DIET IN KIDNEY FAILURE - HOW TO AVOID DIALYSIS

DIET IN KIDNEY FAILURE AND RENAL DISEASE – DIET FOR RENAL PATIENTS- DIETARY ADVICE FOR KIDNEY FAILURE PATIENTS  & HOW TO AVOID DIALYSIS

The kidneys are very important organ in the body. Their action is closely related to the Nervous system and Reproductive organs. They are as important to the water metabolism as the colon is to food. Just as wrong eating habits damage the stomach on G.I.Tract, improper intake of the liquids damage the kidneys and the urinary tract.

The kidneys are weakened by drinking either too much or too little water, by alcohol, by excessive sexual activity, by antibiotics and by not heeding the urge to urination. Fear and fright damage the kidneys on a psychological level. They are delicate in sensitive or traumatized children, or in anyone who has suffered stress to the adrenals. In case of Kidney failure it is very important to follow a specific diet to avoid dialysis and reduce urea and creatinine level. 

KIDNEY DAMAGE DUE TO DIABETES OR BLOOD PRESSURE- HOW TO AVOID DIALYSIS USING HERBS AND NATURAL REMEDIES  

Uncontrolled diabetes or blood pressure is usually the major reason behind Kidney Failure. This is a condition called Diabetic Nephropathy. In this condition, the kidney is excreting more proteins, the Urea, Creatinine levels are high, the potassium levels are high and there is a risk of electrolyte imbalance. The toxins level is raised and therefore regular dialysis is required. Dialysis is nothing but filter the whole blood through machine.

There are many other reasons due to which the toxins accumulate and lodge themselves in the kidneys and urinary tract, particularly when the kidneys are not filtering the blood properly. Symptoms include lower back pain, sciatic pain, difficult or painful urination, urinary tract infections, swollen prostate or kidney stones.

One should follow proper diet to avoid further complications arising from the kidney disease. One should mainly lower the sodium, fluids and protein intake.

One should remember that Diabetes and Hypertension are the major cause of kidney disease. So, one should maintain normal glucose levels and normal blood pressure to maintain proper function of the kidneys.

Impaired Kidneys cannot easily remove salt, potassium and water, that’s why they should be consumed in limited quantities. It is not a threat; these are steps to eat the right amount of nutrients to remain healthy.

LOWER SODIUM INTAKE

Avoid intake of salt in your food. It can raise the blood pressure, risk of heart failure and pulmonary edema and so sodium intake should necessarily be lowered. Have a very low salt diet. Avoid processed foods or canned foods, pickles, cheese etc that are high in salt content. Also avoid potato chips, pizza and any kind of packaged food. It is always preferable to have homemade food.

LOWER POTASSIUM INTAKE

Some people with kidney disease need to lower their potassium intake. It is found naturally in many fruits and vegetables. In poor function of the kidneys, it fails to remove the excess potassium from the blood. A high level in potassium can cause muscle weakness and affect the Heart rhythm. Foods rich in potassium are salt substitutes, bananas and apricots. However salt substitutes are not advisable, because it will further aggravate the disease.

FOODS RICH IN POTASSIUM ARE

Wheat germ, Sunflower seed, Almond, Raisin, Parsley, Lettuce, Radish, Cabbage, Dandelion root, Bananas, Water melon, Citrus fruits, Mushrooms, Greens, Spinach, Cucumber, Dried figs, Apricots, Dates, Wheat bran, Soybean, Avocado, Garlic, Tomato, Peas, Beans, Celery root

Alfalfa seeds, raw (1 cup)- 33 g

Apple (1)- 138 g

Apricot, raw (1)- 35 g

Asparagus , cooked, boiled (4 spears)- 60 g

Banana (1)- 118 g

Beans, baked (1 cup)- 254 g

Cabbage, raw (1 cup)- 70 g

Celery (1 stalk )- 40 g

Cheese (1 tbsp)- 14.5 g

Cucumber, peeled, raw(1 cup)- 119 g

Dates (5)- 41.5 g

Dandelion, boiled (1 cup)- 105 g

Garlic, 1 clove- 3 g

Lettuce, 1 leaf- 10 g

Parsley , 10 sprigs- 10 g

Radish (1)- 4.5 g

Raisins (1 cup)- 145 g

Peas , boiled (1 cup)- 160 g

Spinach, raw (1 cup)- 30 g

Soy beans, cooked ( 1 cup)- 172 g

Tomatoes (1)- 123 g

Watermelon (1 cup)- 152 g

Wheat flour (1 cup)- 120 g

LOWER LIQUID INTAKE

Do not have water or fluid content more than 1.5 Liters per day. Replace it with vegetables that has high water content like snake gourd, radish, spinach etc. even they come under fluid intake. But they are nutritious. Instead of merely drinking water, this can be taken. Also one can have tender coconut water (if they are not diabetic) and even buttermilk. All this should come under one and half litre per day. Have warm water instead of plain water.

LIMIT PROTEIN INTAKE

Protein is very essential to sustain energy levels in the body. A healthy kidney separates protein from the wastes and excretes the wastes from the blood. While an impaired kidney also excretes the protein and causes protein loss. That’s why Doctors suggest limiting protein intake to avoid much pressure on the kidneys. Also complete elimination is not advisable. Hence limited protein intake can balance the functions of the kidneys. Choose high quality protein like chicken, lean meat, fish, eggs etc. have 160 to 190 Gms of protein per day. The quantity depends upon level of blood urea and creatinine. Usually 40-50 gm of protein intake is recommended per day.

Milk (half L)-18 g

Yogurt (1 cup)-7 g

Meat (200 g)-50 g

Beans baked (1 cup)-254 g

Egg (1)-8 g

Soya milk (200ml)-6 g

Fish (100 g )-21 g

Cheese (100 g )-25 g

Roast chicken (100 g )-25 g

Roast beef (100 g )-25 g

Cabbage cooked (1 cup)-150 g

Cabbage raw (1 cup)-70 g

Ripe tomatoes (1 cup)-180 g

LOWER CHOLESTEROL INTAKE

Intake of high fat substances or fried food items may increase the levels of cholesterol. Even if it is home-made it is not advisable to have high fat food. Increase in cholesterol level in blood can cause kidney damage or failure. Use vegetable oils like safflower oil, olive oil for cooking which are the safest and healthiest choices.

AVOID SMOKING

Smoking can complicate the disease further. It has been found that it causes heart attacks and sometimes even death of a person suffering from Chronic Kidney Disease.

LIMIT PHOSPHOROUS INTAKE

Avoid intake of dairy products such as cheese, butter, ice creams etc. Avoid beverages like cola, alcohol etc. avoid nuts, peas and beans. Foods that are high in phosphorous are milk, cheese, nuts and cola drinks. Too much of phosphorous will remove calcium from bones and affect the bones and may lead to osteoporosis.

DIABETIC NEPHROPATHY

Diabetes mellitus affects the structure and function of the Kidney in many ways. The term diabetic nephropathy encompasses all the lesions occurring in the kidneys of patients with diabetes mellitus. These lesions include glomerulo-sclerosis, arterionephro-sclerosis, chronic interstitial nephritis, papillary necrosis and various tubular lesions.

Diabetic nephropathy is associated with a variety of clinical syndromes including mild asymptomatic proteinuria, nephritic syndrome, progressive renal failure and hypertension. Glomerulo lesions are particularly common and account for the majority of the abnormal clinical findings related to the kidney.

The principal clinical manifestation of diabetic glomerular disease is proteinuria. Initially only small amounts of albumin are excreted, particularly following exercise (microalbuminuria). This amount of albumin excretion is undetectable by routine screening methods. Under ordinary circumstances, microalbuminuria develops within 10 to 15 years of the onset of hyperglycemia and usually progresses within 3 to 7 years to overt proteinuria and clinical diabetic nephropathy.

With good control of hyperglycemia and elevated blood pressure, the development of microalbuminuria can be prevented or reversed. Patients with non-insulin-dependant diabetes mellitus also may develop clinical nephropathy. Precise regulation of blood sugar (by meticulous attention to diet, exercise, and insulin dosage) may be effective in reducing the development of nephropathy. During the micro-albuminuric phase, tight metabolic control slows the rate of increase in albumin excretion, as does lowering the arterial blood pressure and dietary protein restriction. Once the nephropathy has reached the stage of overt proteinuria, aggressive management of hypertension will slow the rate of loss of renal function, but strict control of blood sugar does not seem to retard the rate of progression once overt nephropathy (proteinuria > 500mg/d) has emerged.

Patient with ESRF (End stage renal failure) due to diabetic nephropathy are not ideal candidates for long term dialysis because of concomitant multiple organ dysfunction secondary to arterio-vascular disease.

An early sign of kidney damage is when your kidneys leak small amounts of a protein called micro albumin into the urine.

With severe damage; the kidney excretes more amount of protein called proteinuria. More wastes build up in the blood. This damage gets worse until the kidneys fail.

PREVENTION OF KIDNEY DISEASE IN DIABETES AND BLOOD PRESSURE- HOW TO AVOID DIALYSIS 

 Keep your blood sugar and blood pressure under control. Also maintain normal cholesterol levels. Check it every 3 to 6 months.

 Exercise or have a brisk walk regularly. For diabetic patients, it is more advisable to walk in the evening around 45 minutes.

 Always have a healthy and balanced diet. Have low salt diet. Avoid eating outside, because the ones prepared outside, sometimes add soda to cook soon or it may be unhygienic and the oil used may not be suitable for you. So, always prefer home-made food.

 Have a low-salt, low-protein, low-fat and high fruit and vegetable diet.

 Have at least two to three cups of boiled or steamed vegetables per day.

 Eat fiber rich foods like whole grain bread and cereals. Eat frequent small meals.

 Avoid processed foods like sauces, pickles etc.

 Check the labels for added salt. Drink warm and filtered water.

 Avoid food made by using baking powder like cakes, biscuits etc.

 Avoid legumes, milk and dairy products, mainly cheese. Use skimmed milk in the place of whole cream milk. Limit the intake of fish and meat.

 Have your kidneys tested at least once in a year and if you are already suffering from Kidney failure, then the tests of urea, creatinine, electrolytes should be performed every week or 15 days.

 Avoid smoking and alcohol.

 Avoid junk foods and high fat intake, if you have diabetes and not suffering from kidney disease yet.

 Avoid suppression of natural urges- passing or urine or stool or sleep. 

 Maintain proper weight according to your age and height. low-fat diet and regular exercise also will lower your risk of heart and blood vessel (cardiovascular) disease

 Avoid drugs such as NSAID’s (non-steroidal anti-inflammatory drugs) or even the drug to lower uric acid called Zyloric also causes Renal Failure. I have seen  many renal failure patients who used this drug to reduce uric acid and were suffering from Gout. There are certain herbs like Kaishore Guggul, Gorakhmundi, Navkarshik Churna which are very useful for gout. 

HOW TO AVOID DIALYSIS USING HERBS AND NATURAL REMEDIES 

There are certain ayurvedic herbs which are very effective in reducing urea, creatinine levels and help to avoid dialysis. The kidney failure responds very well to these natural remedies. 

The combination of herbs is called "The Revive kidneys package " and mentioned by Dr. Vikram Chauhan MD (Ayurveda ) at PLANET AYURVEDA 

HERBAL REMEDIES TO AVOID DIALYSIS AND HELPFUL IN RENAL FAILURE - BY Dr. VIKRAM CHAUHAN - MD ( Ayurveda ) 

Diet in Kidney failure and Herbal Remedies for Kidney Failure

Send Your Comments and Questions to herbalremedies123@yahoo.com

There is no specific single diet which is good for all kidney failure patients. There are however some guidelines which I am giving for all kidney failure, dialysis, high urea creatinine patients. Detailed advice for patients with severe kidney disease (less than 30% function, stages 4 and 5 CKD) is best from a renal dietitian.

Protein Intake in Renal Failure - The sources of protein are Animal protein - meat, fish, cheese, eggs, milk, and Vegetable protein - nuts, pulses (beans, lentils etc), tofu, corn. If on Haemodialysis, sometimes a little high protein diet is recommended. This is also recommended if the albumin protein level in the blood is low.

Protein breakdown leads to formation of urea and creatinine. So excessive protein intake must be avoided in Chronic Kidney Disease i.e. CKD. Protein intake depends upon your urea and creatinine levels as well as blood and urine protein levels. Kindly discuss with your renal dietician or doctor for protein intake per day, as per your test reports and body requirements.

Usually the daily intake should be less than 1 gram per kg of body weight. If you weigh 75 kg, then 50-70 gm proteins are ok per day but again the role of dietician or your doctor cant be ruled out who is doing the dialysis and follow up.

SODIUM AND SALT INTAKE IN KIDNEY FAILURE

Usually we consume about 150 - 200mmol (9-12g of salt, or 3-5g of sodium) everyday. We actually need less than half of this. Only 10 % of sodium comes from fresh food but the rest 90 % is coming from salt or sodium bicarbonate in cooking / food processing or preserved food (Sodium benzoate is used as a preservative in many health foods). Much of the sodium we consume also comes from Table salt sprinkled on the food after cooking.

I recommend less than 2 gram of Sodium per day. i.e. about 3-6 grams of salt intake.This allows small amounts of salt to be used in cooking, but means limiting very salty foods, and not adding salt to food after it has been cooked. Less salt may be better still!

Lo Salt !! - These are not recommended because they may not contain sodium but they contain much potassium.

Potassium - Potassium is found particularly in leafy vegetables and most fruit and fruit juice, and in potatoes, especially if they are fried or baked.

In severe kidney failure, the potassium levels are usually high. So this may lead to cut down intake of leafy vegetables, fruit juices, potatoes and some health food supplements like Aloe vera juice or coconut fruit water.

But if you are in renal failure or high urea, creatinine levels and the potassium levels are ok, then this diet is ok. Coconut water and aloe vera juice are recommended and work well if the potassium levels are fine.

Avoid these if there is High Potassium Level

Chocolate, toffees, liquorice, black treacle. Marzipan, nuts, potato crisps,chips, Avoid salt substitutes like Lo Salt etc. Tomatoes, beetroot, plantain, mushrooms, sweet corn, avocadoes, aubergine, parsnip,spinach, Bananas, mango, grapes, apricots, rhubarb, fresh grapefruit,pineapple, Fruit and Vegetable Juices,Coffee – up to one cup per day, Beer, cider, lager, sherry, wine

Low Potassium Alternatives - These can be taken if the potassium is high - Tea, Fruit tea, Spirits, Apples, Pears, Boiled vegetables - Carrots, Turnip, Onion, Cabbage, cauliflower, lettuce, cucumber, celery. Snacks made from Wheat, Corn or rice (popcorn without salt are ok)

Boiled potatoes, noodles, rice and pasta are ok

FLUID INTAKE IN KIDNEY FAILURE

It is very important to restrict salt intake if you want to restrict your fluid intake. If you are eating salt (sodium), you feel thirsty quiet often and you can not control the desire to drink more water or fluids. Salt leads to water retention in the body. Salt restriction helps a lot in controlling the urge to drink fluids.
There is definite benefit of drinking water in a healthy individual but too much is not recommended in kidney failure.

Water is present in all fluids/ drinks consumed per day. So restrict your fluid intake as per doctor's advice.You can yourself judge if you are retaining the water or not. So you can adjust accordingly.

You need not restrict fluid intake if you are not on dialysis. Again I would suggest you to ask the dietician or the doctor and write it down in your diary how much you actually need to consume.

Phospate and Calcium

This is usually a problem if the patient is in end stage renal disease when the kidney function is less than 25 % . Phosphate is found in milk and cheese. Only a few other foods contain a lot of phosphate like wholegrain cereals, baking powder, shellfish. Some convenience foods also contain phosphate.

High calcium and phophate causes itching problem. Usually there are drugs which help to lower down the levels but again the diet and the problem needs the concern of doctor and the dietician involved.

Diet alone is hardly helpful in bringing down phosphate levels, so the drugs like phosphate binders are usually given. These are taken with food, and work by keeping the phosphate in your food in the gut, preventing it being absorbed into the blood when the food is digested. It is important that these are taken at the right time just before food (or with it) as they won't work otherwise.

Herbs in Kidney Failure

Few Ayurvedic herbs are recommended in Kidney failure. These are

Mutrakrichantak Churna - Take 1 tablespoonful of this, boil in 400 ml of water. Keep it boiling untill the water remains 50 ml. strain it and consume once daily.

The Other Herbs which are used by Ayurveda Practitioners in India are

1. Rencure Formula Capsules - 2 capsules twice daily
2. Varunadadi Vati - 2 tablets twice daily
3. Punarnava Mandur -2 tablets twice daily