What steps should I take to maintain normal kidney function?

Maintaining Normal Kidney Function

To maintain your normal kidney function, focus on blood pressure control (≤140/90 mmHg), lifestyle modifications including sodium restriction to <2 g/day, maintaining BMI 20-25 kg/m², regular exercise 30 minutes 5 times weekly, smoking cessation, and annual monitoring of kidney function through urine albumin and eGFR testing. 1

Blood Pressure Management

• Maintain blood pressure ≤140/90 mmHg if you have no protein in your urine (albumin excretion <30 mg/24 hours), as this target prevents progression to kidney disease 1
• If you develop any degree of albuminuria (≥30 mg/24 hours), your blood pressure target should be lowered to ≤130/80 mmHg 1
• Blood pressure control is one of the most critical factors in preventing kidney disease development and slowing any future progression 1

Lifestyle Interventions

Dietary modifications:

• Restrict sodium intake to <2 g per day (approximately 5 g of salt), which helps maintain blood pressure control and reduces kidney stress 1
• Consume a balanced diet high in vegetables, fruits, whole grains, fiber, legumes, plant-based proteins, and unsaturated fats 2
• Limit processed meats, refined carbohydrates, and sweetened beverages 2

Weight management:

• Achieve and maintain a BMI between 20-25 kg/m², as obesity increases risk of kidney disease development 1

Physical activity:

• Exercise for 30 minutes at least 5 times per week at moderate intensity, which improves cardiovascular health and helps maintain kidney function 1

Smoking cessation:

• Stop smoking completely, as tobacco use accelerates kidney function decline and increases cardiovascular risk 1

Regular Monitoring

• Obtain annual testing of urine albumin (urine albumin-to-creatinine ratio) and estimated glomerular filtration rate (eGFR) to detect any early changes in kidney function before symptoms develop 1
• Annual monitoring allows for early intervention if kidney function begins to decline 1

Diabetes Management (if applicable)

• If you have diabetes, maintain hemoglobin A1c at approximately 7% to reduce risk of developing diabetic kidney disease 1
• Optimize glucose control through diet, exercise, and medications as prescribed 1

Avoiding Kidney Injury

• Be aware that you would be at increased risk for acute kidney injury if you develop chronic kidney disease in the future, so avoid nephrotoxic medications when possible and stay well-hydrated during illnesses 1
• Discuss any new medications with your healthcare provider to assess potential kidney effects 3

Common Pitfalls to Avoid

• Do not assume normal serum creatinine means normal kidney function, especially if you are elderly or have low muscle mass—always request calculated eGFR 3
• Avoid NSAIDs (ibuprofen, naproxen) for chronic pain management when possible, as these can damage kidneys over time
• Do not use ACE inhibitors or ARBs if you have normal blood pressure and no protein in your urine, as these medications are not indicated for primary prevention in this setting 1
• Ensure adequate hydration but avoid excessive fluid intake beyond normal thirst requirements