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Kidney Diet Tips

Archive for Kidney Research

February 7, 2013

The Obesity Paradox and Kidney Disease

You may have heard or read a recent news report on the benefit of being overweight or obese.

The January 2013 issue of the Journal of the American Medical Association published findings from an analysis of data from 97 research studies to determine risk of death based on body mass index (BMI). Surprisingly, the results show that people who are overweight (BMI 25-<30 kg/m2) and mildly obese (Grade 1 obesity, BMI 30-<35 kg/m2) had a lower risk of death compared to people with normal BMI (18.5-<25 kg/m2). This finding exists in people with heart attacks, strokes and heart failure.

The obesity paradox is not new to the kidney care community. In 2003 Dr. Kamyar Kalantar-Zadeh proposed the term reverse epidemiology to describe a protective survival benefit observed in hemodialysis and heart failure patients who were overweight and mildly obese. Higher cholesterol levels were also associated with reverse epidemiology.

So does this mean your weight does not matter when you have kidney or heart disease? Here’s some food for thought before you abandon your current eating plan. Read more…

February 2, 2012

Inflammation and Chronic Kidney Disease: The Dietary Fiber Connection

Recently I read an article on inflammation and fiber from Renal and Urology News that has a connection to the kidney diet and chronic kidney disease (CKD).

Low dietary fiber intake is a chronic problem in most Westernized diets. Our love of refined grain products, juices instead of fresh fruit, processed and fast foods, sweets and salty snacks, limited vegetable intake and narrow use of whole grains, beans, nuts and seeds has resulted in a fiber intake around 10 to 14 grams of fiber a day. In comparison, the Institute of Medicine recommends 14 grams for each 1000 calories, which is around 25 grams for females, 38 grams for males and 19 to 25 grams for children each day. Read more…

January 21, 2012

New test to detect kidney disease in diabetes-10 years earlier

Today I ran across a Joslin Diabetes Center study about diabetes and early detection of kidney disease. The study results are of particular interest to me for several reasons. I’ve worked with so many people with diabetes, diagnosed with kidney disease and they didn’t even know they were at risk before ending up near or on dialysis. Secondly, while working in a DaVita dialysis center I was involved in a research study called the Nutrition and Inflammatory Evaluation of Dialysis Patients (NIED) Study that has provided extremely useful data about the connection between chronic inflammation and kidney disease. Third, diabetes is one of the chronic diseases in my own family so being as healthy as possible is an important personal goal. Read more…

September 6, 2011

Dietary phosphorus control to prevent or delay kidney failure

You may have chronic kidney disease (CKD) and not even know it. An estimated 17% of US adults have chronic kidney disease and many are undiagnosed. There are 5 stages of kidney disease: stage 1 CKD represents kidney damage with normal kidney function; stage 2 kidney disease is mild kidney disease; stage 3 chronic kidney disease is moderate kidney failure; stage 4 CKD is severe and stage 5 is end stage renal disease which requires dialysis or kidney transplant. If you have kidney disease and you’re looking for ways to preserve kidney function through diet, pay attention to this latest study published in the August 2011 online Journal of the American Society of Nephrology. Read more…

April 21, 2011

Is kidney disease reversible through diet in people with diabetes ?

Anyone with diabetes and chronic kidney disease would gladly accept a treatment that could reverse their kidney disease. That’s why this topic in an article I recently ran across caught my attention.

A report from Mount Sinai School of Medicine researchers indicate a ketogenic diet may help people who have kidney disease related to Type 1 and Type 2 diabetes. A ketogenic diet is low in carbohydrate, high in fat and contains a moderate amount of protein. For years this type of diet has been used for seizure control in children with epilepsy.

When this type of diet is consumed, the body produces ketones because fat is burned as the primary energy source.

Charles Mobbs, PhD, Professor of Neuroscience and Geriatrics and Palliative Care Medicine at Mount Sinai School of Medicine, says “Our study is the first to show that a dietary intervention alone is enough to reverse this serious complication of diabetes. This finding has significant implications for the tens of thousands of Americans diagnosed with diabetic kidney failure, and possibly other complications, each year.”

Researchers believe the ketogenic diet works by blocking the toxic effects that high glucose levels have on the kidneys.

Future research to find out how the ketogenic diet works to reverse nephropathy may lead to drug therapy to mimic the ketogenic diet effect. The research may also help with treatments for other long-term diabetes complications such as retinopathy and neuropathy.

A few considerations are in order before you change your current diet.

  • These findings are from research on mice; human trials are needed before this type of diet could become a part of the treatment plan for people with diabetes.
  • Any changes in your usual intake of carbohydrate will have an impact on glucose levels. Lower glucose would be expected. Any changes in diet must include communication with your healthcare team to monitor glucose changes and regulate insulin and other diabetes medications.
  • A ketogenic diet is very difficult to follow. Until more is known about this topic, stick to fine-tuning your currently prescribed diet and optimize glucose control.

You can read more in the original news article. http://www.newswise.com/articles/low-carbohydrate-diet-may-reverse-kidney-failure-in-people-with-diabetes

For information on chronic kidney disease and diabetes, checkout the following articles on DaVita.com:

Diabetic nephropathy

Preventing chronic kidney disease when you have diabetes

Diet tips for diabetics with kidney disease

Kidney diet resources from DaVita.com

December 16, 2010

Dietary Phosphate Prescription and Survival in Dialysis Patients

“CUTTING DIETARY PHOSPHATE DOESN’T SAVE DIALYSIS PATIENTS’ LIVES” is the latest headline in nephrology news. So does that mean the struggles to control your phosphorus are no longer important?

The study titled “The Association between Prescribed Dietary Phosphate Restriction and Mortality among Hemodialysis Patients” by Lynch, et al is in the online December 2010 issue of the Clinical Journal of the American Society of Nephrology. According to the findings, ‘Dietary phosphate prescription was not associated with improved survival in hemodialysis patients and in some subgroups there may be greater mortality.’ In other words, having a lower phosphorus diet prescription does not necessarily mean hemodialysis patients live longer. The range of blood phosphorus values was similar for all the diet groups (3.8-7.9 mg/dL). Of note, analysis of subgroups with greater survival reveals that participants with phosphorus below 5.5 mg/dL still had a survival advantage.

Finding of the study include: Read more…

December 9, 2010

Fruits and vegetables help delay kidney disease progression in early stages

Your mom said it, the health experts say it and now there’s reason for people with early kidney disease to do it. Eat your vegetables—and fruit every day. The health benefits of fruits and veggies for a general diet are well known. Now a study on patients with hypertension-related kidney disease gives people with early chronic kidney disease a reason to eat fruits and vegetables daily.

Participants in the study at Texas A&M College of Medicine, in Temple, included 40 patients with macroalbuminuric hypertension and estimated glomerular filtration rate (eGFR) levels of 60 to 90 mL/minute. They were given a diet that included fruits and vegetables such as apples, grapes, potatoes and other foods while avoiding some of the higher potassium fruits and vegetables. At the end of the 30-day period, all patients showed reduced excretion of 3 key indicators of kidney injury: albumin, transforming growth factor β, and N-acetyl-β-D-glucosaminidase. In other words, the participants had a reduction in kidney injury after simply adding fruits and vegetables to their daily intake over a 30 day period. This translate into a delay in progression of kidney failure.

According to lead researcher Nimirit Goraya, MD, patients with kidney disease are known to have acid retention, which is often treated with sodium bicarbonate to help slow the decline of kidney function. Some fruits and vegetables can help reduce the acid load.

How does this work? One job of the kidneys is to keep blood pH normal by excreting excess substances that can make the blood more acid or alkaline. The foods you eat can influence the acid load that is regulated by the kidneys. Foods containing chloride, sulfur and phosphorus contribute more acid and foods containing potassium, calcium and magnesium contribute more alkaline.

Acid contributing foods include meat, poultry, fish, eggs, cheese, peanut butter, breads, cereals, cakes, cookies, corn and lentils. Certain fruits–prunes, plums and cranberries also contribute to acidity.

Most other fruits and vegetables are alkaline contributing foods. Greens like Swiss chard, mustard and turnip greens, kale, spinach, beet and dandelion greens tend to be especially high in alkaline production.

Usually in early stage kidney disease, potassium is not restricted, so including more fruits and vegetables is not a concern. For patients who are experiencing high potassium levels it is wise to exclude higher potassium fruits and vegetables. Instead, include several daily servings of the lower potassium fruits and vegetables.

Future long-term, larger studies are needed to investigate if the results of this study were actually due to the reduction in acid production, or due to other components of the added fruits and vegetables.

In the mean time…eat your fruits and veggies everyday!

Try these kidney-friendly DaVita.com recipes to incorporate more fruits and vegetables in your diet:

Ambrosia

Beet and Cucumber Salad

Carrot and Apple Casserole

Fruit Salad Slaw

Green Beans with Turnips

Jicama Fabulous

Ratatouille

Stir-Fry Vegetables

Stuffed Strawberries

June 28, 2010

Kidney disease and B vitamin therapy: Concern or Controversy?

Can too much of a water soluble vitamin really be bad for your kidneys? I first ran across an article “B Vitamins Harm Kidneys” in the June issue of Nutrition Action Healthletter (http://www.cspinet.org/). According to the article about a Canadian research study, 238 diabetics with early stage chronic kidney disease (CKD) took a high dose folic acid, vitamin B-6, vitamin B-12 pill or a placebo. After three years the study revealed a greater decrease in kidney function and heart attack or stroke in the participants receiving the B vitamin. Read more…

April 9, 2010

Diabetes and kidney disease prevention

Diabetes is a risk factor for kidney disease. In fact, over 50% of patients on dialysis have diabetes.  So if you have diabetes find out what can you do to prevent or delay kidney disease.

Results from a 4-1/2 year study of almost 1300 Chinese people with type 2 diabetes points to the American Diabetes Association targets to answer this question. (Archives of Internal Medicine, 2010:170:155-161). The study researchers reported that meeting the ADA target goals for hemoglobin A1C (HbA1C), blood pressure, cholesterol and triglycerides make a difference in keeping kidneys healthy. In fact, focusing on these targets can reduce risk of diabetic nephropathy by up to 35%.

American Diabetes Association Targets

  • HbA1C less than 7%*
  • Pre-meal glucose 90 to 130 mg/dL
  • After meal glucose no higher than 180 mg/dL
  • LDL cholesterol less than 100 mg/dL
  • HDL cholesterol above 50 mg/dL for women and 40 mg/dL for men*
  • Triglycerides less than 150 mg/dL
  • Systolic blood pressure below 130 mm Hg* Read more…

November 13, 2009

Early phosphorus control is recommended for people with chronic kidney disease

I went to a DaVita Dietitian meeting this week and heard a talk by Dr. Shagun Chopra-Sonthalia, a nephrologist from San Diego, CA. I want to share with you some important points from the presentation about new emphasis on earlier phosphorus control. Read more…

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