How Can I Keep My Kidneys Healthy?

Simple strategies for taking care of these vital organs, including hydration, exercise and medication management

Adam Rosenbluth, M.D.,

AARP

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Published November 17, 2025

illustrated gif of a woman poking her kidneys while the doctor points at an x-ray of her kidneys

James Yates

What can I do to keep my kidneys healthy? My last blood test showed they weren’t functioning as well as they should.

When your lab results tell you that your kidneys aren’t working as well as they used to, it raises important questions: Is this just a normal part of aging? Can the decline be slowed? What choices can I make to improve my condition? In this column, I want to guide you step-by-step toward practical, evidence-based strategies to help preserve your kidneys’ health and slow further damage. Even when the numbers shift, there’s almost always room for positive action.

First, know that you’re far from alone. Thirty-four percent of U.S. adults 65 years and older have chronic kidney disease. Like you, about 1 in 3 older people are living with some degree of reduced kidney function. It’s good that you’ve been tested and diagnosed, because an estimated 90 percent of adults with chronic kidney disease don’t know they have it. I don’t mean to scare you, but kidney disease can be quite serious if it isn’t managed well. A recent study found that it’s one of the top 10 causes of death worldwide.

Your kidneys are remarkable multitaskers, so you want to take care of them. Each one filters about 50 gallons of blood a day, clearing waste, balancing minerals and regulating blood pressure. Over the years, illnesses such as diabetes and high blood pressure, or repeated exposure to certain medications, can damage their microscopic filters, called nephrons, reducing their efficiency. Most people don’t feel any symptoms until the damage advances, which is why blood and urine tests are so important. For more information, read this article on 6 Medications That Can Harm Your Kidneys.

The key measure is your eGFR (estimated glomerular filtration rate), a number that estimates how well your kidneys are cleaning your blood. If the number drops below 60 for three months or more, doctors call it chronic kidney disease. The other key test is the urine albumin-to-creatinine ratio, which shows if protein is leaking into your urine. This is an early sign of kidney stress or damage.

What can you do to slow things down or even stabilize their function?

You’ll need to get to the root of the problem. For most older adults, as I said, kidney decline is tied to high blood pressure or type 2 diabetes. Managing those issues is an effective way to protect your kidneys. That might mean taking medications such as angiotensin-converting enzyme inhibitors, also called ACE inhibitors, or angiotensin II receptor blockers (ARBs).

If you have diabetes or even prediabetes, your doctor may discuss SGLT2 inhibitors. These newer drugs are designed to lower blood sugar and have shown kidney-protective effects, even in some patients without diabetes.

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When kidney function drops, certain nutrients become harder to process. What can you do about it? Reducing salt (sodium) helps keep blood pressure in check. If your kidney numbers are lower, your doctor might suggest moderating your protein intake, particularly red meat, because it produces more waste for your kidneys to have to filter.

Hydration matters, too. Drink enough fluids so that your urine is pale yellow in color, not dark. One caveat: If you’ve been told to limit fluids or you have heart issues, follow your doctor’s advice.

One of the most common and preventable causes of kidney injury comes from long-term use of NSAIDS, specifically drugs like ibuprofen (Advil) or naproxen (Aleve). These over-the-counter medications can constrict blood flow to the kidneys and worsen existing damage. If you need pain relief, ask about safer alternatives, such as acetaminophen (Tylenol) or non-drug approaches like mind-body techniques.

Since kidneys are actually two bags of tiny blood vessels, what’s good for your heart is also good for them. Regular exercise, even a daily 30-minute brisk walk, improves blood pressure, circulation and weight control. Not smoking and limiting alcohol also protects those delicate blood vessels.

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Finally, review all your medications and supplements with your doctor. Many prescription and herbal products are metabolized through the kidneys. This includes supplements and vitamins. Some “natural” remedies, such as high-dose creatine, pennyroyal, licorice root and herbal blends with aristolochic acid, should be avoided if you have kidney problems.

The continuing decline of these organs isn’t necessarily our destiny. By addressing the causes early, especially hypertension and diabetes, you can dramatically slow its progress. I encourage you to partner with your health care team, ask questions and make lifestyle choices that lighten your kidneys’ load. Your kidneys will thank you in the best way possible — by doing their job.

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