or hypertension but chronic kidney disease, a condition affecting nearly 40% of people 65 and older. Yet, despite its prevalence, about nine in 10 of those affected — including one in three with advanced-stage disease— are unaware they have it.
"The kidneys constantly filter and rebalance the entire chemical composition of the blood, no matter what we ingest, where we travel, or what illness befalls us," says Samir Parikh, M.D., chief of nephrology at the University of Texas Southwestern in Dallas. "Unlike a car filter, furnace filter or HEPA filter, the microscopic blood filters that make up the kidney have to last an entire lifetime, not just a few months before replacement. They don't regenerate."
"The kidneys constantly filter and rebalance the entire chemical composition of the blood,"
Besides kidney stones and the potential need for lifelong dialysis, unchecked kidney disease can contribute to serious complications such as heart attack, stroke and premature death. Fortunately, it's manageable with medical intervention, and there are several steps you can take to reduce your risk of getting sick to begin with. Here, five experts explain how.
Get Regular Checkups
Modern medicine can stop kidney diseases in their tracks and even bring on lasting remission, Parikh says. This is particularly true with early intervention — one of many reasons not to skip your annual physical.
"Because kidney, metabolic and cardiovascular disease all conspire to make each problem worse, there are a few levels of monitoring that patients over 50 should follow: First, the yearly physical is a time to request two simple kidney function tests," Parikh says. "One is a kidney function test that is cheap to perform, very accurate, and can be added to any blood panel the doctor requests without having to give more blood. The other is a urine analysis to look for elevated protein levels."
At this appointment, your doctor should also check your blood pressure and screen you for metabolic issues like diabetes or prediabetes, Parikh adds.
Parikh says the kidneys filter and remove many medications from the body. With continuous, long-term use, toxic levels may accumulate in the organs' tissue, causing damage.
Among over-the-counter medications, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and aspirin, are the most common culprit, says Adedamola Adeboye, M.D., assistant professor of nephrology at the University of Tennessee Health Science Center in Memphis. Other medicines that can damage the kidneys over time include acid reflux medications, diuretics ("water pills"), lithium, laxatives and certain antibiotics, like gentamicin and vancomycin, Adeboye continues.
To reduce the risk of harm, Adeboye recommends asking your health care provider about kidney-friendly pain relief alternatives (such as acetaminophen), taking medications only as prescribed, and avoiding long-term use if possible.
Stay Hydrated
Dehydration reduces blood flow to the kidneys, which can lead to injuries, according to the National Kidney Foundation. The organs also need water to properly function.
"Drinking enough water (but not too much) helps flush toxins and prevent kidney stones," Adeboye says.
Most people should aim for 64 ounces of fluid per day, says Melanie Betz, founder and CEO of The Kidney Dietician in Chicago. However, she recommends asking a doctor or dietician how much water you need, as it can vary significantly based on your body size and specific health conditions. People with advanced kidney disease, for instance, may need to drink less. Also, Betz notes that not all liquids have to come from a bottle or glass.
"Another great way to stay hydrated is to eat plenty of fruits and vegetables — they all give us a little extra fluid," Betz says. "Some excellent options for hydration are watermelon, cucumbers, tomatoes, strawberries and melon."
Type 2 diabetes is the single-most cause of chronic kidney disease in the U.S., and it's becoming more prevalent, notes Tim Pflederer, M.D., chief medical officer of Evergreen Nephrology in Nashville, Tennessee.
"High blood sugar over time can damage the small blood vessels and filters in the kidneys, causing protein leakage in the urine and eventually leading to kidney failure," Adeboye says.
Eating a balanced diet with plenty of fruits, vegetables, whole grains and lean protein, exercising regularly, maintaining a healthy weight and taking prescribed medications can help, Adeboye says.
Hypertension (high blood pressure) is the second-leading cause of chronic kidney disease nationwide, Pflederer says.
"As part of the kidneys' job is to regulate blood pressure, hypertension can damage the kidneys' blood vessels, causing them to weaken and harden," he explains.
According to the Mayo Clinic, lifestyle adjustments that may help prevent high blood pressure include losing excess weight, reducing stress, consuming minimal salt and alcohol, managing cholesterol, not smoking and exercising regularly. If you already have hypertension, your doctor may prescribe medication.
Eat a Healthy Diet
Healthy eating is important for anyone, but especially those with a higher risk of kidney problems.
"This will not only help prevent kidney disease but help control high blood pressure and blood sugar," Betz says. "Specifically, avoiding too much salt and added sugar and getting plenty of fruits, vegetables and whole grains is good for the kidneys."
"Avoiding too much salt and added sugar and getting plenty of fruits, vegetables and whole grains is good for the kidneys."
Many people underestimate their sodium intake as it shows up in unexpected places, particularly highly processed products such as condiments, canned soups, pre-sliced American cheese and prepared meats, says Blake Shusterman, M.D., who is known as "The Cooking Doc," a healthy eating expert and nephrologist in Greenville, South Carolina. He says learning to cook at home, minding nutrition labels, and seasoning foods with herbs, spices and citrus can help.
Betz also suggests cutting back on meat — especially red and highly processed varieties — and swapping these for plant-based proteins. Shusterman agrees.
"After the body breaks down all this meat, the kidneys have to process it," Shusterman explains. "Some data suggest that if the kidneys are kind of working overtime to process these broken-down animal proteins … they develop scarring and are unable to function as well."
Staying active is another way to maintain healthy blood pressure, blood sugar levels, and overall kidney function, Adeboye says. It can also help prevent or diminish obesity — another risk factor for kidney disease.
Betz suggests finding enjoyable ways to move your body, as this will help you keep up the habit long term.
"Exercise doesn't have to be walking or going to the gym if you don't enjoy that," Betz says. "Any activity that gets you out of your seat 'counts.'"
The Centers for Disease Control and Prevention recommends most older adults get 150 minutes of moderate-intensity activity (such as brisk walking, doubles tennis or swimming laps) every week. The agency also suggests adults incorporate at least two days of strength training weekly. Whether you're thinking of cycling or taking tango lessons, talk to your doctor before starting an exercise plan, especially if you have an existing health condition.
Be Wary of Detox Regimens
"Detox" regimens and certain supplements may do more harm than good, Betz warns.
"Supplements are a very concentrated dose of something. Since your kidneys are responsible for getting rid of excess waste — including waste from supplements — they are especially susceptible to harm," Betz says.
"Ironically, many detox regimens cause dehydration or recommend dangerously large amounts of a particular food or nutrient, which can cause kidney damage."
Moreover, Betz says, the U.S. government doesn't regulate supplements in the same way as medications, so there's often no telling what is (or isn't) actually in them. She recommends consulting a doctor before taking any nutrition or herbal supplement, even those that seem "safe" or "natural."
"Detoxes are another red flag. Your body does not need help 'detoxing.' Your liver and kidneys already do a good job getting rid of waste," she says, aligning with guidance from the National Center for Complementary and Integrative Health. "Ironically, many detox regimens cause dehydration or recommend dangerously large amounts of a particular food or nutrient, which can cause kidney damage."
