March is National Kidney Awareness month. Surprised? Me too! While all the attention of the medical world goes to the heart, the brain or the lungs—the kidneys are treated like they don’t even exist. Wellness influencer, after wellness influencer hocks the latest trendy “cleanse” concoction from lemon water to celery juice, all the while the poor forgotten kidneys are like “Wait a minute? I cleanse your blood every minute of every day! Where’s my Instagram account?” Truth be told—even I wouldn’t be thinking about kidneys if my own mother hadn’t recently been diagnosed with early stage kidney disease.
Chronic Kidney Disease: A Silent Epidemic I Have To Take Medication for My Medical Conditions. How Can I Save My Kidneys!?!
Chronic Kidney Disease: A Silent Epidemic
Typically, most people don’t think about their hard working kidneys—until there’s a problem. Unfortunately due to high rates of obesity, high blood pressure and diabetes, the CDC estimates that 37 million people in the USA have some level of Chronic Kidney Disease (CKD). That’s about 1 out of every 7 people! According to the 2020 United States Renal Data System an additional 786,000 people in the US are living with end stage kidney disease requiring dialysis or a kidney transplant to survive.
Kidney disease often develops when the delicate blood vessels and filtering units in the kidneys called nephrons, become damaged from high levels of pressure and/or sugar in the blood. Medical professionals frequently warn about the risk of stroke or heart attack from high blood pressure, but little time is spent warning patients of the risk to their precious kidneys. Similarly, warnings of the dangers of high blood sugar focus on the loss of eyesight, peripheral neuropathy and infection, while too few warnings are issued for high blood sugar’s negative effect on our delicate nephrons. This could be why, according to the National Institutes of Health, an estimated 9 out of 10 people who have kidney disease are unaware that they have it at all!
To make matters worse the medications prescribed to treat blood pressure and other conditions can actually cause kidney damage and acute kidney failure with long-term use.
I Have To Take Medication For My Medical Conditions. How Can I Save My Kidneys!?!
Medications and the negative side effects that come with them, are sometimes a necessary risk that people have to take in order to control dangerous conditions like hypertension, diabetes and high cholesterol. It is never a good idea to stop medication that your doctor has prescribed without consulting them and setting up a strictly monitored protocol to do so. Suddenly stopping medications you have been taking regularly puts you at additional risk of serious adverse side effects. Fortunately, many of the conditions that lead to kidney disease, such as hypertension, diabetes and high cholesterol, can actually be reversed, improved and even cured, by:
Losing weight and achieving a healthy Body Mass Index of 18.5-24.9.
Eating a healthy, balanced diet of whole, unprocessed foods.
Getting regular exercise.
Getting enough sleep.
Drinking water instead of sweetened beverages or juice.
Quitting smoking.
Eliminating alcohol consumption.
If you can achieve all of these goals, kidney damaging medications may no longer be necessary. But again, it is up to you to work with your doctor to develop a plan for how to safely reduce or halt your medications if you are taking them. Otherwise you can experience life threatening withdrawal symptoms or suffer a stroke or heart attack if your blood pressure oscillates rapidly from suddenly stopping your medications.
Chronic Kidney Disease: Know Your Numbers!
Chronic kidney disease can be a silent and slow killer. If your kidney function continues to decline, you will eventually need dialysis to stay alive. Many people will not know that they have kidney disease until it is advanced, as symptoms aren’t always evident in the early stages. This is a problem because kidney damage is irreversible. It can’t be undone, but it can be slowed down with medical, lifestyle and dietary interventions.
The clearest way to monitor the health of your kidneys is with your eGFR score. This test is usually done as part of your complete blood panel during your annual physical. The eGFR gives an estimation of how well your kidneys are filtering your blood. You want this score to be between 60 and 120 for an adult. A score below 60 means your kidneys aren’t working as well as they should and you may have developed chronic kidney disease (CKD).
Unfortunately, your doctor may not be monitoring your eGFR as closely as you would think. They may not notice a slowly declining eGFR score from year to year and may not warn you something could be going wrong until your kidney function has fallen into the danger zone. This means it is up to you to be your own best health advocate. Always request the full lab results from your complete blood panel and keep track of your eGFR score yourself. If you notice a steady decline, ask your doctor about it and if there is anything you can do to stop it, including switching to less damaging medications if you are taking any. At the very least your doctor should order more frequent checks of your eGFR and analyze your levels of sodium, potassium, creatinine, nitrogen and other factors to make a diagnosis, if there is one to be made.
If you have any risk factors for kidney disease and are taking any medications and your doctor dismisses you out of hand, find another doctor who treats your concerns with proper respect. Remember, no one cares about your life more than you do, so don’t be afraid to speak up and be your own advocate.
Once you have been diagnosed with kidney disease or if you are noticing a steady decline in your eGFR, you should see a nephrologist (a doctor who specializes in treating the kidneys) as soon as possible. Again, kidney damage cannot be reversed, but it can be slowed down, so the sooner you intervene the better!
Healthy Can Hurt: Drastic Changes Can Endanger Your Kidneys!
Besides the negative long-term outcomes of kidney disease, there is a more immediate danger. Damaged kidneys do not filter out excess sodium and potassium from the blood as effectively as healthy kidneys. Sodium and potassium are important electrolytes that, amongst other things, help to regulate muscle contractions in our bodies. Disruptions in the balance of electrolytes in your body can lead to a sudden heart attack or stroke. This is a scary risk, and it may scare you into making drastic changes to your diet and exercise regimen. But this is where you want to exercise caution, because some of those “healthy” changes may lead to an even worse outcome.
Diet Dangers for Kidney Disease Patients
Most “healthy” diets and exercise programs are designed for basically healthy people with fully functioning kidneys. They include high protein meal plans with lots of whole grains and vegetables, as well as lots of water and possibly caffeine packed pre-workout concoctions and electrolyte drinks to boost your performance at the gym. While these diets may be fine for people with fully functioning kidneys, this type of diet could speed kidney damage in those with kidney disease.
Dietary interventions are key to slowing kidney damage in those with kidney disease who are not on dialysis. Because damaged kidneys cannot filter the blood as effectively, it is often recommended that people with kidney disease adhere to dietary guidelines that are very different from what you might find in the latest “Drop 5 lbs in 5 Days” miracle diet. Chronic Kidney Disease patients are often instructed to limit their consumption of protein, potassium, sodium and phosphorus to reduce the strain on their kidneys and keep their electrolytes in balance. How much of each of these essential nutrients you can tolerate depends on the stage of your kidney disease, any other health conditions you may have and any medications you are taking. That it why it is absolutely crucial that you see a Renal Dietitian as well as a Nephrologist before you make any drastic changes to your diet, fluid intake or consume any new vitamins or supplements. Because there is a lot of conflicting information on the internet about which foods to eat and avoid if you have kidney disease, a renal dietitian will be able to help you create a personalized kidney safe diet that will protect your kidneys as you achieve your other health and fitness goals.
Helpful Nutritional Resources
One of the challenges of managing a kidney safe diet is finding the amount of potassium, sodium and especially phosphorus in the foods that we eat. Many of the healthy foods we should include in our diet, like dairy, meat, legumes, nuts, whole grains, fruits and vegetables are very high in potassium and phosphorus. Since fruits and vegetables don’t come with nutritional labels it can be challenging to figure out which foods will place you over the safe limits for these minerals. To make matters worse, food manufacturers aren’t required to list the phosphorus content of their products on their nutritional panels. Since I have a strong interest in nutrition and culinary science, I helped my own mother compile the nutritional information for some of her favorite foods from some reliable nutritional databases. The most official and reliable nutritional database is the USDA FoodData Central database. The FoodData Central database can be a little confusing and cumbersome, so I also like to use the Self Nutrition Database which uses much of the same information from the USDA database and information direct from the manufacturers. Self formats their database in a way that is familiar and easy to understand. Be warned the Self Nutrition Database is a little glitchy and slow, but with patience it is a great resource.
As an example of how you need to approach food as you move forward in your journey to healthier kidneys, you can see the spreadsheet I compiled for my mother’s kidney safe diet HERE. I listed many popular and widely accessible foods on this spreadsheet, so you may find it helpful as you get started working with a doctor and dietitian to customize your own meal plan. The foods listed aren’t necessarily recommended foods for a kidney disease diet, but the list allows you to gain a greater awareness of the surprising amounts of potassium, phosphorus and sodium in the foods we eat. Once you know the mineral contents of various foods, you can then decide which foods you want to include in your diet as you adhere to whatever limits your doctor or dietitian determines are best for your current condition. You can also find the mineral content of many more foods on the Self Nutrition Database. This can support you in the goal of adding healthy variety to your diet and ensuring that you get the most nutrition, with the least amount of risk to your kidneys. Since many products vary by manufacturer and fruits and vegetables naturally vary in their nutritional content, you should take any information on my spreadsheet or from the Self Nutritional Database as an average and always consult the nutritional information panel (if available) for the food you are eating for the most accurate levels of potassium, sodium and phosphorus (if listed) in the product.
Finding Hope: Living with Chronic Kidney Disease
Besides having a strong interest in nutrition and culinary science and being the creator of Simmer & Stir; I am also a Licensed Mental Health Counselor. As a mental health counselor, I want to address the emotional and psychological effects of being diagnosed and living with Chronic Kidney Disease.
If you have recently been diagnosed with kidney disease, you may be feeling scared and hopeless. The fact that kidney damage cannot be reversed is startling information. It never feels good to find out something you would rather not experience, can’t be undone. You may feel overwhelmed and powerless as you imagine your future riddled with disease and eventual death. Although a diagnosis of kidney disease is scary and depressing, do not lose hope. Medical, dietary and lifestyle interventions really can slow down the progression of kidney disease. According to WebMD, if you are diagnosed and start interventions by stage 3 of the disease, there is a good chance your kidney disease will not progress to complete kidney failure.
The key to living with hope, in spite of a diagnosis of kidney disease, is to focus on the present and what you can control. It is natural to look back with regret and think of what you should have done, how you should have eaten a healthier diet or how you should have gotten to the gym. Everybody has regrets no matter where they are in life or what challenge or consequence they are currently facing. Just remember the old saying, “Hindsight is 20/20”. It may be easy to judge your past self given what you know today, but that is unfair. Would you judge your past self for not picking the winning lotto numbers last week? Of course not! That would be silly. It is healthy to take lessons from the past that can inform and improve our current decision making process. However, dragging irrational shame from ill-informed past mistakes into our present, will only serve to hinder our personal growth and development. Irrational shame can make you feel as if all is lost and you should just give up and do nothing because your kidneys are going to fail and you’re going to die anyway. These thought patterns are not functional and nothing could be further from the truth. Instead of shame, try grace. Forgive yourself for what you didn’t know, didn’t do and can’t change and resolve to move forward in the knowledge and capabilities you have today.
You can take control of your health and live a better healthier life from this moment on. So instead of focusing on shame, fear and powerlessness focus on:
Education: Learn all you can about your kidneys and all the other medical conditions you might have. Knowledge truly is power.
Building Your Team: Find and work with a Nephrologist and Renal Dietitian to develop an appropriate treatment plan the will slow the progression of your kidney disease and improve your overall health. Team work makes the dream work!
Consistency: Commit to making small, consistent improvements to your diet and lifestyle everyday. Overtime they will add up to a healthier you, without the stress of drastic changes.
Kindness: Your kidneys aren’t the only ones that need special care and attention right now. So do you! You are learning a lot and developing many new and healthier habits. You may experience setbacks here and there. Don’t let setbacks cause you to spiral into guilt and shame. Mistakes and setbacks are just a natural part of the learning process.
Words of Encouragement: The world is full of critics, but what you really need right now is a cheerleader! No one will be a better cheerleader for you, than you! Find a quote, saying, song or bible verse that you find encouraging. Memorize it and repeat it to yourself whenever you are struggling to stick to your treatment plan.
Finally, remember you can do this! Yes, it might be hard, but it will be worth it. A diagnosis of kidney disease is not a death sentence and can be managed with proper interventions.
Finding Reliable Information for Your Kidney Health
Much of the information I learned about this topic came from the National Kidney Foundation. I found their website to be easy to understand with lots of great tips on all aspects of Chronic Kidney Disease (CKD) and maintaining a healthy kidney safe diet and lifestyle.
I encourage you to visit the website for the National Kidney Foundation if you or someone you know has been diagnosed with kidney disease.
Other valuable sources of information include but are not limited to:
Disclaimer: The above article is for informational purposes only. The information contained therein does not constitute medical advice and should not be used as a substitute for professional medical advice or treatment or for the purpose of diagnosis. Please consult your primary care physician, nephrologist or renal dietitian for diagnosis and treatment for all kidney related and other health aliments.