One in ten Britons have chronic kidney disease (CKD) – soaring to one in two by the age of 75. A further million, meanwhile, have the condition but are unaware of it.
Worryingly, half of those with the most common risk factors – high blood pressure, diabetes and disease of the heart and blood vessels – don’t consider themselves at risk of kidney problems. But the good news is there are lots of ways to make sure your kidneys are working as they should.
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What causes kidney problems?
The most common – and controllable – reasons are high blood pressure and poorly controlled diabetes. Other risk factors include:
- heart disease
- being of African, African-Caribbean or Asian origin
- a family history of kidney disease
- abnormal kidney structure
- large kidney stones
- prostate problems
- being aged over 60
Why you need to drink more water to help your kidneys
Good hydration is vital for healthy kidney function, according to a 2016 review, as it helps to reduce the release of a hormone called vasopressin, an antidiuretic. Water is the best beverage, helping the kidneys remove waste substances from the blood as well as keeping the vessels dilated so blood can flow freely to the kidneys to supply essential nutrients.
They are two bean-shaped organs found just below the rib cage, one on either side of the spine. Their functions include:
Filtering blood to eliminate waste products in urine
Balancing the body’s fluid content
Helping regulate blood pressure
Producing a hormone that’s involved in manufacturing red blood cells
Activating vitamin D to keep bones healthy
Balancing levels of minerals and other chemicals in the body
And that’s not all. A high water intake is also vital to help prevent kidney stones and urine infections. It’s best to drink little and often throughout the day rather than consuming large quantities in one go. Aim to quaff at least 3 litres of water a day (men) and 2.2 litres (women).
How can you tell you’re getting enough? Check your urine – it should be pale straw coloured or colourless. Dark yellow urine? You need to turn on the tap.
Strategies to prevent dehydration
How exercise helps your kidneys
Regular exercise is as good for the kidneys as it is for the rest of the body. Research from King’s College Hospital in London discovered that regular light exercise (three times a week) significantly slowed the rate at which kidney function deteriorated in people with CKD.
Similarly, a Taiwanese study of those with the condition, aged over 70, showed that regular walkers were 21% less likely to need dialysis or a kidney transplant and a third less likely to die from the condition than their more sedentary peers.
As well as walking, other low-impact activities, such as swimming, are ideal. Check with your GP first, though, if you haven’t been active for a while.
Healthy reasons to go for a walk
Why a thick neck might be linked to kidney stones
Repeated kidney stone formation can damage the kidneys and increase the risk of kidney disease. Recent research published in the journal Frontiers in Physiology shows that, surprisingly, a thick neck is a risk factor for kidney-stone formation. The reasons aren’t clear, but a wide neck is thought to reflect the amount of harmful visceral fat around vital organs, which can affect kidney function.
A large waist circumference is also linked to an increased risk of kidney stones. In this case, it’s a sign of insulin resistance, which is thought to change the way the kidneys control the acidity of your urine. Whittle your neck and waist by losing weight and taking regular exercise. Experts also advise cutting down on meat, sugar and salt to reduce the risk of stone formation.
Kidney disease is usually silent at first. If you experience any of the following, see the doctor::
Dark, red or foamy urine
Frequent urination, sometimes with pain or burning
A change in the amount of urine you produce
Swelling of the legs, hands, face
Raised or high blood pressure
Back pain, especially if there is fever
Tiredness or feeling unwell
Widespread itchy skin
Don’t take too many painkillers
Overuse of over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can cause kidney damage and disease. In fact, according to a study published last December, NSAIDs are the biggest cause of drug-induced kidney disease. The risk is especially high if you already have reduced kidney function or if you take NSAIDs alongside diuretics or certain blood-pressure-lowering drugs such as ACE inhibitors and angiotensin receptor blockers.
If you use painkillers only occasionally, provided your kidneys are working properly, there’s no need to worry. But if you suffer from chronic pain, such as arthritis, backache and headaches, and take NSAIDs regularly, it could be time to find other ways to control pain, such as acupuncture, yoga, t’ai chi or transcutaneous electronic nerve stimulation (TENS). Other medications, both OTC and prescribed, can be culprits too, especially if kidneys are already damaged. Ask your pharmacist or GP for a medication review if you are worried.
Say ‘no’ to salt
A high salt intake is linked to a greater risk of kidney disease, according to a study published last year. Among other things, it increases blood pressure, placing a strain on the delicate blood vessels that lead to the kidneys.
Although as a nation we have reduced our salt intake in recent years, according to Dr Alison Tedstone, national director with responsibility for diet, nutrition and obesity at Public Health England, we’re still consuming a third more than the recommended 6g a day (around a teaspoon).
So cut down on processed foods and ready meals, increase your intake of fresh fruit and vegetables and check labels for sodium content. Aim for blood pressure of lower than 140/90mmHg, or even 130/80mmHg if you have diabetes or another illness.
Regular exercise, a healthy diet, losing weight, cutting down on alcohol and quitting if you’re a smoker can all help to keep blood pressure in check. But don’t reject medication. BP-lowering drugs such as ACE inhibitors or angiotensin receptor blockers help to protect the kidneys against further damage.
Signs you're eating too much salt
Gum disease link to kidney problems
It’s long been known that uncontrolled gum disease (periodontal disease) increases the risk of heart problems. And now it seems that it could increase the risk of kidney problems too. So says a review published last year.
Why? Gum disease is a result of inflammation caused by bacteria from food becoming trapped around the gum line. It may damage the kidney directly by causing inflammation or through bacteria entering the blood stream.
US researchers are now trying to discover whether treating gum disease can avoid or slow the progress of chronic kidney disease, so watch this space. In the meantime, it’s yet another good reason to keep those regular dental and hygienist appointments.
How oral health affects both body and brain
How the Mediterranean diet may help your kidneys
The latest results of the long-term Seguimiento Universidad de Navarra study published recently shows that Spaniards who eat the traditional Mediterranean way are less likely to develop kidney stones. Other research, meanwhile, suggests that a Mediterranean diet is the optimum eating pattern for those with existing kidney problems.
The reasons? The researchers suggest eating the Mediterranean way helps control metabolic acidosis, when the kidneys are not removing enough acid from the body, as well as improving the function of the arteries, helping to quell inflammation, improve levels of healthy blood fats and regulate blood pressure. Yet other research shows that olive oil helps defend the kidneys against damage – at least in rats.
10 healthy Mediterranean foods
Know your kidney numbers
Two key tests can tell you how well your kidneys are functioning.
1. Estimated glomerular filtration rate (eGFR): a blood test that estimates of the volume of blood your kidneys filter in a minute based on levels of a protein called creatinine. A healthy reading differs according to age, sex and ethnic origin. But as a rough rule of thumb, an eGFR of more than 90 is normal, a reading of 60-89 should be monitored and a reading of less than 60 is usually a sign of CKD, although in the over 75s it can be normal.
2. Albumin: creatinine ratio (ACR): a urine test to checks levels of two proteins called albumin and creatinine. A low ACR shows your kidneys are working normally, although precise readings can’t be given as these vary from lab to lab.