Hitting the gym is a cornerstone of a healthy lifestyle for many, aimed at building strength, improving endurance, and promoting longevity. Yet, occasionally, concerning stories emerge linking dedicated fitness enthusiasts to kidney problems or even serious heart issues. This apparent contradiction can be confusing: if exercise is so beneficial, why these potential risks? This article delves into the evidence, exploring the specific circumstances under which gym-related activities might pose challenges to kidney and heart health, moving beyond simple generalizations to understand the nuances of intensity, conditioning, hydration, and supplementation.

It’s crucial to start by emphasizing the overwhelming scientific consensus: regular physical activity is profoundly beneficial for overall health, including the cardiovascular and renal systems. Engaging in physical activity contributes to a substantial 27% reduction in the relative risk of cardiovascular mortality.¹ Furthermore, population studies indicate that the most physically active individuals generally have a lower risk of developing chronic kidney disease (CKD) compared to their least active counterparts, with a pooled risk reduction of about 9%.² Even moderate activities, like increasing daily standing time, are associated with lower mortality rates.³ Exercise improves a multitude of risk factors for cardiovascular disease (CVD) ⁴ and is a key component of rehabilitation for those already living with heart or kidney conditions.⁴

However, the way one exercises matters. The potential risks highlighted in anecdotes often relate not to moderate, consistent activity, but to specific scenarios involving extreme exertion, inadequate preparation or recovery, poor hydration, or the use of certain substances. Understanding these specific contexts is key to maximizing the benefits of exercise while minimizing potential harm.

Kidneys Under Pressure: When Exercise Becomes a Strain

While regular exercise generally protects kidney health ² and is even recommended for individuals with existing CKD to improve fitness and quality of life ⁶, certain intense physical activities can lead to a sudden decline in kidney function, known as Acute Kidney Injury (AKI).¹⁰ AKI is a serious condition characterized by a rapid decrease in the kidneys’ ability to filter waste from the blood, potentially leading to complications and, in some cases, contributing to the development or progression of CKD over time.¹¹

The primary pathway linking intense exercise to AKI often involves a condition called Exertional Rhabdomyolysis (ER).

The Culprit: Exertional Rhabdomyolysis (ER)

ER is the breakdown of striated muscle fibers resulting from excessive physical stress.¹³ This damage causes muscle cells to release their contents, including large amounts of protein called myoglobin and an enzyme called creatine kinase (CK), into the bloodstream.¹³ The classic symptoms include severe muscle pain (myalgia), weakness, muscle swelling, and often dark, tea- or cola-colored urine, which is caused by myoglobin being excreted by the kidneys (myoglobinuria).¹³

The link between ER and AKI stems primarily from myoglobin toxicity. When large amounts of myoglobin are filtered by the kidneys, they can precipitate within the kidney tubules, forming casts that obstruct urine flow and cause direct damage to the tubular cells (acute tubular necrosis).¹³ Furthermore, the iron component released from myoglobin breakdown can generate reactive oxygen species (ROS), which are chemically reactive molecules that cause oxidative stress and further injure kidney cells.¹⁶

Compounding this direct toxicity, damaged muscles can swell significantly, sequestering large amounts of fluid from the bloodstream.¹⁶ This fluid shift can lead to volume depletion (effective dehydration), reducing overall blood flow to the kidneys.¹² Intense exercise itself temporarily reduces renal blood flow (RBF) as blood is shunted to working muscles and the skin (for cooling), a process driven by the sympathetic nervous system.⁶ This exercise-induced reduction in RBF, especially when combined with dehydration and muscle damage, creates an environment where the kidneys are vulnerable to ischemic injury (damage due to lack of oxygen).¹²

While ER severe enough to cause AKI is considered relatively uncommon in the general exercising population ¹³, its incidence appears to be increasing, possibly fueled by intense fitness trends and social media pressures.¹³ Estimates of AKI occurrence in patients with rhabdomyolysis vary widely across studies, ranging from 8% in a large military cohort ¹⁵ to 10-50% or even higher in other reports.¹³ A recent large study of hospitalized ER patients found AKI in 8.5%.¹⁹ The risk seems particularly elevated in ultra-endurance athletes, where post-event AKI incidence (often defined by changes in serum creatinine) has been reported anywhere from 7% to over 50%, depending on the event, conditions, and diagnostic criteria used.¹⁰

Key Risk Factors for ER and AKI

The development of ER and subsequent AKI is not simply about exercising; it’s strongly influenced by several interacting factors:

1. Exercise Type, Intensity, and Novelty: Risk is highest with unaccustomed, sudden bursts of high-intensity or prolonged strenuous exercise.¹³ Activities involving eccentric muscle contractions (where the muscle lengthens under tension, like downhill running or slowly lowering weights) are particularly implicated.¹⁴ Anaerobic exercise has also been linked to a specific form of AKI with patchy renal ischemia (ALPE).²⁰
2. Conditioning Level: Individuals who are untrained, deconditioned, or abruptly increase their training load are significantly more susceptible than well-conditioned athletes.¹³ Low prior fitness is a recognized risk factor.¹⁵
3. Hydration Status: Dehydration is a major contributor. It reduces RBF and concentrates myoglobin in the kidney tubules, significantly increasing the risk of obstruction and toxicity.⁶ Maintaining good hydration before, during, and after strenuous exercise appears to attenuate the rise in AKI biomarkers.¹²
4. Environmental Conditions: Exercising in hot and humid environments exacerbates dehydration and heat stress, further increasing the risk of ER and AKI.¹²
5. Medication Use: The use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen and naproxen, is strongly associated with an increased risk and severity of AKI in the context of strenuous exercise and ER.¹⁰ NSAIDs can impair the kidneys’ ability to regulate blood flow, making them more vulnerable, especially when already stressed. Avoiding NSAIDs around intense exercise, particularly when dehydrated, could potentially prevent a substantial proportion of AKI cases linked to ER.¹⁹
6. Other Factors: Male sex and certain ethnicities (e.g., African) have been associated with higher risk in some studies.¹⁵ Underlying genetic factors, such as certain metabolic myopathies, can predispose individuals.¹⁴ Use of alcohol or illicit drugs can also increase susceptibility.¹³

It is important to understand that the kidney risk commonly associated with intense exercise is primarily acute (AKI resulting from ER). While repeated, severe episodes of AKI could theoretically contribute to chronic kidney damage over the long term ¹⁰, particularly in ultra-endurance athletes facing recurrent insults ¹⁰, typical gym-based exercise is not considered a cause of developing CKD in healthy individuals. In fact, as noted earlier, regular moderate activity is protective against CKD.² The risk is therefore highly specific to the circumstances surrounding the exercise – particularly doing too much, too soon, without adequate preparation, hydration, and avoidance of aggravating factors like NSAIDs and extreme heat.

Furthermore, while extremely high CK levels (often >50,000 IU/L) are characteristic of severe rhabdomyolysis ¹⁵, recent large-scale research challenges the long-held assumption that the CK level itself is the main predictor of AKI risk in ER patients.¹⁹ This study found that once factors like dehydration and NSAID use were accounted for, CK levels were not independently associated with AKI development. Dehydration and NSAID use emerged as the most critical modifiable risk factors, suggesting that prevention and management strategies should strongly focus on maintaining hydration and avoiding these medications around periods of intense exertion.¹⁹

The Exercising Heart: Balancing Benefits, Triggers, and Extremes

The relationship between exercise and heart health is overwhelmingly positive. Regular physical activity is one of the most effective strategies for preventing cardiovascular disease. It leads to significant reductions in CVD-related mortality and all-cause mortality.¹ Exercise favorably modifies numerous cardiovascular risk factors, including high blood pressure, unfavorable cholesterol levels, insulin resistance, and systemic inflammation.⁴ Higher levels of cardiorespiratory fitness (CRF), a measure of aerobic fitness often improved by exercise, are strongly associated with lower mortality risk, with some evidence suggesting no upper limit to this protective effect.⁷ Even relatively small amounts of activity confer benefits compared to being sedentary ³, and exercise forms a critical part of rehabilitation for patients with existing heart conditions.⁴

The Acute Paradox: Exercise as a Trigger

Despite these profound long-term benefits, each individual bout of vigorous physical activity does transiently increase the immediate risk of an acute cardiac event, such as sudden cardiac death (SCD) or acute myocardial infarction (heart attack, MI).²²

This temporary increase in risk is most pronounced in individuals who are habitually sedentary or unaccustomed to vigorous exertion.²² Crucially, the vast majority of exercise-related acute cardiac events occur in individuals who have underlying, often previously undiagnosed, structural heart disease or significant coronary artery disease (CAD).⁷ In adults over the age of 35 or 40, atherosclerotic CAD (narrowing of the heart arteries due to plaque buildup) is responsible for over 80-95% of exercise-related SCD cases.²² In younger individuals (typically under 35), the underlying causes are more often inherited or congenital conditions like hypertrophic cardiomyopathy (thickening of the heart muscle), coronary artery anomalies, or electrical disorders (arrhythmogenic conditions).²²

Several mechanisms can explain how vigorous exercise might trigger an event in a susceptible individual:

• Increased Cardiac Workload: Exercise increases heart rate and blood pressure, raising the oxygen demand of the heart muscle and increasing mechanical stress on the heart walls and blood vessels.²³
• Plaque Rupture: In individuals with CAD, the increased hemodynamic stress and flexing of coronary arteries during exercise may cause an unstable atherosclerotic plaque to rupture or fissure, leading to the formation of a blood clot (thrombosis) that blocks the artery and causes an MI or SCD.²³
• Arrhythmias: Increased levels of circulating catecholamines (like adrenaline) during exercise can make the heart muscle more prone to dangerous electrical disturbances (arrhythmias), especially if ischemia (lack of oxygen supply) is present due to underlying CAD.²³ Sodium-potassium shifts and changes in fatty acid levels might also contribute.²³
• Exercise-Induced Hypertension (EIH): An excessive rise in blood pressure during exercise, noted particularly in some middle-aged long-distance runners, can increase the load on the heart (afterload) and myocardial oxygen demand, potentially contributing to ischemia or arrhythmias even independent of severe CAD.²⁵

While the relative risk of a cardiac event is higher during vigorous exercise compared to rest (with estimates varying widely, sometimes reported as many times higher ²²), the absolute risk remains extremely low for the general population, particularly for those who exercise regularly.²² For perspective, the risk of SCD during marathon participation is estimated to be roughly 1 event per 80,000 to 200,000 participants.²² The risk is also notably lower for women compared to men.⁷ Regular exercise significantly mitigates this transient risk, likely through improved endothelial function, enhanced vagal tone (leading to lower resting heart rates), vascular remodeling, and better management of risk factors.³

The “Too Much Exercise” Debate: Chronic Extremes

Beyond the acute trigger risk, there is ongoing discussion about whether extremely high volumes of chronic endurance exercise – far exceeding general recommendations, typical of veteran marathoners or ultra-endurance athletes – might lead to potential cardiac maladaptations in some individuals.⁴

Some research hints at a potential U-shaped or reverse J-shaped relationship between exercise volume/intensity and certain health outcomes. For example, one large observational study found that while runners had lower mortality than non-runners, those running very high mileage (>20 miles/week) or at very fast paces did not experience better survival than moderate runners.²⁷ Another study involving patients with existing CVD found that the benefits for reducing mortality and recurrent vascular events appeared to plateau or slightly diminish at very high exercise volumes (beyond approximately 29 MET-hours/week) compared to moderate volumes.⁴

Specific potential maladaptations observed in some highly trained, long-term endurance athletes include:

• Accelerated Coronary Artery Calcification (CAC): Some studies report higher CAC scores (a measure of plaque burden in heart arteries) in veteran male endurance athletes compared to sedentary controls.⁷ However, the clinical significance remains debated, as the plaque in athletes may be denser and potentially more stable. Importantly, higher fitness levels appear protective even in individuals with high CAC scores.⁷
• Myocardial Fibrosis: Patchy areas of scarring (fibrosis) in the heart muscle have been detected via imaging in a subset of endurance athletes, which could potentially increase the risk of arrhythmias.⁷ It’s worth noting, however, that exercise generally has anti-fibrotic effects in models of heart disease, indicating a complex relationship.²⁸
• Atrial Fibrillation (AFib): Long-term endurance athletes seem to have an increased prevalence of AFib, an irregular heart rhythm originating in the upper chambers of the heart.⁷
• Exercise-Induced Hypertension (EIH): As mentioned, EIH is more prevalent in some groups like middle-aged long-distance runners. Chronic EIH might contribute to adverse remodeling (like ventricular hypertrophy) and increase the risk of arrhythmias, potentially via mechanisms involving imbalances in myocardial oxygen supply/demand or increased arterial stiffness, distinct from traditional CAD pathways.²⁵

It is critical to place these findings in context. These concerns relate to a small fraction of the population engaging in extreme levels of exercise, often 5- to 10-fold greater than standard public health recommendations.²⁷ The vast majority of people who exercise regularly, even vigorously, are unlikely to reach these volumes. Furthermore, even among extreme athletes, the overall cardiovascular benefits of high fitness levels generally remain substantial.⁷

Understanding cardiac risk related to exercise requires recognizing that it’s not uniform. Risk is heavily influenced by age (reflecting different likely underlying pathologies – CAD in older adults, structural/electrical issues in younger individuals), sex (lower absolute risk in women), the presence of underlying heart disease, and critically, the individual’s habitual level of physical activity and fitness.⁷ The highest relative risk occurs when sedentary individuals suddenly engage in unaccustomed vigorous activity.²² Regular training significantly lowers this exercise-associated risk.²²

It’s also vital to distinguish between the mechanisms of acute exercise-triggered events and potential chronic maladaptations from extreme training. Acute events are typically caused by the interaction of the exercise stressor with a pre-existing vulnerability (like unstable plaque or an electrical abnormality).²³ Potential chronic changes like fibrosis or increased AFib risk in extreme athletes likely involve different long-term processes related to sustained hemodynamic stress, inflammation, metabolic shifts, or hormonal changes.⁵ Conflating these distinct scenarios can lead to unnecessary anxiety for the average gym-goer, whose activities are far more likely to be protective than harmful.

Beyond the Barbell: Supplements, Culture, and Contributing Factors

The gym environment often involves more than just exercise; dietary supplements are commonly used by attendees.²⁹ Understanding their potential role, alongside cultural factors, adds another layer to the discussion of health risks.

Common supplements include protein powders for muscle repair and growth, creatine monohydrate for enhancing strength and performance, pre-workout formulas aimed at boosting energy and focus, and various vitamins and minerals.

Supplement Considerations for Kidney Health

Concerns are sometimes raised about the impact of popular gym supplements on kidney function:

• Protein: Historically, high protein intake was discouraged due to concerns it could strain the kidneys. While severe protein restriction is indeed a management strategy for advanced CKD ³⁰, the picture for healthy individuals or those with early CKD is evolving. A recent meta-analysis surprisingly found that higher intake of total dietary protein, as well as plant and animal protein specifically, was associated with a lower risk of developing CKD in the general population.³¹ While extremely high protein intake logically increases the kidneys’ workload in processing nitrogenous waste, robust evidence that typical high-protein diets or supplementation damages healthy kidneys is lacking.³¹ One cross-sectional study did find that gym users taking supplements had a slightly higher prevalence of minor alterations in blood urea levels (a kidney function marker), but the clinical significance of this finding is unclear.²⁹
• Creatine: Creatine supplementation is frequently questioned regarding kidney safety. However, despite occasional case reports mentioned in the literature ²⁹, the overwhelming body of scientific evidence from numerous controlled trials indicates that creatine monohydrate is safe for kidney function in healthy individuals when used at recommended dosages.²⁹ The case reports linking creatine to kidney issues often involve single patients with pre-existing conditions or confounding factors, requiring cautious interpretation.²⁹
• Other Supplements: Some supplements like Vitamin D, omega-3 fatty acids, fiber, and Coenzyme Q10 have been investigated for potential protective effects in patients already diagnosed with CKD, though the evidence for significant benefit on disease progression is generally rated as low to very low.³⁰ The aforementioned cross-sectional study also noted a slightly higher prevalence of altered levels of the liver enzyme AST among supplement users, alongside the urea changes, suggesting some metabolic impact, although likely subclinical for most.²⁹

Supplement Considerations for Heart Health

• Pre-Workout Supplements: These popular multi-ingredient formulas often contain significant doses of caffeine and other stimulants, alongside compounds like beta-alanine, citrulline, or nitrates, designed to enhance performance, energy, and focus.³³ Due to their composition, they can directly affect the cardiovascular system, notably increasing heart rate and blood pressure.³³ While some individual ingredients might offer potential cardiovascular benefits in other contexts (e.g., improving blood flow or having antioxidant effects ³³), the combination of potent stimulants with the physiological stress of intense exercise could pose risks. This is particularly true for individuals sensitive to stimulants, those consuming excessive doses, or people with underlying cardiovascular conditions. Adverse cardiovascular events associated with pre-workout use have been reported, although systematic data on their frequency may be limited.³³

Table 1: Common Gym Supplements & Considerations (Healthy Individuals)

Supplement Type	Common Use	General Efficacy Note	Kidney Considerations (Healthy Individuals)	Heart Considerations (Healthy Individuals)
Protein Powder (Whey, Casein)	Muscle repair/growth, recovery	Effective for increasing muscle mass/strength with training	Generally considered safe; high intake may increase kidney workload but unlikely to cause damage 31	Generally considered safe
Creatine Monohydrate	Strength, power, performance	Highly effective for high-intensity exercise performance	Extensive research indicates safety at recommended doses; rare case reports lack strong evidence 29	Generally considered safe
Pre-Workouts (Stimulant-based)	Energy, focus, pump, performance	Variable; caffeine component is effective	Generally no direct issue known, but dehydration risk from intense workouts could be relevant	Can increase heart rate & blood pressure; caution advised, potential risk with high doses, sensitivity, or underlying conditions 33
Branched-Chain Amino Acids (BCAAs)	Muscle recovery, reduce soreness	Evidence for significant benefit is mixed/limited	Generally considered safe	Generally considered safe

Note: This table provides general information for healthy individuals. Those with pre-existing conditions should consult healthcare professionals.

A significant issue with dietary supplements is the lack of stringent regulation compared to pharmaceuticals. This raises concerns about product purity, accurate labeling of ingredients and dosages, and the potential presence of undisclosed or banned substances. Consumers should choose products from reputable manufacturers and ideally consult with a healthcare professional or registered dietitian before starting new supplements, especially if managing any health conditions.

Finally, gym culture itself can sometimes contribute to risky behaviors. An emphasis on pushing limits (“no pain, no gain”), striving for rapid transformations often promoted on social media, or inadequate guidance can encourage individuals to progress too quickly, ignore warning signs, or adopt practices that increase the risk of ER, overtraining, or other adverse events.¹³

It becomes clear that the risks associated with supplements are not uniform. While concerns about well-researched supplements like protein and creatine causing kidney damage in healthy individuals appear largely unfounded based on current evidence ²⁹, a more tangible potential risk, particularly to the cardiovascular system, may stem from stimulant-heavy pre-workout formulas or products from less reputable sources.³³ The interaction of these substances with the physiological demands of intense exercise is a key area of concern.

Furthermore, adverse health events related to gym activities rarely occur due to a single isolated factor. More often, it’s the interplay of multiple elements – such as an untrained individual taking a potent pre-workout supplement, attempting an overly ambitious workout session while dehydrated, and perhaps using NSAIDs afterward for muscle soreness – that creates a “perfect storm” scenario, significantly elevating the risk of conditions like ER with AKI or potentially triggering a cardiac event.¹⁰

Finding the Sweet Spot: Training Smart for Long-Term Health

The evidence clearly shows that the potential kidney and heart risks associated with gym attendance are not inherent to exercise itself but are strongly linked to specific, often preventable, circumstances. These include extremes of exercise intensity or volume, inadequate conditioning, poor hydration, exercising in excessive heat, the use of NSAIDs around workouts, underlying health conditions, and potentially the misuse of certain supplements, especially stimulants.¹⁰ For the vast majority of individuals engaging in regular, sensible exercise, the practice is overwhelmingly safe and profoundly beneficial for long-term health.

By understanding the potential pitfalls and adopting smarter training strategies, individuals can effectively minimize these risks:

• Progress Gradually: Avoid abrupt increases in workout intensity, duration, or frequency. Allow the body adequate time to adapt physiologically. Listen to your body; pain is a signal to ease off or stop, not necessarily to push through.¹⁹ This is paramount for preventing ER.¹³
• Prioritize Hydration: Maintaining adequate fluid intake before, during, and after exercise is crucial, especially for intense or prolonged sessions or when exercising in the heat. Good hydration helps maintain kidney blood flow and dilutes potentially harmful substances like myoglobin.¹² Studies suggest adequate fluid intake can lessen the rise in AKI biomarkers after strenuous activity.¹²
• Be Mindful of Heat: Exercise caution when training in hot and humid conditions. Acclimatize gradually if necessary, adjust intensity, ensure even greater attention to hydration, and consider training during cooler parts of the day to reduce the risk of heat stress, dehydration, and ER.¹²
• Use NSAIDs Wisely: Avoid relying on NSAIDs (like ibuprofen, naproxen) to manage exercise-related pain, particularly around intense workouts or if dehydrated, due to the increased risk of AKI.¹⁰ Consider safer alternatives like acetaminophen for pain relief if needed, and address the underlying cause of persistent pain.¹⁹
• Make Informed Supplement Choices: Be skeptical of marketing hype. Research ingredients and choose products from reputable, third-party tested brands if opting for supplements. Be particularly cautious with multi-ingredient pre-workouts containing high doses of stimulants.³³ Consulting a doctor or registered dietitian is advisable, especially if you have any pre-existing health conditions.
• Know Your Health Status: Individuals, particularly those over 35-40 or with known cardiovascular risk factors (like hypertension, diabetes, high cholesterol, smoking history, family history of heart disease) or symptoms (like chest pain, shortness of breath, palpitations during exercise), should consider discussing exercise plans with a healthcare provider. Pre-participation screening may be appropriate before embarking on vigorous exercise programs.²² Those with diagnosed CKD or CVD must follow exercise prescriptions tailored by their healthcare team.⁴
• Embrace Balance and Recovery: Incorporate rest days into the training schedule to allow muscles and physiological systems to recover and adapt. Chronic overtraining without sufficient recovery can increase susceptibility to injury and potentially lead to adverse health effects.

Table 2: Key Risk Factors & Mitigation Strategies for Exercise-Related Issues

Risk Factor	Associated Risk(s)	Mitigation Strategy
Sudden High Intensity/Volume	Exertional Rhabdomyolysis (ER) / AKI; Cardiac Trigger	Gradual progression; start slowly and increase intensity/duration over time; listen to body’s signals 13
Dehydration	ER / AKI (increased severity); Cardiac Stress	Maintain adequate hydration before, during, and after exercise; monitor urine color 12
Exercising in Heat/Humidity	ER / AKI; Heat Stroke; Cardiac Stress	Acclimatize; adjust intensity; hydrate aggressively; exercise during cooler times; wear appropriate clothing 12
NSAID Use (around exercise)	AKI (especially with dehydration/ER)	Avoid use for exercise pain; use alternatives like acetaminophen if needed; address underlying pain source 10
Lack of Conditioning/Training	ER / AKI; Higher Relative Cardiac Trigger Risk	Start with lower intensity/duration; build fitness base gradually; seek guidance if new to exercise 13
Underlying Disease (Kidney/Heart)	Worsening of condition; Acute Event Trigger	Medical consultation/screening before vigorous exercise; follow prescribed exercise guidelines 4
Stimulant Supplements	Increased Heart Rate/BP; Potential Cardiac Strain	Cautious use or avoidance; be aware of dosage; avoid if sensitive or have heart conditions; choose reputable brands 33

Conclusion: Train Smart, Reap the Rewards

Returning to the initial question, the perception that gym attendance leads to more kidney and heart problems is largely a misunderstanding stemming from specific, often extreme, situations rather than a general rule. The gym remains overwhelmingly a place to enhance health and longevity. The vast benefits of regular, sensible physical activity for cardiovascular and renal health are well-established and far outweigh the potential risks for most people.¹

The documented risks – primarily acute kidney injury secondary to exertional rhabdomyolysis, and the triggering of acute cardiac events – are real but are strongly associated with context-dependent factors. These include sudden unaccustomed high-intensity exercise, inadequate physical conditioning, significant dehydration, exercising in extreme heat, the use of NSAIDs to mask pain, underlying (often undiagnosed) health conditions, and potentially the misuse of high-stimulant or unregulated supplements.¹⁰ Concerns about chronic negative effects from exercise generally apply only to the extreme training volumes undertaken by a very small subset of elite endurance athletes.⁷

Ultimately, knowledge is empowering. By understanding the potential pitfalls associated with intense physical exertion and adopting smart, evidence-based training practices – emphasizing gradual progression, prioritizing hydration, listening attentively to the body’s signals, being cautious with medications like NSAIDs, making informed choices about supplements, and being aware of personal health status – individuals can safely and effectively harness the immense power of exercise. Engaging with healthcare professionals for personalized advice, particularly when starting a new vigorous program or if managing existing health conditions, further ensures that fitness pursuits contribute positively to long-term kidney, heart, and overall well-being.

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