How to protect your kidneys

Why are your kidneys important?

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.

What are the types of kidney damage?

There are 2 main types of kidney damage — chronic kidney disease and acute kidney injury.

How can I protect my kidneys?

Make healthy lifestyle choices

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. 

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 three months (HbA1C test). Get your test at least twice a year, but ideally up to four times a year.
• If your blood pressure is high, check it regularly and get it under control to make sure your kidneys stay healthy.
• Read more about diabetes.

Avoid dehydration

Dehydration is the loss of water and salts from your body. Drinking enough fluid every day is an important part of kidney health. 

If you are unwell

If you are unwell with vomiting (being sick), diarrhoea (runny poos), or have a fever, you can lose extra fluid. It is important to keep yourself hydrated by having small sips of  water every few minutes. 

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. 

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 are taking medicines for blood pressure or heart problems such as diuretics (water tablets), ACE inhibitors and ARBs (angiotensin II receptor blockers or sartans), do not 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 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.

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 also elderly, or are dehydrated. 

If you are 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.

Be careful when taking multivitamins, food supplements and herbal or complimentary medicines

Multivitamins, food supplements and herbal or complimentary 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. 

Learn more

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.

Take care of your kidneys and they will take  care of you Centres for Disease Control and Prevention (CDC), US 
Tips to keep your kidneys healthy World Kidney Day 2012

Reviewed by

	Dr Eskildsen is the GP Clinical Lead for the ‘Safety in Practice’ programme with WDHB/ADHB. She is also a GP at a high needs practice in central Auckland. Her particular interests are focused on improvement in processes and systems within General Practice to improve safety and quality.