Kidneys may be small, but their impact on the body is enormous.
“The kidneys are a really small organ, but they actually have a very large role in the body,” said Memorie Wilcoxon, PharmD, BCPS, a board-certified clinical pharmacist specializing in critical care and infectious disease.
In a recent presentation, Wilcoxon outlined why kidney health is critical, the early warning signs of dysfunction and steps people can take to support their kidneys.
The many roles of the kidneys
“They’re only about the size of a deck of cards, one on each side,” Wilcoxon explained, “but they have a lot of different roles.”
Most people know the kidneys filter waste, but Wilcoxon emphasized their broader impact.
“They filter out excess fluid, they filter out waste, they filter out your medications… and they create urine,” she said.
The kidneys also reabsorb minerals and water when needed, regulate acid-base balance and perform critical endocrine and metabolic functions.
“Your kidneys have a huge role in maintaining your blood pressure,” Wilcoxon noted. They also produce erythropoietin, which helps the body make red blood cells and activate vitamin D to aid calcium absorption.
Recognizing early signs of kidney disease
Chronic kidney disease (CKD) often develops gradually, progressing through five stages.
“Stage one kidney disease is actually, you still have normal kidney function,” Wilcoxon said. “But what we start to see in those patients is a little bit of kidney damage… like spilling protein into your urine.”
She urged people to pay attention to warning signs such as:
- Change in urinary habits (increased/decreased urine, very dark urine, or colored or foamy urine
- Flank pain or pain between your ribs and low back area
- Nausea and vomiting, particularly when combined with other symptoms
- An increase in weight due to fluid accumulation
- Edema or swelling
- Volume depletion (hypotension — low blood pressure, skin tenting, dry mouth or nose)
- Hypertension or high blood pressure
“Being aware of the signs and symptoms of early kidney disease can help you be proactive in treating it,” Wilcoxon stressed.
Hydration and kidney protection
One of the simplest ways to protect kidney health is staying hydrated.
“Water helps your kidneys flush out toxins and waste through your urine,” Wilcoxon said. Adequate hydration also reduces kidney stone risk, supports blood flow and lowers the chance of urinary tract infections.
She recommended a baseline of “at least 64 ounces or 8, 8-ounce glasses of water” daily. Caffeine and alcohol, however, can worsen dehydration.
In summer, hydration is especially critical.
“When it’s hot outside and you’re sweating, that can cause quick loss of the body’s total water,” she explained. This increases risks for dehydration, kidney stones and even heat stroke–related kidney damage.
Medications and kidney safety
Medication management is another key factor.
“There are actually a lot of medications that require a dose change when you have kidney dysfunction,” Wilcoxon said. Antibiotics, blood thinners, diabetic medications and certain pain relievers all may need adjustments.
She cautioned against common over-the-counter drugs.
“NSAIDs… like Advil, ibuprofen, Aleve… can make kidney disease worse if they’re used frequently,” she said. Tylenol is generally a safer alternative.
Wilcoxon also warned about herbal supplements such as ginkgo or St. John’s wort.
“These are not regulated by the FDA… we don’t know if it can make your kidney disease worse,” she said.
Everyday choices for healthier kidneys
Lifestyle and diet also play a role.
“Eat your fruits and veggies,” Wilcoxon advised. Processed foods heavy in fat and salt put more strain on the kidneys. She recommended sticking to the “outside edge of the grocery store,” where fresh produce, dairy and meats are typically found.
Even with aging, when kidney function naturally declines, Wilcoxon encouraged people to take preventive steps.
“Kidney disease happens as you age, period,” she said. “But being proactive about hydration, diet and medications can make a big difference.”
Above all, she urged patients to communicate with their care teams.
“Talk to your doctor, talk to your pharmacist,” she said. “Just make sure that the dose is correct for you.”
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