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How to protect your kidneys
Key points about how to protect your kidneys
Having healthy kidneys is important for your general health and well being because they play a vital role in keeping your body functioning.
Here are a few tips on how to keep your kidneys safe, including having a healthy lifestyle, staying well hydrated, keeping your blood pressure under control and managing your diabetes.
Having healthy kidneys is important for your general health and well being because they play a vital role in keeping your body functioning. For example, the kidneys:
remove waste products from your body
balance your body's fluids
release hormones that regulate your blood pressure
produce an active form of vitamin D that promotes strong, healthy bones
control the production of red blood cells.
There are 2 main types of kidney damage – chronic kidney disease and acute kidney injury.
Chronic kidney disease (CKD)
Chronic kidney disease (CKD) or kidney disease happens slowly over a long period of time, usually without you noticing. It tends to affect both kidneys and can also cause damage to other parts of your body, especially your heart.
Diabetes and untreated high blood pressure are 2 of the most common causes of CKD.
If you are Māori or Pacific Peoples and have diabetes, you are at increased risk of kidney disease.
It's important to see your doctor regularly. Doctors can detect CKD with simple blood and urine tests.
Early detection and treatment of kidney disease is important as it can prevent or slow the worsening of kidney disease.
Acute kidney injury (AKI) means that your kidneys have suddenly stopped working as well as they used to. This can happen over a few hours, days or weeks.
AKI affects both your kidneys and can range from minor loss of kidney function to complete kidney failure.
It's essential that AKI is detected early, as the earlier AKI is picked up the better the chance of your kidneys fully recovering.
If you are at increased risk of AKI, it is important to protect your kidneys.
Maintaining a healthy lifestyle is one of the best ways to keep your kidney's healthy. For example, eat foods lower in salt and eat more fruits and vegetables. You should also aim for a healthy body weight, make physical activity part of your daily routine and quit smoking.
Image credit: Canva
Get your blood pressure checked
Having high blood pressure can damage blood vessels in your kidneys, reducing their ability to function properly. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. Having extra fluid in your blood vessels may then raise your blood pressure even more, creating a dangerous cycle. Read more about high blood pressure.
Manage your diabetes
If you have diabetes, here are some steps you can take to reduce harm to your kidneys.
Maintain your blood glucose targets as often as you can.
Get tested for your average level of blood glucose over the past 3 months (HbA1c test). Get your test at least twice a year, but ideally up to 4 times a year.
If your blood pressure is high, check it regularly and get it under control to make sure your kidneys stay healthy.
If you are unwell with vomiting (being sick), diarrhoea (runny poos), or have a fever, you can lose extra fluid. It's important to keep yourself hydrated by having small sips of water every few minutes.
If you are unwell and unable to drink fluids properly, or you notice that you're passing less urine (pee) than usual, contact your doctor immediately.
In hot weather
In hot weather, always drink plenty of fluids during the day, especially when working or exercising in the sun. Where possible, try to schedule all physical outdoor activities for cooler parts of the day. Drink water before, during if possible, and after you play sport to ensure your body stays hydrated. Read more about preventing dehydration.
Manage your medicines
Have a sick day plan
Taking some medicines (see table below for examples) increases your risk of getting acute kidney injury, especially if you take these medicines while you are dehydrated, or you take a combination of these medicines. If you are unwell and are unable to drink fluids properly, have a sick day plan. You may need to miss doses until you feel better. Check with your doctor and pharmacist whether the medicines you are taking put you at risk of AKI and about having a sick day plan(external link).
Examples of medicines that increase your risk of AKI
The list above is not complete. Ask your doctor or pharmacist about the medicines you are taking.
Be careful when taking some pain relief medicines
Taking the group of pain relief medicines called ‘non steroidal anti inflammatory drugs’ (NSAIDs) can be harmful to your kidneys. Examples include ibuprofen, diclofenac and celecoxib. These medicines reduce the blood supply to your kidneys.
If you're taking medicines for blood pressure or heart problems, eg, diuretics (water tablets), ACE inhibitors and ARBs (angiotensin II receptor blockers or sartans), don't use NSAIDs for pain relief. When taken together, these medicines are very harmful to your kidneys. Ask your doctor or pharmacist for other medicines for pain relief.
Before buying NSAIDs for pain relief, check with your pharmacist whether these are safe for you. Read more about the risks of NSAIDs.
Are you taking an ACE inhibitor ('-pril') or ARB ('-sartan')?
ACE inhibitors or ARBs are used for a range of health problems including blood pressure and heart failure. These medicines are very important to help protect your kidneys from damage if you have diabetes. In most cases taking ACE inhibitors or ARBs are not only safe, but they are protective as well.
Examples of ACE inhibitors
Examples of ARBs
cilazapril (Zapril, Apo-Cilazapril)
enalapril (Renitec M)
lisinopril
perindopril
quinapril (Accupril®, Accuretic®)
candesartan (Candestar®, Atacand®)
losartan (Cozaar®)
However, if you are on ACE inhibitors or ARBs and take diuretics (water pills), the combination of these with NSAIDs (anti-inflammatory pain relief medication), can be very harmful to your kidneys. It can cause acute kidney injury. This combination is called the 'dangerous trio' or 'triple whammy'. You have a higher risk of harm to your kidneys if you are an older person or you're dehydrated.
If you're taking an ACE inhibitor or ARB, with a diuretic, do not use NSAIDs for pain relief. Ask your doctor or pharmacist for a safer option.
Examples of diuretics
Examples of NSAIDs
bendrofluazide (Arrow-Bendrofluazide)
chlorthalidone (Hygroton)
indapamide (Dapa-Tabs, Napamide)
metolazone (Zaroxolyn)
furosemide (Diurin)
ibuprofen (Ibugesic, I-Profen, Nurofen)
diclofenac (Voltaren)
naproxen (Noflam, Naprosyn)
mefenamic acid (Ponstan)
celecoxib (Celebrex)
Be careful when taking multivitamins, food supplements and herbal or complementary medicines
Multivitamins, food supplements and herbal or complementary medicines may contain ingredients that are harmful to your kidneys. Always check with your pharmacist whether the medicines you are taking may interact with these.
The following links provide further information on how to keep your kidneys safe. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.