How are your kidneys performing?

This year, I’ve developed a strong appreciation for the kidneys. In the popular health arena, compared to the organs like the liver and gut, the poor old kidneys don’t get a lot of attention. Kidney disease research is also hugely underfunded, so public campaigns for prevention and awareness are lacking.But, if Naturopathic medicine shines anywhere, it's in the preventative health space, which is one of the reasons I feel so strongly about kidney disease. Although kidney disease is devastating, misunderstood, and incredibly common; in many cases, it's preventable.What do the kidneys actually do?The kidneys aren’t just rubbish collectors and filtering bags, they are sophisticated and dynamic (so much so we have TWO!). They regulate our blood pressure, filter wastes and toxins, contribute to bone health, are involved in red blood cell production, balance crucial electrolytes and pH, and they are involved in the production of many important hormones, like Vitamin D. The kidneys are very, very busy.A word on Chronic Kidney DiseaseChronic kidney disease (CKD) is the progressive and often irreversible destruction of the kidneys. One in TEN Australians over the age of 25 have some form of kidney disease, and ONE IN THREE Australians is at an increased risk of developing CKD. Most people with renal impairment are completely unaware they have it. In fact, less than 10% of people with CKD know they have it because the body can lose up to 90% of it's renal function, and seemingly still be asymptomatic.This is why it's been referred to as society's silent epidemic.What causes CKD?Like other chronic diseases, CKD generally takes decades to develop.CKD shares similar risk factors to Type 2 Diabetes and Cardiovascular Disease - these are risk factors related to poor metabolic health, and include - being overweight, having high blood pressure, smoking, eating poorly, being sedentary and having chronic inflammation. Chronic dehydration also increases the risk, as does alcohol.What can you do to support your kidneys?1.Stay hydrated – The more water people drink, the lower the risk of CKD. Most people should aim for between 2-3L of pure water each day.2. Quit smoking and minimise alcohol 3. Keep your weight in a healthy range, monitor blood pressure and monitor blood sugar - I've made these tasks sound simple but I'm acutely aware they're anything but "simple" to combat for many people. Remember, don't be afraid to ask for help if you need it.4. Be careful with long-term high protein diets – too much protein over a long period of time can be taxing on the body in several ways. One of those ways is increasing our net acid load, which is highly stressful to the kidneys. Of course, we need protein, but we need plants too. Balance is key!5. Get regular sunshine – Vitamin D is important for healthy kidneys, so if you’re always covered up or have an office job, make an effort to get some safe sun exposure.6. Eat Brazil nuts – Selenium is also important for kidney health, and a few Brazil nuts each day will go a long way to ensuring you have sufficient levels of Selenium.7. Limit processed salty foods (like  processed breads, condiments and take-away foods) – The sodium content of the modern diet is about 10 times that of the Paleolithic era. I’m not suggesting you omit natural sources of salt from you diet altogether (that would be a really bad idea!), but certainly limiting the processed foods high in salt will help enormously.8. Avoid artificial sweeteners - Whilst we need more research here relating to kidney disease specifically, the risks absolutely outweigh the benefits in my opinion.9. Check your medications – there are certain medications that can impair kidney function, in some cases considerably, so please always have a conversation with your GP or pharmacist about the potential nephrotoxic effects of any medication you’re taking.10. Check your thyroid - Communication between the kidneys and thyroid is multifaceted and bidirectional. Thyroid hormones influence renal development, kidney structure, renal haemodynamics, filtration rate and the function of many transport systems along the nephron. An under-functioning thyroid can be both a cause, and an effect, of kidney decline. 11. Reduce heavy metal exposure - Acute exposure as well as low-level chronic environmental exposure to heavy metals may damage nephrons (kidney cells). Heavy metals of particular concern are mercury, lead, cadmium and arsenic.12. Reduce environmental chemical exposure - Environmental chemicals found in common household and personal care products have been associated with a decline in renal function. The full impact of persistent exposure to environmental chemicals on renal function however, is largely unknown and probably still to be seen.12. Treat the cause – If for you, kidney damage has been caused predominantly by Diabetes, controlling your blood sugar is obviously a crucial first step. If the primary cause is high blood pressure, control that first. If it’s inflammation, control that first. You get the gist, treat your specific drivers first.If you’re concerned about your kidney health, speak with your GP or primary health practitioner about getting some basic pathology testing done to check things out. There is no need for expensive or fancy testing initially, a simple routine blood test will tell you a lot.