Causes of Kidney Failure & Nutrition Tips for Kidney Health

Kidney disease is becoming increasingly common in Malaysia, with 1 in 10 Malaysians estimated to have some form of kidney problem. Many cases are linked to long-term dietary habits and lifestyle choices. Understanding how the kidneys work—and how our food affects them—is the first step towards protecting this vital organ.

Why the Kidneys Matter

The human body has two kidneys, each responsible for filtering metabolic waste such as urea from the blood. They also help recycle beneficial substances like glucose, amino acids, water, and electrolytes. On average, our kidneys filter about 1 litre of blood every hour, keeping the internal environment stable.

The kidneys also regulate:

• Blood pressure, through the renin–angiotensin system

• Calcium absorption, through calcitriol

• Fluid and electrolyte balance, through aldosterone

Because of this close relationship, issues such as high blood pressure, high cholesterol, and arteriosclerosis can gradually damage the kidneys.

How Kidney Function Is Measured

Doctors commonly use the glomerular filtration rate (GFR) to assess kidney health.

• Normal GFR: ≥ 90 ml/min

• Lower GFR: Indicates declining kidney function

Kidney failure can be chronic or acute. In Malaysia, unregulated supplements have been reported as one of the causes of acute kidney injury.

Two other important indicators include:

• Protein–Creatinine Ratio (PCR): < 15 mg/mmol

• Albumin–Creatinine Ratio (ACR): < 2.5 mg/mmol (men), < 3.5 mg/mmol (women)

The presence of protein (proteinuria) or blood (haematuria) in the urine often signals early kidney injury.

Early Prevention for Healthy Individuals

If your kidney function is normal (GFR ≥ 90), you can protect your kidneys by:

• Staying well-hydrated

• Eating more fruits and vegetables

• Maintaining a healthy body weight

• Controlling blood sugar, blood pressure, and cholesterol

• Avoiding smoking and alcohol

Since dialysis is costly, early prevention is the most effective strategy.

Nutrition & Lifestyle Tips for Kidney Failure (Stage 3 and Above)

If you have diabetes, hypertension, a family history of kidney disease, persistent fatigue, or appetite loss, it’s advisable to test your kidney function once a year, especially after age 65.

For patients with kidney impairment, the following evidence-based strategies help slow progression:

1. Do Not Stop Medications Without Proper Medical Advice

There is insufficient evidence that prescribed medications worsen kidney disease. Always ask your doctor before discontinuing any treatment.

2. Maintain Blood Pressure Around 130/80

Uncontrolled hypertension accelerates kidney damage.

3. Control Blood Sugar Levels

Stable glucose levels are essential for diabetic kidney disease.

4. Moderate Protein Intake

Aim for 0.6–0.8 g protein per kg body weight.

5. Reduce Proteinuria

Risk of kidney deterioration over 3 years:

• 1 g/day: 7.7%

• 2–4 g/day: 22.9%

• 8 g/day: 64.9%

6. Limit Potassium to 2000–3000 mg/day

High-potassium foods include bananas, beans, spinach, durian, cocoa products, coconut water, and stink beans.
To reduce potassium in vegetables: cut them small and soak in warm water.

7. Limit Phosphorus to 800–1000 mg/day

Avoid or reduce:

• Processed foods

• Canned foods

• Chocolate

• Dairy products

• Excessive meat

8. Reduce Salt Intake

Keep sodium below 2400 mg/day (about 1 teaspoon of salt).

9. Maintain a Healthy Weight

Regular physical activity and weight management help slow kidney deterioration.

Kidney Stones: Another Hidden Risk

Kidney stones form when waste products crystallize due to insufficient water intake. Large stones may require surgery. To reduce the risk:

1. Drink enough water

2. Reduce meat; increase plant-based protein

3. Get vitamins and minerals naturally from whole foods

4. Limit salt intake

Kidney stones significantly increase the risk of kidney failure.

Final Takeaway

Protecting your kidneys is not complicated. A balanced diet, adequate hydration, 3–4 servings of vegetables and 2 servings of fruits daily, plus long-term lifestyle discipline, can dramatically reduce your risk. Kidney health is a lifelong investment—start today, and your body will thank you for years to come.