What steps can I take to maintain kidney health with normal kidney function?

Maintaining Kidney Health with Normal Kidney Function

With normal kidney function, focus on lifestyle modifications to prevent future kidney disease: maintain blood pressure <120/80 mmHg, restrict sodium to <2 g/day, exercise 150 minutes weekly, achieve healthy body weight (BMI 20-25), and avoid nephrotoxic exposures. 1

Blood Pressure Optimization

• Target systolic blood pressure <120 mmHg using standardized office measurement, even with normal kidney function 2
• For those without albuminuria, maintain blood pressure ≤140/90 mmHg at minimum 2
• Blood pressure control is the single most critical modifiable factor for preventing future kidney disease 2

Dietary Modifications

Sodium restriction is paramount:

• Limit dietary sodium to <2.0 g/day (<90 mmol/day) 2, 1
• Focus on reducing processed and restaurant foods, which account for nearly 80% of sodium intake 2
• Choose lower-sodium alternatives at point of purchase rather than restricting salt in cooking 2

Protein intake:

• Maintain protein at 0.8 g/kg body weight/day 1
• Avoid high protein intake >1.3 g/kg/day, which may increase risk of kidney disease development 1

General dietary pattern:

• Emphasize plant-based foods over animal-based foods 1
• Reduce consumption of ultraprocessed foods 1
• Increase intake of fresh fruits and vegetables 2

Physical Activity

• Engage in moderate-intensity physical activity for at least 150 minutes per week 1
• Aim for 30 minutes of exercise 5 times per week 2
• Avoid sedentary behavior 1

Weight Management

• Achieve and maintain healthy body weight with BMI 20-25 kg/m² 2, 1
• Weight loss is recommended for those with obesity 1

Smoking Cessation

• Stop smoking completely, as tobacco use accelerates kidney disease development and progression 2, 1

Monitoring and Screening

For those at increased risk (age >60, hypertension, diabetes, cardiovascular disease, or family history of CKD):

• Screen with serum creatinine for estimated GFR and urine albumin-to-creatinine ratio 2, 3
• Repeat screening every 3-6 months if risk factors are present 1
• Early detection allows intervention before irreversible damage occurs 3

Avoiding Nephrotoxic Exposures

• Be aware that even with normal kidney function, you are at risk for acute kidney injury from various insults 2
• Avoid nephrotoxic medications when possible (NSAIDs, certain antibiotics) 2
• Stay well-hydrated during illness, especially with vomiting or diarrhea 2
• Inform healthcare providers about any kidney concerns before procedures involving contrast dye 2

Glycemic Control (if diabetic)

• Target hemoglobin A1c of approximately 7% 2, 1
• Good diabetes control prevents development of diabetic kidney disease 2

Common Pitfalls to Avoid

• Do not assume normal labs mean you can ignore prevention: The relationship between acute kidney injury and chronic kidney disease is bidirectional—even single episodes of AKI can lead to future CKD 4
• Do not delay lifestyle modifications: Primary prevention is most effective before any kidney damage occurs 2
• Do not ignore cardiovascular risk factors: Hypertension and diabetes are the leading causes of kidney disease 2, 3
• Do not consume excessive protein: High protein diets (>1.3 g/kg/day) may increase kidney disease risk over time 1

When to Seek Medical Attention

• Development of new hypertension, diabetes, or cardiovascular disease warrants kidney function screening 2, 3
• Any episode of acute illness with decreased urine output or dark urine requires evaluation 2
• Family history of kidney disease should prompt discussion with your physician about screening 2