Our kidneys are critical in keeping our body functioning properly by regulating the composition and volume of blood, removing wastes our body doesn’t need and activating the vitamin D necessary for calcium absorption and bone health. If our kidneys aren’t working their best, everything goes haywire.
When a person develops chronic kidney disease (CKD), the function of these vital organs deteriorates over time. As the disease worsens, waste builds up in the blood resulting in complications such as hypertension, anemia, weak bones, poor nutritional health and nerve damage.
CKD may not be a disease frequently mentioned in the news, but around 31 million Americans have it (roughly ten percent of the population). Many, however, won’t discover the issue until it has become severe. In its most advanced state, the only treatment options are dialysis or a kidney transplant.
The most common reasons why people develop CKD is if they are already dealing with the issues of high blood pressure or diabetes. Other causes include:
- A family history of kidney failure
- Aging (60 years or older)
- A history of kidney stones
- Lupus and other autoimmune diseases
- Frequent urinary infections
- Tumors or an enlarged prostate gland in men
Stages, signs and symptoms of CKD
There are five stages of CKD. Stages one and two often have no symptoms, but a person may discover they have CKD if they are being treated for high blood pressure or diabetes. Testing may reveal the following:
- Higher than normal levels of creatinine or urea in the blood
- Blood or protein in the urine
- Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast x-ray
Stage three is more likely to be discovered due to a person developing complications of high blood pressure, anemia or bone disease. An individual may also be experiencing the following symptoms:
- Too much fluid leading to swelling (edema) in the lower legs, hands or around the eyes.
- Foamy, dark orange, brown, tea-colored or bloody urine
- Frequent need to urinate during the night
- Trouble falling and staying asleep; itching, muscle cramps or restless legs during the night
Stage four has many of the same symptoms as stage three, but with some additional complications:
- Changes in taste, such as food suddenly tasting metallic
- Bad breath, with urea building up in the blood
- Loss of appetite
- Difficulty concentrating
- Nerve problems, like numbness or tingling in toes or fingers
Stage five includes the same symptoms as stages one to four, along with:
- Changes in skin color
- Increased skin pigmentation
At stage five, the kidneys can no longer remove waste and fluids from the body so toxins build up in the blood causing a person to feel extremely ill. At this point, a nephrologist will decide between dialysis or a kidney transplant for the course of treatment.
Diet choices to help control CKD
When diagnosed with CKD, you should look first at your diet, and switch to a kidney-friendly food plan. This will limit certain minerals in the foods you eat, helping prevent waste buildup in the blood. Doing so may help slow down the progression of CKD.
The main minerals that usually need to be reduced are sodium, potassium and phosphorus. You should also reduce your intake of protein.
Sodium needs to be reduced to help lower blood pressure, which may slow down CKD. A high sodium intake stays in the body, making blood pressure rise, since damaged kidneys cannot filter sodium out of the body as well as healthy kidneys. Aim for less than 2,300 mg of sodium a day and try to keep blood pressure below 140/90 mmHg.
Foods high in sodium that you should reduce include bacon, corned beef, hot dogs, luncheon meat, sausage, canned and instant soups, boxed mixes like hamburger meals and pancake mixes, canned vegetables, pickles, cottage cheese, frozen meals, snack foods like pretzels, crackers, chips, soy sauce, baked goods and bread.
Potassium needs to be reduced because in CKD, the kidneys may not be able to remove extra potassium from the blood. Additionally, some medicines can raise your levels of potassium, which could affect your heart rhythm.
Low potassium foods to choose include apples, blackberries, blueberries, cabbage, carrots, cauliflower, corn, cucumbers, eggplant, grapes, green beans, mushrooms, onions, peaches, pears, pineapple, plums, raspberries, strawberries, tangerines and watermelon.
While phosphorus is needed to keep bones healthy and help blood vessels and muscles work properly, in CKD, phosphorus can build up in the blood, making bones thin and weak, and causing itchy skin and bone and joint pain. Many packaged foods contain phosphorus, so look for the word “phosphorus” or for “PHOS” in words such as “pyrophosphate” on ingredient labels.
Avoid foods high in phosphorus, which include:
- Meat, poultry and fish: a cooked portion should be about 2 to 3 ounces or the size of a deck of cards
- Dairy foods: A half a cup of milk or yogurt, or one slice of cheese
- Beans and lentils: Portions should be about a half a cup of cooked beans and lentils
- Nuts: Reduce your portion sizes to about a quarter of a cup
- Cut out bran cereals, oatmeal, colas and some bottled iced teas
Protein provides the building blocks to help maintain and repair muscles and organs. However, when the body uses protein, it produces waste that needs to be removed by the kidneys. If you consume too much protein, your kidneys have to work overtime. Following the guidelines for reducing your phosphorus intake will also have the added benefit of controlling your protein portions.
Food choices do make a difference in helping slow down the progression of CKD. Making some simple diet changes can go a long way to keeping your kidneys healthy.
Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical contributor for the Fox News Channel’s Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pintrest, SamadiMD.com, davidsamadiwiki, davidsamadibio and Facebook