The kidneys are twin organs that filter the blood, removing the waste products and sending them to the bladder to be eliminated from the body. There are a number of other functions that the kidneys fulfill as well, so it is important that they are as healthy as possible. However, there are a number of conditions and diseases that can cause the kidneys to stop working properly, including chronic kidney disease.
Chronic kidney disease (CKD) is defined by either kidney damage or a decline in their function that continues for more than three months. One in nine adults in the United States meets these criteria for CKD, with that same number at risk for developing it. (Source: Martin, Armstrong and Rodriquez 2005) It is important to know the warning signs of CKD as well as the risk factors, both the ones that can be changed and the ones that cannot.
The National Kidney Foundation classifies chronic kidney disease in five stages. The fifth stage is the final stage, or end stage renal disease. This stage will require the use of dialysis and will also require different dietary guidelines for the patient.
The second leading cause of chronic kidney disease is high blood pressure. 30 percent of all cases are caused by hypertension, and controlling the blood pressure numbers can slow the progress of CKD. In addition to high blood pressure, race, gender, age, and family history are additional risk factors for chronic kidney disease. While these risk factors are not controllable, other risk factors for the disease are able to be changed. Three of these changeable factors include physical inactivity, smoking, and obesity. It is suggested that protein and fiber intake can reduce the blood pressure, however, further studies need to be completed.
It is a common treatment for protein intake to be limited, especially in certain stages of chronic kidney disease since certain studies suggest that protein intake may be a risk factor for a “progressive loss of remaining renal function in dialysis patients.” (Source: Martin, Armstrong and Rodriquez, 2005) The most common treatment plans have typically been to limit protein in the first four stages of the disease but to increase it once again in the final stage so that the patient is able to better deal with dialysis, maintain immune function and to be stronger. Because so many patients may need to have a kidney transplant, it is important to make sure that they are as strong and healthy as possible in the meantime.
Brent is an African American man in his mid-forties. He has smoked for years and has been overweight for most of his adult life. His diet is high in fat and salt, all factors that have led to his hypertension and his chronic kidney disease. He has had kidney stones in the past, which should have served as a wakeup call for him and his health, however, he has ignored them all, repeatedly. While he cannot change his age, race, or gender, he can and should control the other factors that have led him to this condition.
Brent’s doctor is concerned because his blood tests keep revealing high levels of protein (proteinuria), which raises the risk of death, heart attack, and kidney failure. In a study of one million people, the mortality rate has doubled with heavy proteinuria, regardless of whether or not the glomerular filtration rate is affected. (Source: Gever 2010) In fact, these studies show patients with heavy proteinuria but an acceptable GFR fare much worse than those who had the reverse.
At this stage of his disease, Brent’s GFR is 35, which puts him at Stage 3. Glomerular filtration rate determines how much blood the kidneys can filter. A normal rate is 90 or above. The typical recommendation for protein intake at this stage is 12-15% of the overall daily calories, which is slightly less than the typical diet. One of the recommendations Brent’s doctor makes is to exchange vegetarian protein for animal-based proteins so that he can first get the right amount of protein to fulfill his needs, second, to maintain sodium, potassium, and phosphorous balances, and third, to maintain good nutrition. (Source: Brookshyer)
In addition to making sure that he gets the right amount of protein as determined by his own doctor, Brent must be sure to monitor the foods that he eats so that he can keep his phosphorous level balanced. If he experiences itchy skin, he will consult his doctor, as this is a sign of phosphorous buildup. He must take great care in choosing his foods because a number of the foods that would technically be very beneficial to him are high in this mineral. This is yet another reason that working with a nutritionist or dietician is so important, especially in those who have been unable or unwilling to make good choices in the past.
While trying to keep his kidneys as healthy as possible, Brent is also working on a number of the other risk factors that have contributed to his disease. He is enrolled in a smoking cessation program and will also try to control his weight. He monitors his blood pressure which is being controlled right now by medications. As he works on losing weight and reducing the salt in his diet, he will rely less and less on the meds, however.
One of the ways that he is working on losing weight without compromising his health and nutritional goals is by using Profect, a protein supplement from Protica. For only 100 calories, he gets 25 grams of protein, which is factored into his daily intake by his nutritionist. Using this small supplement keeps him from feeling hungry between meals and allows him to stay on track with his healthier food choices from the DASH (dietary approaches to stop hypertension) diet. He will eat foods from this plan which focuses on fruits, vegetables, and whole grains, while also watching for the foods that will raise his phosphorous level too high. Bran cereals, skim milk, brown rice, dried beans, lentils, organ meats, salmon, sardines, chocolate, and cola drinks are all loaded with phosphorous. (Source: Maree 2002)
The studies contradict one another – some say that protein intake should be limited until the final stage while others say that it should be limited for all of the stages of chronic kidney disease. Other studies say that except in certain cases, protein intake should not be limited at any stage of CKD. While the National Kidney Foundation has accepted guidelines for treatment of CKD, it might be necessary to rethink this universal approach and start using guidelines that are more tailored to the individual instead. For instance, the criteria give guidelines for each stage regardless of the GFR and the level of protein in the urine which can differ from patient to patient.
Protica Research (Protica, Inc.) specializes in the development of Capsulized Foods. Protica manufactures Profect, IsoMetric, Pediagro, Fruitasia and over 100 other brands, including Medicare-approved, whey liquid protein for cancer patients. You can learn more at Protica Research – Copyright