Sep 2411 min read

Taking Care of the “Quiet Champions” of our Body: Our Kidneys

Updated: Sep 26

Kidneys are the quiet champions of our body, working to filter your blood and remove excess fluid and waste from your body. They are deeply integral to our health, as are the heart, lungs, and liver. Your kidneys keep you healthy by maintaining just the right balance of water and other substances inside your body. Unfortunately, if your kidneys start to malfunction, you might not realize it for a long while. Kidney disease usually doesn't make you feel sick until the problem becomes severe and sometimes irreversible.

Prevention of kidney disease is key, and you should be proactive in talking with your doctor about tests you may need to determine whether your kidneys are healthy. You may know someone or yourself who is dealing with chronic kidney disease (CKD) or have wondered about the signs and symptoms of the disease, its connection to high blood pressure and diabetes, how to discuss it with your doctor, and how to get tested. Let’s get into it and learn more about these important organs of our precious bodies.

The Background of Our Phenomenal Kidneys

The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, on each side of your spine. Daily, your kidneys filter about 40 gallons (or 150 quarts) of blood. If you follow its filtering system, the kidneys are the key players in our renal system, comprising our kidneys, renal pelvis, ureters, bladder, and urethra.

Healthy kidneys filter about a half cup of blood every minute, removing wastes and extra water to make urine. The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of your bladder. Your bladder stores urine. Your kidneys, ureters, and bladder are part of your urinary tract. Read here about how to keep your urinary tract healthy, and here about urinary tract infections.

Your kidneys remove wastes, extra fluid from your body, and acid produced by your cells. They also maintain a healthy balance of water, salts, and minerals—such as sodium, calcium, phosphorus, and potassium—in your blood.

Without this balance, your body's nerves, muscles, and other tissues may not work as needed to keep you healthy. Your kidneys also make hormones that help control your blood pressure, make red blood cells, and keep your bones strong and healthy. Yes, our kidneys do all this!

Kidney Disease in the United States

Did you know?

Approximately 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure may have chronic kidney disease
More than 1 in 7 US adults (about 35.5 million people) have Chronic Kidney Disease, which is about 14% of the adult population.
CKD is slightly more common in women (14%) than in men (12%), and as many as 9 in 10 adults with CKD do not know they have it.
Chronic Kidney Disease is more common in people aged 65 years or older (34%) than in people aged 45–64 years (12%) or 18–44 years (6%) and is more common in non-Hispanic Black adults (20%) than in non-Hispanic Asian adults (14%) or non-Hispanic White adults (12%); about 14% of Hispanic adults have CKD. Sourced from the Centers for Disease Control and Prevention, Chronic Kidney Disease in the United States, 2023, updated May 2024.

The Link Between Diabetes, Hypertension (high blood pressure), and the Health of our Kidneys

Meda E. Pavkov, MD, PhD, a medical epidemiologist in the Chronic Kidney Disease Initiative within the Division for Diabetes Translation at the Centers for Disease Control and Prevention, says of the link and link between diabetes and kidney disease and the importance of early detection and management of kidney disease:

“Diabetes is the most frequent cause of chronic kidney disease, not only in the United States but in most industrialized countries. Kidney disease in people with diabetes is caused by multiple factors, including diabetic changes in the kidneys as well as vascular changes due to hypertension. People with diabetes have high glycemia, or blood glucose, which can damage the kidneys and lead to kidney disease. When people are diagnosed with diabetes, they may already have hypertension. Hypertension is an additional risk factor for diabetic kidney disease because high blood pressure damages the kidneys, which may prevent proper function.”

Diabetes in America, 3rd Edition (free/downloadable), in which Dr. Pavkov co-authored a chapter, offers more insights on the relationship of our kidneys to these two conditions and a compilation and assessment of epidemiologic, public health, clinical, and clinical trial data on diabetes and its complications in the United States. It was published by NIDDK from 2016 to 2018. The intended audience is a wide range of individuals in the research community, clinicians, health policymakers, and individuals with diabetes, as well as their caregivers and family members. In other words, it is written for you and others.

Discover How to Care for Your Kidneys – the Unsung Heroes of Your Body!

There’s a familiar phrase we often hear about self-care of our bodies: “Know your numbers. " This often pertains to knowing the impact of your “numbers” on your overall health. It’s no different with protecting our organs—in this case, the kidneys. Below is important advice from the Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Take action to prevent, delay, or manage our kidney health.

Our body weight: Extra weight forces the kidneys to work harder and filter wastes above the normal level. Over time, this extra work increases the risk of kidney disease. Remember, your kidneys must work harder to keep up when there's more of you.

Physical activity: Be active because physical activity helps control blood sugar levels. Regular physical activity is vital to slowing the progression of chronic kidney disease (CKD). By improving cardiovascular health, regulating blood pressure, and managing blood sugar levels, exercise reduces primary risk factors for CKD progression.

If you smoke, quit as soon as possible. “Sure, smoking isn't good for your lungs or your heart. But did you know that smoking isn't good for your kidneys either? As noted by the American Kidney Foundation, the Surgeon General issued a report not long ago that said that smoking causes diseases in every organ of the body—including the kidney. People who smoke are more likely to have protein in their urine. This is a sign your kidneys are under stress. The more someone smokes, the more likely they are to show kidney damage. Smokers are also more likely to need dialysis or kidney transplants.

If you are on medication for any reason, follow and understand the relationship of your meds on your organs – including your kidneys, and if you have diabetes or have high blood pressure (hypertension) and are on medications to help manage these conditions, consider the following:

Diabetes: monitor and aim to meet blood sugar targets as often as possible; get your A1C level tested at least twice a year, ideally up to 4 times per year. People who have diabetes may be able to prevent or delay CKD with blood pressure-lowering drugs. These medicines reduce protein in the urine, a risk factor for developing CKD.

Having CKD increases the chances of heart disease and stroke. Treatment can help prevent or delay cardiovascular death and kidney failure. In addition, kidney infections and physical injuries can also cause kidney disease.

High blood pressure: check it regularly and get it under control to protect your kidneys. Also, talk to your health provider about medicines to learn which may harm your kidneys and other ways to lower your blood pressure. (Source: CDC)

Each medicine you are prescribed plays a vital role in controlling symptoms and slowing disease progression. Still, regular conversations and reviews of your medicines are crucial to your overall health.

Staying in your target cholesterol range is also essential. As a reminder, cholesterol is a waxy substance that your body makes and uses to build your cells. You also get it from many foods. But having too much cholesterol can lead to health problems. High cholesterol can build up in arteries to increase your risk of a heart attack or stroke. It turns out that high cholesterol isn’t good for your kidneys, either.

The National Kidney Foundation (www.kidney.org) states abnormal cholesterol levels are a kidney hazard. People with high total cholesterol or reduced HDL (“good”) cholesterol are found to have reduced glomerular filtration rate (GFR). This is the best way to assess kidney function. A GFR of 60 or lower usually means chronic kidney disease. People with cholesterol problems were twice as likely to have chronic kidney disease over time. Check our “Things to Know” section below to learn about GFR.

For overall health and that of your kidneys, these reminders are imperative:

Eat foods lower in salt.
Eat more fruits and vegetables.
Limit how much alcohol you drink. Alcohol can increase your risk of high blood pressure.
Get your flu shot every year. People with CKD have a higher risk of severe illness from the flu.
Get plenty of sleep

More About Sleep

I’m sure you’ve probably heard most of the earlier guidance before (aim for good nutrition, lower salt, limit alcohol, etc.), but it’s evidence-based, and I'd like to emphasize the latter guidance on sleep.

Studying Sleep's Impact on Kidney Health was authored by Ciaran McMullan, MD, of Brigham and Women's Hospital, whose research confirmed that a good night’s rest is crucial to your overall well-being and, it turns out, your kidneys. His recent article states, “Researchers have already linked sleep deprivation and sleep disorders to higher rates of diabetes and cardiovascular disease. The link between shut eye and kidney function is becoming clearer with [his] new research. “Kidney function is regulated by the sleep-wake cycle. It helps coordinate the kidneys’ workload over 24 hours,” Dr. McMullan said. “We also know that nocturnal patterns can affect chronic kidney disease and that people who sleep less usually have a faster decline in kidney function.

I don’t want to put you to sleep about this topic (pun intended), but the NIDDK recommends getting 7–8 hours of sleep each night to help prevent chronic kidney disease (CKD). However, studies have shown that both short and long sleep durations can increase the risk of CKD: Short sleep

A study of 4,238 participants found that those who slept 5 hours or less per night (or over eight hours!) were more likely to experience a rapid decline in renal function.

So, come on, sis, phones off, eyes closed, and let’s sleep! Zzz

Wake refreshed and ready to take on the world with yo’ bad self!

Two Videos to Help with your Understanding of your Kidneys

and other Resources

Raise your hand if you see a link to a video sent to you by a friend or in a newsletter, and promise yourself, "I’ll watch it later,” but then in a few minutes, you’ve forgotten all about it. Well, these two short videos are too essential to take a pass. The first video (3 minutes and 21 seconds) stresses the importance of understanding how your kidneys work and how to care for them. The second video (13 minutes 11 seconds) provides clear and easy-to-follow information on the signs of kidney disease – both can be useful to you or pass along to friends and others.

1. The Basics About Our Kidneys YouTube video from the Cleveland Clinic: https://www.youtube.com/watch?v=uiiKPdFdlX0&t=73s

2. 11 Early Warning Signs of Kidney Failure: What Your Body Is Telling You features Dr. Frita McRae Fisher, M.D., a highly respected nephrologist specializing in diagnosing and treating kidney disease. She has created an easy-to-follow video that discusses the 11 early warning signs of kidney failure that your body could be showing without you realizing it. She notes that patients’ bodies had been signaling distress long before they ever stepped into her office. Link: Dr. Frita's YouTube channel. Find her complete bio here.

Things to Know, To Share, and To Discuss with your Healthcare Provider

Prevention, Symptoms, and Treatments of Kidney Disease – What You Should Know

· Prevention: Early detection and management of kidney disease can slow or stop the deterioration of kidney function and reduce the risk of complications.

· Symptoms of CKD: Changes in urination, blood in the urine, puffiness in the legs and ankles, back pain, and pain or burning when urinating. However, even when symptoms are present, they can be overlooked or attributed to another health issue.

· Risk factors: High blood pressure and diabetes are leading risk factors for kidney disease.

· Complications: Kidney disease can lead to heart disease, type 2 diabetes, and kidney failure.

· Treatment: In advanced stages, kidney disease can only be treated with dialysis or a kidney transplant. Learn more about the stages of kidney disease. Overall, kidney disease does not happen overnight. It happens slowly over many years and in stages. There are five stages of kidney disease. In each stage, the kidneys don’t work as well as they did in the previous stage.

Questions to have in your pocket at healthcare visits

What physical and dietary changes do I need to make to keep my kidneys healthy?
Do I need to make any other lifestyle changes?
What medications am I on that may affect my kidneys, and are there others that may keep my kidneys getting worse?
Do I have hypertension, diabetes, or other disorders that may worsen my kidneys?
Is my blood pressure where it needs to be?
What should my blood pressure be?
If I have an acute kidney problem, do you expect me to recover, and how long might that take?
If my kidney problem is chronic, how long can I continue without dialysis, or will I ever need dialysis?
If dialysis is recommended, ask, “What type of dialysis do you recommend?”
Am I a good candidate for a kidney transplant? Will I need dialysis or a transplant soon?
What dietary changes do I need to make during treatment or recovery?
Do I have anemia or any other complications, and how can those complications be treated?
About test results: Has my GFR changed since last time?

a) Healthcare providers use estimated glomerular filtration rate (eGFR) to determine if you have kidney disease, and if so, what stage. eGFR measures your kidneys' ability to filter toxins or waste from your blood. A very low number may indicate kidney failure, which requires dialysis or a kidney transplant.

b) When discussing your estimated glomerular filtration rate (eGFR), it's important to know that for African Americans, current equations that factor in race, sex, and age tend to overestimate measured GFR. However, simply removing race from the equation without making other adjustments can lead to an underestimation of measured GFR in Black individuals. See below for “A Race-Free Approach to Diagnosing Chronic Kidney Disease.”

About test results: What is my urine albumin level; what does it mean?
About test results: Has my urine albumin changed since the last time it was checked?
About test results: Are my kidneys healthy, improving, or getting worse (if previous tests were done)?

About treatment and self-care:

What can I do to keep my kidney disease from getting worse?
Do any of my medicines or doses need to be changed?
Does what I eat need to be changed?
Do my foods have enough (or too much) protein, salt (sodium), potassium, and phosphorous, and what foods should I avoid (especially if you are diagnosed with CKD because foods that may be good with healthy kidneys may not be recommended with CKD)?
What do I need to do to protect my veins?

Complications: