Can You Reverse Kidney Disease?

If you have kidney disease, you may wonder if you can reverse it. After all, you can do that with some other chronic health conditions, such as high blood pressure, elevated cholesterol, and type 2 diabetes. But when it comes to chronic kidney disease (CKD), it's not as simple.

"CKD tends to be a progressive chronic condition," explained Dugan Maddux, MD, PhD, vice president of kidney disease initiatives at Fresenius Medical Care in Waltham, Mass.

You may be able to "stabilize or even reverse some of the injuries to your kidneys very early on in the course of the disease when you're just experiencing kidney inflammation," Dr. Maddux told Health. But many people don't have symptoms at that point, "and they don't know to make the necessary changes," Dr. Maddux added.

That said, there are things you can do, even if you don't have a diagnosis of kidney disease, to help keep your kidneys healthy, Dr. Maddux advised. Here's how.

Get Regular Checkups

About a third of all Americans are at risk for developing kidney disease, according to the National Kidney Foundation (NKF), often because of risk factors such as being overweight or having high blood pressure, type 2 diabetes, or a family history of kidney disease.

If you have any of these, it's important to see your healthcare provider regularly so you can get screened for kidney disease, Dr. Maddux noted. Per the NKF, there are two main tests:

• A urine test called ACR (urine albumin-to-creatinine ratio). This test looks at how much albumin, a type of protein, is in your urine. If your test comes back positive, it's a sign that your kidneys are not filtering your blood well enough. Your healthcare provider will repeat the test three times over a three-month period to confirm that you do indeed have early CKD.
• A blood test that looks for creatinine, a waste product that can build up in your blood when your kidneys are damaged. Your result is plugged into a math formula to calculate your glomerular filtration rate (GFR). A normal GFR is above 90. If yours is between 60 and 90, you may have very early-stage kidney disease, said NKF.

Lower Risk With Lifestyle Changes

Diabetes and high blood pressure are the two most common causes of chronic kidney disease.

When you have too much glucose in your blood, it damages blood vessels everywhere—including your kidneys, Dr. Maddux said. As a result, your kidney's filters become damaged.

The good news? "Diabetes is one of the most modifiable risk factors," said David Goldfarb, MD, clinical chief of nephrology at NYU Langone Health.

A small study published in The Lancet Diabetes and Endocrinology in 2019 found that people with type 2 diabetes who underwent an intensive weight-management program could reverse their diabetes, and about a third of them were still in remission two years later. The goal is to get your A1C levels (a marker of type 2 diabetes) to under 6.5% for over three months.

The same is true for high blood pressure, which also damages blood vessels in the kidneys, so they don't work as well, Dr. Maddux explained. If yours is high (and anything over 120/80 is elevated), try to get it under control with lifestyle changes.

Some changes you can make include:

• Staying at a healthy weight
• Exercising
• Following a heart-healthy, low-sodium diet like the Mediterranean diet
• Quitting smoking or not starting

If those steps don't work, you'll probably need to try medications. Two types of blood pressure-lowering meds—angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)—work well to both lower blood pressure and slow the progression of kidney disease. It's not unusual for people with both conditions to require at least two drugs to control their blood pressure.

Watch Your Meds

If you are at risk for kidney disease or have early-stage chronic kidney disease, it's important to avoid taking large amounts of over-the-counter painkillers such as acetaminophen, nonsteroidal anti-inflammatories, or aspirin, Dr. Maddux said.

All of these drugs can damage kidney tissue and reduce blood flow, according to the NKF. This is especially true if you're over age 65.

If you do need to take them to treat aches and pains, the NKF recommends that you follow the dosing directions on the label, and take the lowest dose possible for the shortest period of time.

You also should stay hydrated—drinking about eight glasses of fluid a day—and avoid alcohol while taking them. If you've already been diagnosed with kidney disease, always check with your healthcare provider before you take an OTC pain medicine, NKF advises.

Quit Smoking

Yes, you know lighting up raises the risk of both heart and lung disease. But did you know it affects your kidneys too?

"Studies have shown that quitting smoking may slow the decline of kidney disease," Dr. Maddux said. A 2018 study published in the Clinical Journal of the American Society of Nephrology found that both former and current tobacco smokers were significantly more likely to experience the progression of their chronic kidney disease.

"Smoking raises the risk of developing heart disease, which in turn leads to decreased blood flow to the kidneys," Dr. Maddux explained. "It also narrows blood vessels, including those in the kidney, and thickens and hardens renal arteries."

A small study published in 2017 in the American Journal of Nephrology found that people who quit smoking were half as likely to experience GFR decline than those who continued the habit over a five-year period.

Eat a Healthy Diet

In general, a heart-healthy Mediterranean-style diet is best, said Erin Rossi, RD, a nutritionist who specializes in kidney disease at the Cleveland Clinic. A 2014 study in the Clinical Journal of the American Society of Nephrology found that this sort of eating pattern reduces the risk of developing chronic kidney disease by about 50%.

All patients with CKD—even at the early stages—need to watch their salt intake since even slight damage to your kidneys can affect how it filters sodium, Rossi added.

The American Heart Association advises consuming less than 2,300 milligrams of salt a day. You may also want to moderate your daily protein intake slightly—generally, you'll want 0.8 grams of protein per kilogram of body weight or roughly 55 grams of protein a day for a 150-pound person, according to NKF.

In the later stages of kidney disease, you may need to restrict potassium and phosphorous as well.

A Quick Review

There are several lifestyle habits that you can adopt to keep your kidneys healthy, prevent chronic kidney disease, or reverse it in the earliest stages. They include: watching your weight, exercising, quitting smoking, getting regular checkups, and avoiding too much of certain medications.

Picking up behaviors that are healthy for your kidneys can also help to manage or prevent conditions that lead to kidney diseases, such as diabetes and high blood pressure.