Preventing Chronic Kidney Disease

chronic kidney disease?

Chronic kidney disease (CKD) is an umbrella term for any condition resulting in kidney damage and reduced kidney function over time. CKD may progress through five stages over time, and can eventually lead to stage five, known as end-stage renal disease (ESRD). ESRD is characterized by total kidney failure and requires dialysis treatment or a kidney transplant. (17)

Chronic kidney disease stages

The stages of chronic kidney disease include:

  1. Chronic kidney disease stage 1, which is characterized by kidney damage, normal kidney function, and persistent elevated protein in the urine for at least three months
  2. Chronic kidney disease stage 2, which is characterized by kidney damage, mild loss of kidney function, and persistent elevated protein in the urine for at least three months
  3. Chronic kidney disease stage 3, which is characterized by mild to severe loss of kidney function
  4. Chronic kidney disease stage 4, which is characterized by severe loss of kidney function
  5. Chronic kidney disease stage 5, which is characterized by kidney failure that requires dialysis or organ transplant (17)

The following table outlines the characteristics of each chronic kidney disease stage.

image of a table outlining the characteristics of each chronic kidney disease stage

Glomerular filtration rate (GFR) is a measure of kidney function used to identify an individual’s stage of kidney disease (17)

Chronic kidney disease causes and risk factors

There are several causes and risk factors for chronic kidney disease, including:

  • Certain autoimmune conditions (e.g., Goodpasture syndrome, lupus nephritis) (16)
  • Certain infections (e.g., urinary tract infections) (14)(16)
  • Certain genetic disorders (16)
  • Certain medications (e.g., acetaminophen, aspirin, lithium) (5)
  • Diabetes (3)(16)
  • Dysbiosis (imbalanced intestinal microbiota) (9)
  • Family history of CKD (3)
  • Heavy metal poisoning (16)
  • Hypertension (elevated blood pressure) (7)(16)
  • Moderate to heavy alcohol intake (27)
  • Smoking (7)
  • Overweight and obesity (3)
Image of a person getting a kidney scan

While CKD can worsen over time, the CDC states that it can be treated and early intervention can yield better results. (3)

Signs of chronic kidney disease

Individuals with CKD may not experience or notice any symptoms, particularly in the early stages. Advanced-stage chronic kidney disease symptoms include:

  • Chest pain
  • Fatigue
  • Difficulty concentrating
  • Difficulty sleeping
  • Dry skin
  • Increased or decreased frequency of urination
  • Itching and numbness
  • Muscle cramps
  • Nausea and vomiting
  • Reduced appetite
  • Edema (swelling) of the feet and ankles
  • Weight loss (18)

The Centers for Disease Control and Prevention (CDC) estimates that approximately half of individuals with severely reduced kidney function who are not receiving dialysis are unaware they have CKD. (3) Specific urine and blood tests that assess kidney damage and filtration rate are used to identify CKD. (3)(26)

CKD has been associated with certain health complications, such as anemia, depressionstroke, increased risk of infections, and imbalanced mineral levels in the blood. (3) Individuals with CKD are also at an increased risk of premature mortality associated with cardiovascular disease and cancer, making it critical to address CKD as early as possible. (26)

How to improve kidney health

Although certain risk factors for CKD may be beyond your control, you can reduce your overall risk by managing conditions that may contribute to CKD and implementing healthy lifestyle changes. (14) Additionally, chronic kidney disease treatment may include certain lifestyle and dietary interventions.

Lifestyle for kidney health

For CKD prevention, the National Institutes of Health (NIH) recommends quitting smoking, limiting alcohol intake, and working with your healthcare practitioner to achieve a healthy weight. (14)

Did you know?
Non-steroidal anti-inflammatory drug (NSAID) use has been associated with acute kidney injury. Speak with your healthcare provider to understand the benefits and risks of any medications. (25)

Exercise and kidney health

Research has demonstrated several benefits of physical activity for individuals with CKD. A recent meta-analysis found that aerobic exercise is associated with improved cardiorespiratory function, exercise duration, high-density lipoprotein (HDL) cholesterol levels, and quality of life in patients with CKD. (20) Physical activity can also contribute to prevention by improving metabolic risk factors, which may protect kidney function. (24)

Kidney health diet

Specific dietary patterns that may prevent and address kidney disease include the Mediterranean diet (4) and the Dietary Approaches to Stop Hypertension (DASH) diet. (21) Both of these diets involve a low to moderate intake of protein, which has been associated with delaying the progression of CKD. (4) One meta-analysis identified healthy dietary patterns that were associated with lower mortality rate in individuals with CKD. The evidence suggests that the best foods for kidney health include vegetables, fruit, legumes, whole grains, and cereals, all of which are excellent sources of dietary fiber. Foods to avoid with chronic kidney disease include red meat, salt, and refined sugars. (11)

Image of freshly prepared vegetables

Healthy dietary patterns, such as the Mediterranean diet, may improve kidney health.

Kidney health supplements

Outlined below are several supplement ingredients that have been shown to improve kidney health. It’s important to note that the National Kidney Foundation has identified a list of dietary supplements that may be harmful to individuals with CKD, including supplements containing potassium, phosphorus, and several medicinal herbs. (19) If you’re a patient interested in using supplements for chronic kidney disease, we always recommend consulting with your integrative healthcare practitioner first.

Alpha lipoic acid

Alpha lipoic acid (ALA) is an antioxidant that may help address one of the complications seen in kidney disease, cardiovascular disease (CVD). A randomized controlled trial in patients undergoing hemodialysis found that ALA supplementation may increase the activity of certain antioxidant enzymes that protect against oxidative stress and oxidative disorders, including CVD. (12)

Andrographis

Andrographis paniculata, commonly referred to as andrographis, is a medicinal herb that contains andrographolide and arabinogalactan proteins, two active components. Animal studies suggest that these components may reduce hepatic renal (liver kidney) alcohol toxicity. This means there may be potential for andrographis to protect kidneys against the harmful effects of alcohol. However, further research is needed. (23)

Image of ground moringa

Herbs for kidney health include moringa, which is commonly referred to as a superfood.

Moringa

Moringa oleifera, a plant native to India, has nutrient-dense leaves that are used for their therapeutic properties. Research in animals suggests that moringa may prevent kidney dysfunction, as moringa-supplemented diets were found to decrease blood levels of urea and creatinine (waste products). (6) Additionally, animal studies demonstrate that moringa leaf extract may protect against kidney toxicity caused by acetaminophen, a common over-the-counter medication known as Tylenol or Paracetamol. (10)

NAC

N-acetylcysteine (NAC) is an amino acid and a precursor to glutathione, a major antioxidant in the body that targets oxygen radicals. (13) A four-month trial assessed the effects of NAC supplementation in patients undergoing hemodialysis. The findings suggest that NAC may benefit hemodialysis patients by reducing oxidative stress and improving outcomes of uremic anemia, a complication of CKD. (8)

Probiotics

Scientific literature suggests that dysbiosis is associated with increased urea toxin levels that may accelerate CKD development. One meta-analysis assessed the effects of probiotic supplementation for at least four weeks on individuals with CKD. The analysis concluded that supplementation may protect the intestinal barrier by reducing levels of a urea toxin called p-cresyl sulfate and increasing the levels of interleukin (IL)-6, (9) a signaling protein that has been shown to promote the growth and regeneration of cells lining the intestines. (28)

Resveratrol

Resveratrol, a polyphenol found in berries, grapes, and peanuts, exerts antioxidant, cardioprotective, and kidney-protective activity. In animal models, resveratrol has been shown to protect against kidney injury including drug-induced injury, diabetic neuropathy, and hyperuricemic injury (from elevated uric acid levels). (1) Researchers propose that resveratrol may target the inflammation and oxidative stress associated with CKD progression, but clinical trials are needed. (22)

The bottom line

CKD commonly goes unnoticed and as a result, is left untreated. You can improve your kidney health and reduce your risk of CKD by implementing the dietary and lifestyle changes outlined above. Consider working with an integrative healthcare practitioner to develop your individual wellness plan.

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