WARNING: The modern-day health crisis no one is talking about

From chronic disease to painful stones, here’s how to dodge disaster—and keep your body’s filtration system firing on all cylinders

Do you protect your kidneys? Better yet, do you think about your kidney health at all?

If you’re like most people, I bet the answer is a resounding “no.” After all, even the medical community seems to take these vital organs for granted. I mean, how many public health campaigns have you seen advising you to protect your kidneys?

But the fact is, taking our kidneys for granted comes with some very real risks.

Your kidneys are your body’s filtration system. They filter your blood, eliminate toxins, maintain a critical balance of sodium and potassium in your body, and help regulate your blood pressure—just to name a few of their critical functions.

And yet, most people only pay attention to them when they’re unfortunate enough to wind up with painful stones.

That’s why I’m going to outline what you should be doing to protect your body’s biggest workhorses… but probably aren’t. Because many of us abuse our kidneys on a daily basis—often in ways we don’t even realize.

So, let’s kick off our discussion by highlighting exactly what’s at stake when you neglect your kidney health…

A modern malady on the rise

Rates of kidney disease have been skyrocketing in the United States in recent years. In fact, two separate studies in the last decade showed more than half of diabetics—and up to a quarter of the total population—may have chronic kidney disease.

Of course, diabetics are at a particularly high risk because when you have blood sugar problems, your “filtration system” gets overloaded. Rather than effectively filtering waste from your blood—and diverting that waste into the urine for a speedy exit—things start to malfunction.

More specifically, blood sugar spikes eventually cause damage to the tiny blood vessels that deliver blood to the kidneys. When these blood vessels are damaged, the kidneys get flooded with too much blood. (This is the same reason why obesity and high blood pressure also drive kidney disease.)

Over the years, your kidneys will start to leak. Waste products build up in your blood, overloading your body with toxins. And useful nutrients (like protein) end up spilling into your urine.

If nothing’s done to stop this breakdown, this filtration system malfunctions entirely. That’s called end-stage renal disease (ESRD). At that point, you need a kidney transplant—or you’ll spend the rest of your life on dialysis… a machine that filters your blood for you, since your kidneys can’t.

What you don’t know can kill you

I trust it’s pretty clear by now why chronic kidney disease should never go unchecked. But here’s the kicker: Statistics also suggest that a huge portion of cases remain undiagnosed, even when lab results point to a problem.

If you ask me, that’s nothing short of malpractice. And it amounts to a crisis all on its own—especially since you often won’t have symptoms until you have full-blown chronic kidney disease.

Unfortunately, the situation has only gotten more dangerous since COVID-19 came to town.

For one thing, we know that patients hospitalized with COVID-19 are three times more likely to die if they also have chronic kidney disease.1 And if they don’t arrive at the hospital with kidney problems? Well, there’s a pretty good chance they’ll be leaving with them.

In fact, new research shows that as many as half of all patients hospitalized with COVID-19 will suffer acute kidney injury.2 And if that doesn’t kill you, it can cause or worsen chronic kidney disease—which can quickly progress to ESRD, in some cases.

Pinpointing the problem

The good news here is that it only takes a routine blood test and a routine urinalysis to indicate how well your kidneys are working.

So, at your next physical, be sure your doctor runs a comprehensive metabolic panel. Then, pay close attention to your estimated glomerular filtration rate (eGFR) and blood urea nitrogen (BUN) number.

The eGFR is an important measure of kidney function that analyzes levels of creatinine (a waste product) in the blood alongside your age, race, and gender. (Your creatinine level determines how well your kidneys are working to remove waste from your blood.) Anything greater than 60 is considered normal, but I like to see results between 100 and 130.

Then, your BUN test will tell you whether you are dehydrated or not. In general, a normal range is around 7 to 20 mg/dL—and results greater than 20 can indicate that you’re at risk for kidney problems.

As for the urinalysis, the goal is to look for a protein called albumin—an early sign of kidney disease. Normal levels are between 0 and 3. (Your doctor can do this test in the office or you can buy test strips and do it yourself at home.)

Then, once you have all of your results, you’ll have a better understanding about how well you’ve been protecting your kidneys thus far—and whether you need to take extra steps to hopefully avoid suffering the consequences later.

A simple protocol for prevention

Research shows that lifestyle plays a major role in preventing chronic kidney disease. And a lot of the same steps that curb a whole host of other health conditions can work wonders for your kidneys, too.

In fact, one recent review showed that diet and exercise—among other factors—play a crucial role in reducing risk of kidney disease:

  • Higher potassium intake cut risk by 22 percent
  • Increasing veggie intake cut risk by 21 percent
  • Regular exercise (30 minutes daily) cut risk by 18 percent
  • Moderate alcohol intake (one to four drinks daily) cut risk by 13 percent
  • Smoking raised risk by 18 percent

Ultimately, these five simple “rules” could slash your risk of chronic kidney disease by nearly 25 percent.3

But winning the fight against kidney disease doesn’t stop there. Because there’s one serious risk factor hiding in more than half of the groceries in your supermarket—and it’s not something most people pay any attention to.

I’m talking about phosphorus.

Inorganic phosphates are everywhere

Your kidneys help your body get rid of excess phosphorus. So hidden phosphates are an especially serious concern for people with kidney problems.

To make matters worse, more than one-third of all Americans eat a diet that’s way too high in phosphorus. (And this doesn’t just spell trouble for your kidneys—overall mortality risk also doubles with higher phosphorous intakes.)

Don’t get me wrong—we need phosphorous to thrive. But we need it from fresh, healthy, nutrient-rich foods… like pumpkin seeds, cheese, salmon, scallops, brazil nuts, pork, beef, and lentils. Focusing on whole foods like these will keep your phosphorus levels where they need to be without getting too much of a good thing.

Unfortunately, processed and packaged foods often contain ingredients classified as inorganic phosphates. Manufacturers put them in their products as preservatives, anti-caking agents, and stabilizers.4 So when you include a lot of boxed, bagged, and canned foods in your diet, your chances of excess phosphorus are much higher.

Phosphate content is something that I counsel my patients with renal insufficiency (the medical term for compromised kidney function) to pay attention to. But doing so requires knowing where the danger lurks in the first place.

And the sad truth is, you’ll find phosphates hiding practically everywhere. 

Just say “no” to packaged foods

To give you an idea of the scope of this threat, let me share a few statistics. Nearly half of the nearly 2,400 best-selling grocery brands feature phosphorus additives. That includes:

  • 72 percent of all prepared frozen foods
  • 70 percent of dry food mixes
  • 65 percent of processed, packaged meats
  • 57 percent of bread and baked goods
  • 54 percent of soups
  • 51 percent of yogurts

Of course, the Food and Drug Administration (FDA) maintains that they’re all perfectly safe.

But let me be clear: They’re not safe. Because in excess, phosphorus can harden your arteries, cause endothelial dysfunction, and lead directly to heart attacks, strokes, and, you guessed it… chronic kidney disease.

Everyone can benefit from steering clear of inorganic phosphates—especially folks with kidney disease. It’s truly a matter of life and death.

Doing so doesn’t have to require obsessive label reading, either. After all, if a food even has a label, that’s one strike against it.

If you really want to avoid phosphate additives, shop along the outer perimeter of the supermarket (and stay away from the center aisles). Or better yet, buy as many of your groceries as you can at your local farmer’s market instead. And stick to a high-protein, low-carb diet that incorporates lots of fresh vegetables and other whole foods.

The REAL kidney killers lurking in your pantry

Of course, maybe you’ve heard warnings about high protein diets being hazardous to kidney health.

So allow me to set the record straight: When it comes to your kidney health, the real saboteurs are sugar and processed food. Not high protein—or even salt. And research bears this out.

One recent analysis looked at 18 different studies featuring more than 600,000 adults, followed over more than a decade. Researchers examined how dietary patterns influenced kidney function.

In this case, a healthy diet featured higher intakes of fruits and veggies, nuts, and fish. And lower intakes of red and processed meats, sodium, and sugar-sweetened drinks. (I won’t split hairs on these criteria today—even though it always infuriates me to see salt and steak lumped in with sugar. Check out the sidebar on page 4 for the truth about salt restriction.)

In other words, researchers basically analyzed a Mediterranean-style diet versus the sugar-packed standard American diet (SAD). And I’ll let you guess which came out on top…

The “healthy” diet pattern correlated with a 30 percent lower rate of chronic kidney disease. As well as a 23 percent lower rate of albuminuria, or elevated urinary protein.5

So if you want healthy kidneys, avoid sugar and processed foods and, once again, stick to fresh, healthy, nutrient-rich foods—like organic produce, grass-fed and -finished meat, wild-caught fish and seafood, nuts, and cheese. In other words, follow my very own A-List Diet. (Order yourself a copy at AListDietBook.com.)

The simple solution to a painful—and prevalent—problem

Now, let’s get back to the one reason why most people do start to pay attention to their kidneys: kidney stones. While they may not kill you, they absolutely will make you miserable. And unfortunately, they’re more common now than ever before.

In fact, one recent study found that the number of people with kidney stones has doubled among men—and quadrupled among women—since 1990.6

A kidney “stone” is a hardened mass of calcium crystals that gets stuck in the urinary tract—most often formed from calcium oxalate or calcium phosphate. That’s why, if you want to prevent them, the best thing to do is drink the right amount of water.

So how much is the right amount?

Simply divide your body weight in half—that’s how many ounces you should be drinking every day.

Of course, that number may increase slightly based on how much exercise you’re getting, how much you’re sweating, and how much coffee or caffeinated tea you’re drinking. (As a general guideline, you should match each cup of coffee with another cup of water. And 30 minutes in the gym requires another 8 ounces to replenish the fluid you lost through sweat.)

You’ll also want to avoid sodas (especially diet ones) and sugary drinks (if you don’t already). High-sugar diets ramp up excretion of calcium in the urine—which, in turn, raises risk of kidney stone formation.

Limiting oxalate is also important for kidney stone prevention. High oxalate, fresh foods include spinach, rhubarb, beets, berries, nuts, okra, and cocoa—and some experts suggest limiting or eliminating them. But I suggest cutting out the much bigger threats… like potato chips and French fries. (Both of which are high in oxalate and inorganic phosphorus.)

Supplementing for stalwart kidney health

So, now that you know how to eat (and drink) to help maintain general kidney health, let’s take a look my top supplement recommendation for added support: French maritime pine bark extract (or Pycnogenol®).

Published research shows the dramatic difference that pine bark extract can make in improving a multitude of critical health markers—including kidney function.

As part of one study, 58 patients took the blood pressure drug Ramipril. Then, a subgroup took a specialized extract of pine bark extract as a combination treatment for six months. Researchers found that all patients had improvements in several critical markers.

But the pine bark extract group had additional benefits:

  • Kidney function improved by 47 points
  • Creatinine levels dropped significantly lower
  • Blood pressure decreased from 189.3/97.2 mmHg to 122.2/85.3 mmHg
  • Fasting blood glucose dropped to 102.3 mg/mL
  • HbA1c (blood sugar levels) dropped by 6.9 percent
  • Body mass index (BMI) dipped from 26.5 to 25.0

In my view, none of these results are surprising. Pine bark extract has an unparalleled ability to protect your delicate small blood vessels—and these are the vessels that supply your kidneys (and support your metabolic health). Which is why I recommend 100 mg per day for general support.

And when it comes to kidney stone reduction? Well, I have supplement recommendations for that as well…

Extra support for avoiding stones

To help conquer kidney stones—especially as we enter another hot summer season, when your risk of developing stones increases—I recommend:

  • Calcium. This reduces oxalate absorption and lowers the risk of stone formation. I recommend 500 mg per day.
  • Vitamin B6. Studies show that a combination of magnesium and vitamin B6 (pyridoxine) may be able to dramatically reduce kidney stone recurrence. I recommend 50 mg per day.
  • Magnesium. I recommend either magnesium orotate (32 mg per day) or taurate (125 mg per day). These forms are the ones best absorbed by the body.

At the end of the day, it’s really not hard to avoid falling victim to kidney disease—of any kind. Knowing the danger is your first step. Followed by proper hydration, a sensible diet with regular exercise, and smart supplementation. So, start making changes today…
before trouble starts to brew.

SIDEBAR: The truth about salt restriction

Fact: Your body needs salt to stay alive. Sodium is a key player in a host of biological functions—most notably nerve conduction, muscle contraction, and the fluid balance that keeps nutrient- and oxygen-rich blood flowing everywhere it needs to go.

All of these processes require very precise amounts of sodium to continue. Too much, and your body has to work to eliminate it through your skin, intestines, and kidneys. But too little, and your kidneys will work overtime to hold onto it.

The fact is, you’re a lot more likely to die from failure to keep up this balancing act than from salt-related high blood pressure. And even small decreases in blood levels of sodium point to higher mortality risk among healthy people.

Now don’t get me wrong—this isn’t carte blanche to have a salt free-for-all. High-sodium packaged and processed junk will never be healthy, and that’s a fact. But as long as you’re eating real, fresh, whole foods, there’s no reason you can’t add salt to them.

In other words, don’t give up salt altogether—especially when you’re following a healthy, balanced diet. The restriction won’t do a single thing to help your kidneys—or other areas of your health. In fact, it may actually cause more harm than good.


  1. Al-Aly Z, et al. High-dimensional characterization of post-acute sequalae of COVID-19. Nature, 2021; DOI: 10.1038/s41586-021-03553-9
  2. Half of Patients in Hospital for COVID-19 Get Acute Kidney Injury. Medscape Medical News, 04/27/2021. (medscape.com/viewarticle/950008)
  3. “These lifestyle choices can reduce the risk of chronic kidney disease.” Science Daily, 09/02/2020. (sciencedaily.com/releases/2020/09/200902095136.htm)
  4. Association of dietary phosphate and serum phosphorus concentration by levels of kidney function. American Journal of Clinical Nutrition, June 3, 2015. ajcn.nutrition.org/content/early/2015/06/03/ajcn.114.102715.abstract?papetoc
  5. “A healthy diet may help prevent kidney disease.” Science Daily, 09/24/2019. (sciencedaily.com/releases/2019/09/190924175716.htm)
  6. Kittanamongkolchai W, et al. Mayo Clin Proc. 2018 Mar;93(3):291-299.