Diabetes

What are the most common CKD risk factors? Diabetic kidney disease is the most common cause of CKD in the United States. [1] Over 30% of patients with diabetes will develop kidney disease within their lifetime. These patients are at greater risk of morbidity and mortality if the diabetes is not controlled 1  High blood sugar gradually damages the microscopic nephrons within the kidneys which are highly sensitive to damage. When this happens, the kidneys are not as effective at removing waste products and excess fluid from the body. Over time, patients may experience fluid retention, anemia, damage to the blood vessels in the eye, bone and mineral disorders due to the kidneys’ inability to maintain the right balance of minerals in the blood, and end stage renal failure. To prevent these complications, it is vital patients with diabetes are vigilant at keeping regular appointments with their physician to monitor their glucose levels. Patients who are able to control their blood sugars have a much better outcome in preventing or delaying kidney disease caused by diabetes .  In addition, patients with diabetes may also consider speaking with a registered dietitian to create a healthy-eating guide. A diet for a patient with diabetes should be comprised of a high amount of nutritionally dense foods and be low in fat and calories. These foods include fruits and vegetables, whole grains, and low-fat dairy. By eating more whole foods, patients with diabetes will be able to better control blood glucose levels.

High Blood Pressure

            For patients with hypertension, another approach to removing CKD risk factors is lowering blood pressure.  Blood pressure is the force of blood which is pushing against the walls of your blood vessels. When the force is too high, the heart is being overexerted to pump blood. Over time, serious health problems such as heart disease and kidney failure can develop due to the damage high blood pressure can cause to the blood vessels.  This condition is called hypertension. For patients diagnosed with hypertension,  their physician will most likely prescribe medications to lower their blood pressure.  There are several types of medication which can be used to treat high blood pressure. These include ACE inhibitors, ARB’s, calcium channel blockers, or water tablets. As with diabetes, dietary intervention is another form of treatment for hypertension. One of the most well-known diets for hypertension is called the DASH diet. The DASH diet stands for Dietary Approaches to Stop Hypertension.   The DASH diet encourages the consumption of fruits, vegetables, and low-fat dairy food. An additional recommendation of the DASH diet is to cut back on foods containing a high amount of cholesterol, saturated fats, and sodium. The DASH diet gradually limits sodium from 2,4000 milligrams a day to 1,500 milligrams. [2]

Diet

            If you’ve been diagnosed with early CKD, regulating acid balance is an approach that can stabilize or delay the progression of kidney disease. One of the most fundamental functions of the kidneys is maintaining an acid-base balance. Healthy kidneys eliminate excess acid through the urine. This process maintains an adequate amount of bicarbonate in the blood. Bicarbonate plays an essential role in maintaining acid-base balance because it is a base. However, when kidneys are damaged, not enough acid is being removed from the body and can lead to a condition called metabolic acidosis. Metabolic acidosis may cause serious long-term health conditions if not treated. These conditions include increased bone loss, muscle loss, high blood sugar, and progression of CKD. Research has indicated a link between metabolic acidosis and increased mortality. Therefore, a nephrologist will most likely monitor serum bicarbonate to ensure levels do not fall below 22 mEq/L in patients with CKD.

            Patients can help control the amount of acid in the blood by watching their intake of foods with a high potential renal acid load (PRAL). CKD patients can increase the alkaline in their diet by only consuming the amounts of higher PRAL foods which have been recommended by their registered dietitian or physician. High PRAL foods include most animal products such as meat, poultry, fish, cheese, eggs (especially the yokes), grains, and soda. Foods with a low PRAL value include plant foods such as fruit, legumes, tofu, and vegetables.  Fruits and vegetables are considered part of a high-alkaline diet and can be an essential tool in maintaining adequate pH levels. As mentioned, metabolic acidosis has a serious effect on the progression of kidney disease. However, through medication and dietary intervention with alkaline foods, there can be a slow-down in the advancement.[3]  This is a complicated change to make to your diet, and working with a dietitian who specializes in kidney disease may be in order. If you’re interested, you can set up a free discovery call here.

There is hope!

              Ultimately, there is hope with kidney disease. The American Kidney Fund’s website shared an amazing story of a woman named Gaul Rae-Garwood who was diagnosed with stage three kidney disease 9 years ago. By consuming kidney-friendly foods, watching fluid intake, and altering her lifestyle, she has been able to maintain her stage 3 kidney diagnosis.  With the proper education, consultations with both your renal dietitian and physician, and small sacrifices in your diet, you too might be able to pump the breaks of CKD and live a happier and healthier life.

Working with a registered dietitian who can help you gain control of your chronic health conditions through diet may be the most important decision you ever make. If you would like to explore that possibility, book a free discover call here.

[1] Bonner R, Albajrami O, Hudspeth J, Upadhyay A. Diabetic Kidney Disease. Prim Care. 2020;47(4):645-659. doi:10.1016/j.pop.2020.08.004

[2] Filippou CD, Tsioufis CP, Thomopoulos CG, et al. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020;11(5):1150-1160. doi:10.1093/advances/nmaa041

[3] Navaneethan SD, Shao J, Buysse J, Bushinsky DA. Effects of Treatment of Metabolic Acidosis in CKD: A Systematic Review and Meta-Analysis. Clin J Am Soc Nephrol. 2019;14(7):1011-1020. doi:10.2215/CJN.13091118