Kidney Disease – Causes, Prevention and Management
Chronic Kidney Disease (CKD) is a condition where the kidneys are impaired or damaged resulting in a loss of normal kidney function for greater than 3 months.
- When your kidneys aren’t functioning properly, dangerous levels of waste and fluids can accumulate in your body instead of being properly filtered and released as with normal kidney function.
- Complications associated with diminished kidney function may include high blood pressure, low blood count (anemia), bone disease, and heart disease.
- Since patients with CKD do not process nutrients normally, many CKD patients are at high risk for poor nutritional health. A multivitamin specifically formulated for CKD patients can help supplement nutrition and support kidney health.
What are the risk factors for kidney disease?
If you can answer yes to any of these questions you may have an increased risk for kidney disease:
- Do you have diabetes?
- Do you have high blood pressure?
- Do you have a family history of chronic kidney disease?
- Do you belong to a population group that has a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians?
If any of these risk factors apply to you, please take the time to consult your doctor on strategies for maintaining the health of your kidneys and kidney disease treatment.
Are there dietary restrictions when you have kidney disease?
It is important to follow a kidney healthy diet when you have diminished kidney function or are at high risk for CKD.
- Certain minerals may be a problem for people with damaged kidneys.
- A low salt diet may need to be followed to help lower blood pressure and swelling.
- Potassium and Phosphorus imbalance are common in CKD patients and may need to be addressed by dietary restriction and/or medication.
- Since many kidney-friendly meals are deficient in the necessary vitamins and minerals, your dietician or physician may recommend a kidney supplement or multivitamin in your diet.
There are special considerations when choosing a kidney multivitamin:
- A kidney vitamin should contain iron for preventing anemia.
- A kidney vitamin should contain Vitamin D for supporting bone health.
- If you are concerned about heart disease which can be associated with kidney disease, omega-3 fatty acids may be helpful in your supplement to support heart health.
- A kidney vitamin should never contain Potassium or Phosphorus.
Why is Vitamin D important?
There are an estimated 1 billion people worldwide that are deficient in vitamin D.1 Vitamin D deficiency is a problem that affects all races and age groups, regardless of how much sun they receive. Vitamin D helps your body absorb and retain calcium and phosphorus, which are important for healthy bones. Maintaining healthy Vitamin D levels is essential for bone, heart, and immune health. Emerging research suggests it may support blood sugar levels already in the normal range.
How can I get Vitamin D?
Vitamin D is not found naturally in many foods and since it is so important for fighting disease it is often fortified in cereal and dairy products. The body synthesizes vitamin D from cholesterol in the skin, through a process that involves exposure to sunlight, but the widespread use of sunscreen impedes this process and the skin cannot produce adequate amounts vitamin D. Vitamin D is found naturally in fatty fish and eggs, but in most people, taking a vitamin D supplement is usually recommended. There is ongoing research as to the correct amount of vitamin D to include in a daily multivitamin. The 400 IU in most multivitamins is now considered too low, with recent studies and statements from the Institute of Medicine and the Endocrine Society suggesting taking about 1000 IU of vitamin D daily.
How is Vitamin D related to heart disease?
There are several studies that suggest that Vitamin D is associated with good cardiovascular health.2-3 The heart muscle, blood vessels and circulatory system are full of vitamin D receptors and that is why it is important to maintain normal levels of Vitamin D as we age. However, because we do not get enough sun, the best way to avoid Vitamin D deficiency is to supplement.
Are all Vitamin D supplements the same?
There are two different forms of vitamin D often found in multivitamins, D3 (cholecalciferol) and D2 (ergocalciferol). Research shows that vitamin D in the form of D3 (cholecalciferol) is more effective than D2 (ergocalciferol) when taken as an oral supplement.6
Is there a Vitamin D supplement that doctors recommend for kidney health?
ProRenal® is a doctor formulated and recommended multivitamin specially designed for supporting kidney and heart health. ProRenal incorporates the appropriate amounts of selective multivitamins and 1000 IU of vitamin D3 based on a review of the most recent clinical guidelines. ProRenal multivitamins have “Everything you need, Nothing you don’t” for supporting kidney health.
References
- Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357:266-81.
- Pilz S, Marz W, Wellnitz B, et al. J Clin Endocrinol Metab. 2008; 93:3927-35.
- Wang TJ, Pencina MJ, Booth SL, et al. Circulation. 2008; 117:503-11.
- Pilz S, Tomaschitz A, Marz W, et al. Clin Endocrinol (Oxf). 2011 Nov;75(5):575-84.
- Sanders KM, Stuart AL, Williamson EJ; et al. JAMA. 2010;303:1815-1822.
- 6. Houghton, LA. Am J Clin Nutr. 2006 Oct; 84(4):694-7
Do you get enough Omega-3 fish oil in your diet?
Omega-3 fatty acids are essential nutrients that your body cannot synthesize, so you can only obtain omega-3 from your diet. The American Heart Association (AHA) recommends eating oily fish at least 2 times per week. Examples of oily fish that are high in omega-3 fatty acids include salmon, mackerel, herring, lake trout, sardines and albacore tuna.1 If you do not get enough omega-3 through diet alone, you may want to consider taking an omega-3 fatty acid supplement.
Why do you need Omega-3?
Omega-3 levels are associated not only with heart and cardiovascular health but also cognitive and joint health and a healthy mood.2 If you are not eating enough fatty fish, take a moment to consult your physician on whether fish oil supplements are the right choice for you.
What’s the purpose of Omega-3 in your body?
Omega-3 fatty acids are an integral part of cell membranes throughout the body and affect the function of the cell receptors in these membranes. They provide the starting point for making hormones that regulate blood clotting, contraction and relaxation of artery walls, and normal inflammatory response. They also bind to receptors in cells that regulate genetic function. Likely through these cellular mechanisms, while substantial but not conclusive evidence suggests that omega-3 fatty acids may help prevent heart disease and stroke.3 There is also evidence to support the benefit of fish oil supplementation in reducing oxidative stress and healthy triglyceride level profiles.4 Since omega-3 fatty acids play such an integral role in optimizing our heart health, it is one of the best supplements for heart health and it is important to make sure you are getting enough omega-3 through your diet or with supplementation.
What is the Difference between Omega-3 and Fish oil?
Omega-3 fatty acids are the active components in fish oil. The two essential omega-3 fatty acids found in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which come from the fatty tissue of oily fish. An omega-3 fish oil supplement is most effective when it contains high concentrations of EPA and DHA rich fish oil. Unfortunately, common fish oil supplements can contain as little as 8% of active DHA and EPA, and instead include inferior fish oil that may not be beneficial to your health. 5
Are there Different forms of Omega-3 used in Supplements?
There are a variety of considerations that differentiate fish oils found in supplements. For the best source of omega-3, choose fish oil that is derived from wild, cold-water fish that are low on the food chain, such as sardines and anchovies. Avoid fish oils that are sourced from bottom feeders, scavengers or farm-raised fish, which can increase the risk of contaminants including dioxins, PCBs and mercury.
Is there an Omega-3 Supplement Doctor’s Recommend for kidney health?
ProRenal with Omega-3® was developed in conjunction with our esteemed group of physicians and is designed to support both kidney and heart health. The omega-3 used in ProRenal with Omega-3 is sourced from wild sardines and anchovies from the cold waters off Chile, which reduces the risks associated with pesticides or other contaminants. The omega-3 is continually batch tested in the pharmaceutical grade facility where ProRenal with Omega-3® is produced. The concentration of omega-3 fish oil in ProRenal with Omega-3® includes 1000 mg of fish oil, consisting of 330 mg EPA and 220 mg DHA.6 ProRenal with omega-3® is specially formulated to support kidney and heart health.
- American Heart Association, Fish and Omega-3 Fatty Acids, Fatty fish like salmon, mackerel, herring, lake trout, sardines and albacore tuna are high in omega-3 fatty acids
- Omega-3 fatty acids | University of Maryland Medical Center http://umm.edu/health/medical/altmed/supplement/omega3-fatty-acids#ixzz2hGuG1F2s
- Omega-3 Fatty Acids: An Essential Contribution, Harvard School of Public Health, http://www.hsph.harvard.edu/nutritionsource/omega-3-fats/
- Chronic Kidney Disease Evidence-based Nutrition Practice Guideline, U.S. Department of Health and Human Services, http://www.guideline.gov
- Fish Oil and Omega-3 Fatty Acid Supplements Review (Including Krill, Algae, and Calamari Oil), http://Consumerlab.com, 2014
- Kris-Etherton, P. Circulation 2002; 106:2747
Selected Nutrients for Kidney Health
People with kidney disease have different nutritional needs. Learn which nutrients to supplement and which to avoid for supporting overall health and well-being, including brain, heart, and kidney health.
Potassium
The kidneys are responsible for maintaining the balance of minerals such as potassium and phosphorus in the body. The kidneys are not functioning properly in patients with with chronic kidney disease (CKD) and those on dialysis. It is therefore imperative for kidney patients to limit their intake of certain minerals. If body potassium levels become elevated, an irregular heartbeat or heart attack may ensue.1 In addition to limiting certain foods with potassium, kidney patients should not take supplements, heart vitamins or multivitamins that contain potassium. ProRenal and ProRenal with Omega-3 are formulated to be the best vitamins for health and, therefore, do not contain potassium, so we do not unduly tax the kidneys which itself will support kidney health.
Phosphorus
Phosphorus is a mineral that should be limited in patients with kidney disease. In these patients, phosphorus can build up in the blood, which can weaken bones, making them more likely to break. Kidney patients need to be aware of high phosphorus foods and control their intake through diet.2 It is paramount that you are careful with your phosphorus intake. You should especially avoid taking any supplements, heart vitamins or multivitamins that contain phosphorus. ProRenal and ProRenal with Omega-3 are specifically formulated to not have phosphorus.
Calcium
Not all kidney patients need extra calcium. Therefore, calcium supplementation requirements should be determined individually, as advised by a physician. Supplementation can be beneficial for some patients by supporting heart health. People often take heart health vitamins and cholesterol supplements that contain calcium, but in kidney patients, calcium can cause kidney stones or dangerously high blood calcium levels (hypercalcemia).3 Excess calcium can lead to kidney stones when free calcium crystals fuse together and they cannot be easily excreted through the urine. Higher levels of calcium in the blood can sometimes lead to kidney damage, and severe levels can result in a permanent loss of kidney function.4 Always discuss your calcium regimen with your doctor.
Trace Elements
Decreased levels of the trace elements, copper, zinc and selenium, are often found in patients with kidney disease and those on dialysis.5 The loss of these trace elements can result in increased oxidative stress. Supplementing with appropriate trade minerals helps support heart health. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) recommends specific guidelines for supplementation of trace elements in kidney and dialysis patients. Heart vitamins and multivitamins for kidney patients should have adequate amounts of trace minerals as delineated by the KDOQI Guidelines.6 ProRenal and ProRenal with Omega-3 are formulated to be the best vitamins for kidney health as well as the best vitamins for health and thus have been especially formulate contain the optimal amount of trace elements.
Iron
Iron is essential for red blood cell formation and a decline in iron levels can cause anemia, or a low red blood cell count. Kidney patients, especially those who are on dialysis, cannot maintain adequate iron stores so they are at risk for developing anemia. To prevent anemia in kidney patients, the KDOQI Guidelines recommend regular iron supplementation to achieve target iron levels.7 A daily dose of iron in your multivitamin could be helpful for kidney and dialysis patients.
ProRenal multivitamins are formulated by doctors to be the best supplements for heart health and kidney health. ProRenal has been formulated to address the specific nutrient needs of kidney patients. Trace elements and iron are included as part of a complete multivitamin, specially designed to support kidney health. Certain minerals should be limited in a kidney healthy diet so ProRenal supplements never contain potassium or phosphorus. ProRenal multivitamins are available in two varieties: ProRenal for supporting kidney health or ProRenal with Omega-3 for supporting heart health and kidney health.
- Potassium and your CKD diet, National Kidney Foundation, http://www.kidney.org/atoz/content/potassium.cfm, 2013.
- Phosphorus, tips for people with chronic kidney disease (CKD), National Kidney Disease Education Program, http://nkdep.nih.gov/resources/nutrition-phosphorus-508.pdf.
- Shane E: Philadelphia, PA, Lippincott, Williams & Wilkins, 1999, pp 183-187
- Role of trace elements and lipid peroxidation levels in pre and post hemodialysis of chronic renal failure patients, Ramprasad. N, Al- Ghonaim Mohammed I, International Journal of Research in Biochemistry and Biophysics 2013; 3(1): 1-6.
- The National Kidney Foundation Kidney Disease Outcomes Quality Initiative, Guidelines and Commentary, http://www.kidney.org/professionals/kdoqi/guidelines_commentaries.cfm, 2013.
- Guidelines for anemia of chronic kidney disease, NKF KDOQI Guidelines, http://www.kidney.org/professionals/kdoqi/guidelines_updates/doqiupan_iii.html, 2000.
Kidney Infographics [not sure what we’ll do here]
Causes, Prevention and Management