It is National Kidney Month, which means
that it is time for you to understand the
importance of managing kidney disease and
how to achieve optimal kidney health so
that you can appreciate these wonderful
organs and keep them healthy.
Diet & Kidney Disease
Managing kidney disease—especially at the
beginning—is essential. You want to ensure
proper nutrition while minimizing stress
and maximizing kidney function. There is
no one special diet for everyone, though.
Your diet depends on your medical history,
lifestyle habits, and current kidney function.
Your diet may change over time, depending
on your kidney health. There are some
nutrients that you need to watch out for,
including protein, energy foods, sodium,
potassium, phosphorus, and fluids.
Foods such as meat, fish, poultry, soy, beans,
and lentils, for example, are rich protein
sources. When protein is broken down,
it creates the waste product urea. Your
body needs to eliminate urea, which must
be filtered through your kidneys. If you
consume high amounts of protein, you
can increase stress on the kidneys due to
increased levels of urea produced. If the urea
fails to be eliminated, it will cause increased
blood-urea levels. High amounts of urea
can lead to fatigue, headaches, nausea, and
a bad taste in your mouth. However, if you
do not eat enough protein, your body will
have a tough time fighting infections, you
will have low energy levels, and you will
lose muscle mass. The amount of protein
that you need to consume depends on your
disease state and treatment regimen. Speak
to your dietitian to review your specific
Your energy foods are all the foods that
provide you with energy or calories. These
include carb choices such as fruits, starches,
grains, sugars, and vegetables, as well as fats
and oils. If you are restricting your energy
intake from protein, you need to make sure
to replace those calories from other sources
in order to keep up your energy levels and
maintain a healthy body weight.
Since sodium affects your bodily fluids and
blood pressure, it is important to limit your
intake. Watch your intake of high-sodium
foods, including processed foods, deli meats,
canned foods, convenient foods, fast foods,
salty snacks, and so forth. Consider using
other ways to enhance flavors, such as
lemon, spices, and herbs.
Potassium is important for your muscles and nerves
to function. Too much or too little potassium in your
blood can affect your heart beat. Whether you need
to limit your intake or even increase your intake
depends on your disease state, kidney function, and
treatment plan. Treatments like dialysis will affect the
amount that you should be consuming, as will certain
medications. Your doctor will let you know, and your
dietitian can work with you to create an appropriate
meal plan. Foods that are high in potassium include
sweet potatoes, squash, bananas, oranges, tomatoes,
Phosphorus plays an important role in keeping your
bones healthy and strong. However, as your kidney
function declines, the phosphate levels in your blood
will increase. This can result in itchiness and joint
pain, as well as loss of calcium in your bones. You
may need to limit your intake of foods that are high
in phosphorus, such as dairy products and protein
Make sure to speak with a dietitian to help you
develop a meal plan that includes some of these
foods in levels that are right for you, as these foods
contain many important nutrients that you still need
to consume. Also, make sure to read ingredient labels
for hidden sources of phosphorus. Some processed
foods such as deli meats and sodas may contain
phosphates, phosphoric acid, or sodium phosphate
Calcium & Vitamin D
These supplements are essential for good bone
health. Your bones are comprised mostly of calcium,
and you need vitamin D to help absorb it. However,
with diminished kidney function, your kidneys may
not be able to convert vitamin D into its active form.
Therefore, your doctor may recommend that you take
some active vitamin-D and calcium supplements.
Your doctor will be monitoring your blood-calcium
levels, though, so make sure to take these only as
Your body needs fluids to survive, but if your kidneys
are not working properly, you may need to reduce
your intake. As your kidney function declines,
they produce less urine, leading to increased fluid
retention. This can cause swelling in your extremities
and face and may also increase your blood pressure
and cause difficulty breathing. However, limit your
intake only as advised by your doctor. Getting too
little fluids can damage your kidneys.
Optimal nutrition is important to prevent
malnutrition, have good energy levels throughout
the day for performing daily tasks, maintain a healthy
weight, and prevent muscle loss, as well as preventing
infection. These are all great reasons to manage and
reduce your risks of kidney disease.
Other ways of reducing your risk of developing
kidney disease are by decreasing your risk of
developing chronic diseases such as diabetes and heart
disease. We discussed a bit about managing diabetes
during Diabetes Awareness Month in November and
touched on Heart Health last month. Now, we will
discuss why it is important to ensure optimal health
and properly manage your kidney disease.
One of the most common causes of end-stage renal
disease or kidney disease is uncontrolled diabetes.
Firstly, you should understand a bit more about
how your kidneys act as a filtration system. Your
body requires a certain amount of protein each
day. After consuming the protein, your body digests
it and absorbs the essential components into the
blood stream, while needing to eliminate the waste
products. The components of the broken-down
protein get filtered through tiny capillaries and then
through even tinier holes called “nephrons.” The
blood flows through all these tiny filters, but the
essential protein components, red blood cells, and
other important substances that are too big to be
able to pass through do not get eliminated, so they
get filtered out. The waste products are able to flow
through the nephrons and therefore enter the urine
to be eliminated.
Unfortunately, uncontrolled diabetes complicates
this process. Whether your insulin is not working
properly or you just don’t have enough, having high
blood sugar puts a lot of stress on your kidneys. When
sugar levels in your blood are abundant, your kidneys
have to filter a lot more blood, making the filters
work much harder. Eventually, the kidneys begin
to leak from all the pressure, resulting in protein
leaking through into the urine. As long as bloodsugar levels are high, further stress and damage on
your kidneys’ filtering system continues. This leads
to further damage, loss in filtration ability, buildup
of waste products, and eventually kidney failure.
Unfortunately, at this point, your only options are a
kidney transplant or dialysis.
High Blood Pressure
Kidneys are made up of many blood vessels that
get smaller and smaller as you get deeper into
their filtering system. Because kidneys have a very
important role in filtering all of the blood, they
receive a high volume of blood flow regularly. Blood
is rich in many essential nutrients, including oxygen.
Over time, many factors such as smoking, poor
diet, lack of physical activity, and age contribute to
narrowing and hardening of the arteries. The high
blood volume passing through the filtration system
in combination with high blood pressure puts a lot
of pressure on these arteries, further weakening
them. These damaged vessels reduce blood flow to
the kidney’s tissues. They also prevent flow to the
smallest vessels, the nephrons.
Reduced blood flow or elimination of blood flow
altogether means that the tissues are failing to receive
essential nutrients and oxygen, and they lose their
ability to properly function. Therefore, they are no
longer able to efficiently filter blood, fluids, and other
nutrients or regulate hormones—especially those
that are necessary for controlling blood pressure.
When the kidneys are so damaged that they are
no longer able to efficiently regulate blood pressure
in combination with chronic blood pressure, this
leads to dire consequences. Further damages can
occur, and more arteries become blocked, leading to
eventual kidney failure.
So, be aware of your kidneys and appreciate
all that they do for you. Take good care of them by
staying fit, eating well, and being healthy!
Why Should You Take Care of
Kidneys are essential for your well-being. It is true
that you can survive with only one viable kidney,
but you want to do everything possible to keep
them both healthy and working. Your kidneys have
several important functions, but their main role is
to filter your blood and remove waste products and
excess fluid from your body and eliminate them
through your urine. While they are filtering out the
waste, they are also reabsorbing many important
nutrients so that your body can reuse them.
Still unconvinced of their importance? Your
kidneys are also responsible for eliminating excess
drugs from your body. They help balance your
body’s fluids by regulating the amount of sodium,
potassium phosphorus, and acid levels in the body.
They also control the production of red blood cells
and produce an active form of vitamin D that helps
control calcium metabolism and promotes strong and
healthy bones. More so, your kidneys release certain
hormones that are responsible for helping regulate
Keeping your kidneys healthy is extremely
important. If you don’t, they will fail to perform all
the essential aforementioned roles, which will have
debilitating consequences. Unhealthy kidneys lead to
kidney disease and can also cause heart disease and
associated risks such as high blood pressure, stroke,
heart attacks, and death. Kidney disease can also
lead to weakened bones, osteoporosis, anemia, nerve
damage, and complete kidney failure.
Reduce Your Risk of Developing
Engage in regular physical activity. Aim for at least 30
minutes of moderate to vigorous physical activity five
times a week (or any combination for a total of 150
minutes per week at least every other day in bouts of
at least 10 minutes). Also, include some stretching
and strength training at least three times per week.
A combination of both will improve your heart
health and blood flow and strengthen your bones and
Control Your Weight
Maintain a healthy weight with a body-mass index
(BMI) of between 18.5 and 24.9. Monitor your weight
regularly (without obsessing). Don’t weigh yourself
more than once per week, but take note of any
drastic changes. If you notice your weight starting to
slowly creep upward, consider re-evaluating your diet
and physical-activity regime or speak to a registered
dietitian for tips to manage your weight.
Eat a Balanced Diet
Avoid any trendy fad diets, and stick to a regular,
consistent meal plan. Aim for three meals per day with
snacks in between. Avoid going longer than three or
four hours without eating anything. A balanced meal
should consist of half of your plate filled with at least
two different types of colorful vegetables. A quarter
of your plate should be a lean protein choice, such as
fish or chicken, and a quarter of your plate should be
a whole grain like brown rice or quinoa.
Healthy snacks include a carbohydrate or a
vegetable and a protein. Snack ideas such as celery
and a tablespoon of peanut butter or a medium-sized
apple with a small handful of nuts are good options.
Drink in Moderation
Limit your alcohol intake to no more than one glass a
day for women and maximum of two glasses per day
This should go without saying.
Drink six to eight glasses of water per day. Water is
calorie-free and is your best option. Avoid high-sugar
beverages, as they only add unnecessary calories and
often replace nutrient-dense choices.
Monitor Your Meds
Take all of your medications as prescribed by
your doctor. Also, be cautious when taking some
over-the-counter medications such as aspirin,
naxoproxin, and ibuprofen, which may cause harm
to your kidneys. Always check with your family
Stay on Top of Your Health
Know your family history, as this is a good indicator
of any increased risk. Make sure to visit your
family physician annually to keep your health in
check. Your physical should include regular blood
tests to monitor your cholesterol levels and check
your creatinine levels and glomerular-filtration
rate (GFR) for evaluating your kidney function.
You should also check your blood-pressure levels.
Ideally, your blood pressure should be 120/80;
however, as you get older (as long as you don’t have
a history of kidney disease), your blood pressure
should be below 140/90.
As you can see, whether you’re reducing your
risk of developing kidney disease or trying to
manage it, it is vital to make healthy lifestyle
Dr. Victor Marchione
Remember, We Are In This Together!