According to the American Kidney Fund, approximately 37 million Americans have kidney disease. Individuals in the early stages of kidney disease often do not present any symptoms, making these conditions difficult to identify. (2) The kidneys, two bean-shaped organs found below the rib cage on either side of the spine, are essential to filtering waste and water from your blood, as well as removing waste and excess fluid by producing urine. (3)(15) Lifestyle modifications, including diet and dietary supplements, can support your kidney health and may help prevent chronic kidney disease.
What Is Chronic Kidney Disease?
Chronic kidney disease (CKD) is an umbrella term for any condition resulting in kidney damage, and increased kidney dysfunction over time. CKD may progress through five stages over time, and can eventually lead to stage five, known as end-stage renal disease (ESRD). ESRD is characterized by total kidney failure and requires dialysis treatment or a kidney transplant. (17)
Chronic Kidney Disease Stages
The stages of chronic kidney disease include the following:
- Chronic kidney disease stage 1, which is characterized by kidney damage, normal kidney function, and persistent elevated protein in the urine for at least three months.
- Chronic kidney disease stage 2, which is characterized by kidney damage, mild loss of kidney function, and persistent elevated protein in the urine for at least three months.
- Chronic kidney disease stage 3, which is characterized by mild to severe loss of kidney function.
- Chronic kidney disease stage 4, which is characterized by severe loss of kidney function.
- Chronic kidney disease stage 5, which is characterized by kidney failure that requires dialysis or organ transplant. (17)
The following table outlines the characteristics of each chronic kidney disease stage.
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Chronic Kidney Disease Causes and Risk Factors
There are several causes and risk factors for chronic kidney disease, including:
- Certain autoimmune conditions (e.g., Goodpasture syndrome, lupus nephritis) (16)
- Certain infections (e.g., urinary tract infections) (14)(16)
- Certain genetic disorders (16)
- Certain medications (e.g., acetaminophen, aspirin, lithium) (5)
- Diabetes (3)(16)
- Dysbiosis (imbalanced intestinal microbiota) (9)
- Family history of CKD (3)
- Heavy metal poisoning (16)
- Hypertension (high blood pressure), damaged blood vessels (7)(16)
- Moderate to heavy alcohol intake (27)
- Smoking (7)
- Overweight and obesity (3)
Signs of Chronic Kidney Disease or Kidney Failure
Individuals with CKD may not experience or notice any symptoms, particularly in the early stages. Advanced-stage chronic kidney disease symptoms include:
- Chest pain
- Fatigue
- Difficulty concentrating
- Difficulty sleeping
- Dry skin
- Increased or decreased frequency of urination
- Itching and numbness
- Muscle cramps
- Nausea and vomiting
- Reduced appetite
- Edema (swelling) of the feet and ankles
- Weight loss (18)
The Centers for Disease Control and Prevention (CDC) estimates that approximately half of individuals with severely reduced kidney function who are not receiving dialysis are unaware they have CKD. (3) Specific urine and blood tests that assess kidney damage and filtration rate are used to identify CKD. (3)(26)
CKD has been associated with certain health complications, such as anemia, depression, stroke, increased risk of infections, and imbalanced mineral levels in the blood. (3) Individuals with CKD are also at an increased risk of premature mortality associated with cardiovascular disease and cancer, making it critical to address CKD as early as possible. (26)
How to Improve Kidney Health
Although certain risk factors for CKD may be beyond your control, you can reduce your overall risk by managing conditions that may contribute to CKD and implementing healthy lifestyle changes. (14) Additionally, chronic kidney disease treatment may include certain lifestyle and dietary interventions.
1. Change Your Lifestyle
For CKD prevention, the National Institutes of Health (NIH) recommends quitting smoking, limiting alcohol intake, and working with your healthcare practitioner to achieve a healthy weight. (14)
Did you know? Non-steroidal anti-inflammatory drug (NSAID) use has been associated with acute kidney injury. Speak with your healthcare provider to understand the benefits and risks of any medications. (25)
2. Exercise
Research has demonstrated several benefits of physical activity for individuals with CKD. A recent meta-analysis found that aerobic exercise is associated with improved cardiorespiratory function, exercise duration, high-density lipoprotein (HDL) cholesterol levels, and quality of life in patients with CKD. (20) Physical activity can also contribute to prevention by improving metabolic risk factors, which may support healthy kidney function. (24)
3. Eat a Healthy Diet
Specific dietary patterns that may prevent and address kidney disease include the Mediterranean diet (4) and the Dietary Approaches to Stop Hypertension (DASH) diet. (21) Both of these diets involve a low to moderate intake of protein, which has been associated with delaying the progression of CKD. (4) One meta-analysis identified healthy dietary patterns that were associated with lower mortality rate in individuals with CKD. The evidence suggests that the best foods for kidney health include vegetables, fruit, legumes, whole grains, and cereals, all of which are excellent sources of dietary fiber. Foods to avoid with chronic kidney disease include red meat, salt, and refined sugars. (11)
Healthy Kidney Supplements
Outlined below are several supplement ingredients that have been shown to improve kidney problems. It’s important to note that the National Kidney Foundation has identified a list of dietary supplements that may be harmful for individuals with CKD, including supplements containing potassium, phosphorus, and several medicinal herbs. (19) If you’re a patient interested in using supplements for chronic kidney disease, we always recommend consulting with your integrative healthcare practitioner first.
1. Alpha Lipoic Acid
Alpha lipoic acid (ALA) is an antioxidant that may help address one of the complications seen in kidney disease, cardiovascular disease (CVD). A randomized controlled trial in patients undergoing hemodialysis found that ALA supplementation may increase the activity of certain antioxidant enzymes that protect against oxidative stress and oxidative disorders, including CVD. (12)
2. Andrographis
Andrographis paniculata, commonly referred to as andrographis, is a medicinal herb that contains andrographolide and arabinogalactan proteins, two active components. Animal studies suggest that these components may reduce hepatic renal (liver kidney) alcohol toxicity. This means there may be potential for andrographis to protect kidneys against the harmful effects of alcohol. However, further research is needed. (23)
3. Moringa
Moringa oleifera, a plant native to India, has nutrient-dense leaves that are used for their therapeutic properties. Research in animals suggests that moringa may prevent kidney problems, as moringa-supplemented diets were found to decrease blood levels of urea and creatinine (waste products). (6) Additionally, animal studies demonstrate that moringa leaf extract may protect against kidney toxicity caused by acetaminophen, a common over-the-counter medication known as Tylenol or Paracetamol. (10)
4. NAC
N-acetylcysteine (NAC) is an amino acid and a precursor to glutathione, a major antioxidant in the body that targets oxygen radicals. (13) A four-month trial assessed the effects of NAC supplementation in patients undergoing hemodialysis. The findings suggest that NAC may benefit hemodialysis patients by reducing oxidative stress and improving outcomes of uremic anemia, a complication of CKD. (8)
5. Probiotics
Scientific literature suggests that dysbiosis is associated with increased urea toxin levels that may accelerate CKD development. One meta-analysis assessed the effects of probiotic supplementation for at least four weeks on individuals with CKD. The analysis concluded that supplementation may protect the intestinal barrier by reducing levels of a urea toxin called p-cresyl sulfate and increasing the levels of interleukin (IL)-6, (9) a signaling protein that has been shown to promote the growth and regeneration of cells lining the intestines. (30)
6. Resveratrol
Resveratrol, a polyphenol found in berries, grapes, and peanuts, exerts antioxidant, cardioprotective, and kidney-protective activity. In animal models, resveratrol has been shown to protect against various kidney problems including drug-induced injury, diabetic neuropathy, and hyperuricemic injury (from elevated uric acid levels). (1) Researchers propose that resveratrol may target the inflammation and oxidative stress associated with CKD progression, but clinical trials are needed. (22)
7. Vitamin C
Vitamin C’s antioxidant properties are vital for protecting the kidneys, lungs, and other organs against inflammation and oxidative stress. It also helps stabilize the body’s metabolism, creating a healthy internal environment. (29)
Did you know? While low doses of folic acid are nutritionally beneficial in many ways, too high of a dose can actually be toxic to the kidneys by inducing oxidative stress and mitochondrial abnormalities. (28)
Support Kidney Health with Supplementation and Healthy Lifestyle Choices
CKD commonly goes unnoticed and as a result, is left untreated. You can support healthy kidney function and reduce your risk of CKD by implementing the dietary and lifestyle changes outlined above. Consider working with an integrative healthcare practitioner to develop your individual wellness plan.
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- Chauveau, P., Aparicio, M., Bellizzi, V., Campbell, K., Hong, X., Johansson, L., … Carrero, J. J. (2017). Mediterranean diet as the diet of choice for patients with chronic kidney disease. Nephrology Dialysis Transplantation, 33(5), 725–735.
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