Supporting Kidney Health Through Menopause: What Every Woman Needs to Know

Your kidneys are two small, bean-shaped organs that sit just below your rib cage on either side of your spine. Despite their modest size, they perform a vast range of essential functions that help keep your entire body in balance. Every day, your kidneys filter around 180 litres of blood, removing waste products, excess fluids, and toxins via the urine. But their role extends far beyond waste elimination.

Key functions of the kidneys include:

• Supporting glucose metabolism: The kidneys play a role in gluconeogenesis (creating glucose from non-carbohydrate sources), particularly during fasting. They also help regulate glucose reabsorption, preventing excessive sugar loss in the urine and working in tandem with insulin and other hormones to maintain stable blood glucose levels.

• Regulating fluid and electrolyte balance

• Managing blood pressure through the renin-angiotensin system

• Producing hormones like erythropoietin, which supports red blood cell production

• Activating vitamin D to support bone health and calcium absorption

• Maintaining acid-base (pH) balance in the body

• Supporting detoxification and removal of metabolic byproducts

When kidneys begin to lose function, these vital roles are compromised, leading to widespread health effects, including fatigue, fluid retention, hypertension, anaemia, and bone weakness.

This is why protecting your kidneys—especially during life transitions like menopause—is not optional. It's foundational to long-term vitality, energy, and resilience.

Chronic kidney disease (CKD) is often overlooked in women’s health discussions, yet it’s the third leading cause of death in some countries and is increasingly common among women in midlife. The menopausal transition, with its hormonal, metabolic, and cardiovascular shifts, places additional stress on the kidneys. Understanding how to support kidney health during this life stage can be a powerful form of prevention and empowerment.

Early Detection: Your First Line of Defence

Kidney disease is notoriously silent in its early stages. By the time symptoms arise, significant damage may already have occurred. Yet as the disease progresses, some women may notice:

• Changes in urination: frequency, volume, or appearance

• Puffiness in the eyes, face, hands, or ankles

• Pain or discomfort in the lower back or sides

• Persistent tiredness or weakness

• Loss of appetite and unintentional weight loss

• Nausea or metallic taste in the mouth

• Itchy or dry skin

That’s why routine testing is vital—especially for women with risk factors such as high blood pressure, diabetes, autoimmune issues, or a history of recurrent UTIs.

Recommended Tests:

• HbA1c: Assesses long-term blood sugar control, a key risk factor for CKD

• Blood pressure monitoring: Essential for identifying and managing hypertension

• eGFR (Estimated Glomerular Filtration Rate): Assesses overall kidney function

• ACR (Albumin-to-Creatinine Ratio): Detects early signs of kidney damage

• Serum Creatinine and BUN: Evaluate waste filtration capacity

• Electrolyte Panel: Checks sodium, potassium, and acid-base balance

• Urine Dipstick & Microscopy: Screens for protein, blood, and infection.

The Kidney-Menopause Connection

The drop in oestrogen levels during menopause has far-reaching effects, including on kidney function. Oestrogen supports vascular health and glomerular filtration, both of which are essential for kidney performance. When oestrogen declines:

• Renal blood flow may be reduced

• Inflammatory markers may rise

• Blood pressure may increase, straining the kidneys

Women who undergo early or surgical menopause are at even greater risk of CKD, and may benefit from more proactive screening and support.

Modifiable Risk Factors for CKD

Understanding what you can change is empowering. The following lifestyle and environmental factors significantly influence your risk of developing chronic kidney disease:

• Diabetes (especially poorly managed)

• High blood pressure

• Obesity

• Cardiovascular disease

• Poor gut health (dysbiosis, SIBO, leaky gut)

• Toxic burden (mould exposure, heavy metals, cigarette smoking, microplastics, solvents, chemicals)

• Stealth infections (e.g. EBV, Lyme)

• Poor diet (dehydration, excess processed salt, insufficient fruits and vegetables, excess protein)

• Lack of exercise or movement

• Nitric oxide deficiency (impairing vascular tone and filtration capacity)

Many of these factors are interconnected and often compound each other. Addressing even a few can yield substantial benefits for your kidneys and overall wellbeing.