That is the message from British kidney researcher and specialist Prof Peter Mathieson, who said in Dunedin yesterday there was a need for increased awareness of kidney disease.
That would include an end to people being squeamish about urine.
People were insufficiently receptive to the messages about keeping their kidneys healthy, but it was the job of health professionals to make information about kidney disease more accessible.
Kidney disease was "not a very sexy subject", but it was a significant health burden.
The best way to prevent kidney disease was to control diabetes and obesity.
Not gaining weight was the most important thing people could do to keep their kidneys healthy, Prof Mathieson said.
Having your blood pressure checked and controlled if necessary, moderating salt and alcohol intake, and "good levels" of physical exercise also played a part.
There was no evidence drinking lots of water protected kidneys, and the vogue for everyone to drink bottled water had no health evidence to support it, he said.
The body's thirst mechanism was extremely powerful and "if you need more water you will feel thirsty. If you don't feel thirsty, you don't need it".
Tap water was perfectly adequate, he said.
However, in some very hot parts of the world, such as Saudi Arabia, there was a need to keep up fluid intake to prevent the urine becoming too concentrated, because this could lead to kidney stones.
Prof Mathieson would ban high energy drinks if he could.
While they did not have a direct damaging effect on kidneys, their high calories led to associated health risks.
There were "very powerful" statistics suggesting the current generation of children would have a lower life expectancy than their parents.
Parents, who generally wanted their children to have a "better deal", should start disease prevention early.
This included encouraging physical activity and avoiding junk foods and high calorie drinks.
In the United Kingdom, there had been an emphasis on increasing physical exercise in the young, but this was not addressing the major problem of calorie intake, he said.
Prof Mathieson, who was the foundation professor of renal medicine at Bristol University where he is now the dean of medicine and dentistry, has been studying protein in urine, a sign of kidney disease; and ways to prevent kidney disease.
Often kidney disease was diagnosed late because it did not produce early symptoms.
A key to early detection was screening the urine for protein using sensitive tests, and the United Kingdom Government was being encouraged to introduce that.
In the long term, it was hoped research would lead to the ability to predict, by genetics or other means, who was at risk; and aim preventive strategies at those people.
People needed to realise paying for treating complications from obesity and diabetes rather than concentrating on prevention was "already overwhelming most of the developed world economies" where some form of health rationing was inevitable.
There were not enough kidney transplants available and the cost of dialysis meant clinicians would be forced to choose which patients would get a good quality of life on dialysis because they were dealing with a "finite resource".
Tips for kidney health
• Maintain a healthy weight.
• Have your blood pressure checked regularly and controlled if necessary.
• Moderate salt and alcohol intake.
• Have regular physical exercise.
