For healthy kidneys, avoid excess alcohol and salt, have regular check-ups
For healthy kidneys, avoid excess alcohol and salt, have regular check-ups

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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 the minerals in your body and release hormones that help make red blood cells, keep your blood pressure under control and strengthen your bones.

Chronic kidney disease (CKD) is a condition in which the kidneys can no longer filter blood effectively. This can increase the risk of heart disease, other health problems, and even death. More than a third of people aged 65 and over have CKD, and it is rapidly becoming more common. Although kidney damage cannot be reversed, there are a number of effective steps and treatments that can help keep CKD under control.

Eat right, exercise and hydrate

The risk of developing CKD usually increases with age. “This is often due to longer exposure to medical conditions or medications that can harm kidney function,” says Laura Maursetter, MD, a nephrologist and associate professor at the University of Wisconsin School of Medicine and Public Health. Diabetes, high cholesterol, and high blood pressure are known risk factors for kidney disease, as is long-term use of over-the-counter NSAIDs such as ibuprofen and naproxen. Research also shows 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 more likely to have CKD than those who who use histamine-2 receptor antagonists (Pepcid and Zantac).

Maintaining a diet low in salt and sugar can help you control all of these conditions, which in turn can protect your kidneys, says Sumeska Tavarajah, MD, assistant professor of medicine in the division of nephrology at Johns Hopkins University School of Medicine. And a diet high in unprocessed foods like fruits, vegetables, eggs, fish, and nuts can help you maintain a healthy weight, which Thavarajah says will reduce the work on your kidneys.

Physical activity also plays a positive role. “Exercise helps with diabetes control and blood pressure control, which can help protect your kidney health,” says Silvia 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 improvement in symptoms, according to a study published in 2019 in the Clinical Kidney Journal.

Dehydration can affect kidney function, so monitor fluid intake as well. Regular hydration throughout the day helps maintain healthy body function, says Thavarajah, who adds, “If you work outside and sweat a lot or exercise, increase your fluid intake.”

Because CKD is often asymptomatic, it is often undiagnosed. Screening tests are critical — at least once a year if you’re over age 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 working. These test results can be combined with factors such as age, race, and gender to determine the glomerular filtration rate (GFR). The lower it is, the more likely you are to have CKD. Your doctor may also order a urine test to screen for 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 have symptoms of CKD may experience swelling of the feet and ankles, frequent nausea, vomiting, loss of appetite and shortness of breath.

Beware of kidney disease

If your lab tests show worsening kidney function for more than three consecutive months, you may be diagnosed with CKD and referred to a nephrologist.

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

In severe cases where the kidneys fail, Rosas says dialysis or a kidney transplant may be necessary. That’s why prevention through lifestyle steps and routine checkups are so important. “There’s a lot we can do if CKD is caught early,” says Rosas.

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