About 37 million US adults have chronic kidney disease, according to the CDC’s 2026 update, and 87% of those age 20 and older don’t know it. That gap explains most of what you need to know about how to keep your kidneys healthy. Early damage doesn’t hurt, so protection depends on managing blood pressure and blood sugar, plus a lab test most people never think to ask for.
None of that requires a supplement. The advice below follows guidance from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the CDC, and it shows how to protect your kidneys with habits and tests you can check. It also has a section for readers in Alaska, where getting to a clinic can take real effort.
Blood pressure and blood sugar do most of the work
Diabetes and high blood pressure are the usual routes to kidney damage, and the CDC numbers show how often they overlap with it. In the 2026 update, an estimated 38% of US adults with diabetes had chronic kidney disease. So did 21% of adults with high blood pressure and 11% of adults with prediabetes. Across all adults, the figure was 14%.
These are survey estimates, partly based on a single lab reading, and the CDC itself says they might run high. The pattern still holds. The conditions that raise your risk are the ones you can treat.
NIDDK’s prevention guide lays out the playbook. If you have diabetes, keep blood glucose near your goal. Keep blood pressure near your goal. Take every medicine as prescribed, and keep cholesterol in range.
The guide also notes that two blood pressure drug classes, ACE inhibitors and ARBs (names ending in “pril” or “sartan”), may protect the kidneys, so ask your provider whether one fits you. Don’t start or stop one on your own.
The goal number depends on which page you read. NIDDK’s guide, last reviewed in 2016, lists below 140/90 as the goal for most people with diabetes. The CDC analysis counted a reading of 130/80 or higher, or use of blood pressure medicine, as high blood pressure. Your own target should come from a provider who has your whole chart.
The kidney tests most people never ask for
Early kidney disease rarely has symptoms. NIDDK says testing may be the only way to know your kidneys are healthy, and it names four groups who face higher odds: people with diabetes, high blood pressure, heart disease, or a family history of kidney failure.
Two measurements track kidney function. The first is eGFR, an estimate of how well your kidneys filter, calculated from a blood test for creatinine. The second is urine albumin, usually reported as a urine albumin-to-creatinine ratio (uACR). Albumin is a protein that healthy kidneys keep in the blood, so finding it in urine suggests the filters are leaking.
You want both numbers, because they catch different problems. The National Kidney Foundation says albumin in urine can signal kidney disease even when eGFR looks normal. On NIDDK’s clinician reference sheet, a uACR above 30 mg/g or an eGFR below 60 flags possible kidney disease. One odd result doesn’t settle anything, and the NKF describes confirming an abnormal uACR on a repeat test.
eGFR has a quirk worth knowing. Creatinine partly reflects muscle mass, and the same NIDDK sheet warns that eGFR is less reliable for people at the extremes of muscle mass and body size. If you lift heavily or have very little muscle, say so when you get results.
At your next visit, NIDDK suggests asking three things: what your GFR is, what your urine albumin result is, and how often your kidneys should be checked. Your provider sets the schedule.
How to keep your kidneys healthy when a clinic is hard to reach
Distance changes the math. Nationwide, American Indian and Alaska Native people were 33% more likely than the US population overall to be diagnosed with kidney failure in 2022, and 24% more likely to die of kidney disease, according to the HHS Office of Minority Health. Diabetes accounted for 69% of new kidney failure cases in this group in a CDC report covering data through 2013.
These are national figures, since Alaska-specific breakdowns weren’t in the sources reviewed for this article.
The same CDC report carries good news. Diabetes-related kidney failure among American Indian and Alaska Native adults fell 54% between 1996 and 2013, from 57.3 to 26.5 cases per 100,000, the steepest drop of any group. The authors point to Indian Health Service clinical and public health work as a likely contributor. Prevention programs can move these numbers.
Late diagnosis is still the weak spot. A researcher describing a 2024 study of American Indian and Alaska Native patients with diabetes said they reach end-stage kidney disease sooner than white patients and often first turn up in an emergency room. The same study found they survived longer on dialysis, so the gap lies in how early care starts.
When a lab or clinic is a long trip away, start with what a video visit handles well. NIDDK says a urinary tract infection can damage the kidneys if left untreated and tells people to see a provider right away.
At Telemedicine Alaska, Lynn Pura, RN, MSN, FNP-C, treats UTIs by video and answers medication questions too, including the pain reliever question below. A visit costs a flat $60.
A video call can’t draw blood or collect urine. If you need eGFR and uACR, ask at the visit how to arrange the tests near you, then bring the results back for a follow-up.
Pain relievers deserve a second look
NIDDK states that regular use of NSAIDs, such as ibuprofen and naproxen, can damage your kidneys. Kidney Care UK and the National Pharmacy Association explain the mechanism this way: NSAIDs reduce the blood flow through the kidneys, which can lead to acute kidney injury.
The warning is about regular use. A daily ibuprofen for a bad knee is a different situation from one tablet after a long hike. Risk climbs for people who already have kidney disease, diabetes or high blood pressure, or who take an ACE inhibitor or ARB, according to a drug reference summary of the product labeling.
If you reach for these most days, tell a provider. They can suggest another way to manage the pain.
Salt, sugar and the rest of daily life
NIDDK gives specific targets for everyday habits, and they’re easy to check against your own week.
On food, NIDDK suggests cooking with a mix of spices instead of salt, baking or broiling instead of frying, and reading labels for sodium and added sugars. It also points to the DASH eating plan, which research has linked to lower blood pressure. Whole grains, fresh or frozen vegetables and low-fat dairy fill out its list.
The guide also asks for at least 30 minutes of activity on most days, and 7 to 8 hours of sleep each night. If you smoke, the national quitline is 1-800-QUIT-NOW (1-800-784-8669). For alcohol, NIDDK’s limit is one drink a day for women and two for men.
Eating changes once kidney disease is diagnosed. Limits on some minerals and protein can apply at that point, so a dietitian’s plan should replace general advice.
Will drinking more water help?
For kidney stones, probably, though the evidence is messier than the advice. A large Lancet trial published in March 2026, coordinated by the Duke Clinical Research Institute, gave people with a stone history coaching and a personal fluid target to reach at least 2.5 liters of urine a day. The program did not reduce stone recurrence. The researchers suggested that targets may need to fit each person more closely.
That result doesn’t make water pointless. A urologist at Houston Methodist still calls low fluid intake a major stone risk factor and says no data shows one type of water beats another. For general hydration, pale urine is a reasonable rough guide, and people with kidney disease should ask their provider for a fluid target.
What about cleanses and detox teas?
NIDDK’s prevention guide covers blood pressure, blood sugar, cholesterol, food, activity, weight, sleep, tobacco, alcohol, stress and testing. No cleanse, tea or supplement appears on that list. If you take herbal products anyway, tell your provider so they can check them against your kidney results.
What to do this month
Ask for an eGFR and a uACR at your next visit, especially if you have diabetes, high blood pressure, heart disease or a parent or sibling with kidney failure. Write down your last blood pressure reading. Bring a list of every pain reliever and supplement you take, including the ones you buy off the shelf.
If you don’t have a regular provider, or the next appointment is weeks away, a virtual visit with Telemedicine Alaska is a place to start. You need to be physically in Alaska, Arizona, Colorado or Wyoming during the visit.
This article is general information, not a diagnosis, and it can’t replace a visit with a provider who knows your history.
