Wednesday, May 25, 2016

Nephropathy (Kidney Disease)

Diabetic nephropathy occurs when proper blood glucose levels are not maintained, leading to excess inflammation and glucose in the bloodstream, clogging the small capillaries that feed into the kidneys. 

In addition, there is an excess amount of acid waste in the blood that further clogs these small capillaries. The accumulation of calcium (due to the extra insulin) and acid waste in the kidneys causes the formation of kidney stones and uKidneysltimately causes kidney cells to die. Because kidney cells cannot be regenerated or repaired, the remaining cells have to work that much harder to filter substances from the blood. 

To help with the filtering process, the heart increases the flow of blood plasma to the kidneys, which in turn elevates blood pressure. As the kidney cells continue to die, the risk of kidney failure increases dramatically. This eventually leads to one or both of the kidneys losing their ability to function properly, characterized by high protein levels in the urine(proteinuria). Alcohol, tobacco, conventional animal meat, and many of the other “dead” processed foods accelerate the deterioration of the kidneys. 

Don't let this happen to you! Take action -- be proactive and start following a plant-based diet such as the Death to Diabetes nutritional program to protect and nourish your kidneys. Otherwise, you will face kidney dialysis and/or you'll have to wait for a kidney transplant.

Each kidney is comprised of more than a million units called nephrons. Each nephron has a tuft of blood vessels called a glomerulus. The glomerulus filters blood and forms urine, which drains down into collecting ducts to the ureter. 

The earliest detectable change in the course of diabetic nephropathy is a thickening in the glomerulus. At this stage, the kidney may start allowing more albumin (protein) than normal in the urine, and this can be detected by sensitive tests for albumin. This stage is called “microalbuminuria” (micro refers to the small amounts of albumin). 

As diabetic nephropathy progresses, increasing numbers of glomeruli are destroyed. This increases the amounts of albumin being excreted in the urine, and may be detected by ordinary urinalysis techniques. At this stage, a kidney biopsy clearly shows diabetic nephropathy. 

Protein may appear in the urine for five to ten years before other symptoms develop. High blood pressure often accompanies diabetic nephropathy. Over time, the kidney’s ability to function starts to decline. 

Diabetic nephropathy may eventually lead to chronic kidney failure, which consists of 5 stages -- see below for details. The disorder continues to progress toward end-stage kidney disease, usually within two to six years after the appearance of high protein in the urine (proteinuria). 

Diabetic nephropathy is the most common cause of chronic kidney failure and end-stage kidney disease in the United States. People with both Type 1 and Type 2 diabetes are at risk. The risk is higher if blood glucose levels are poorly controlled. However, once nephropathy develops, the greatest rate of progression is seen in patients with high blood pressure. 

Diabetic nephropathy is generally accompanied by other diabetic complications including high blood pressure, retinopathy, and vascular (blood vessel) changes, although these may not be obvious during the early stages of nephropathy. Nephropathy may be present for many years before high protein in the urine or chronic kidney failure develops. 

Diagnosis & Tests 
The first laboratory abnormality is a positive microalbuminuria test, which implies that you are very likely to develop diabetic nephropathy. Most often, the diagnosis is suspected when a routine urinalysis of a person with diabetes shows too much protein in the urine (proteinuria). The urinalysis may also show glucose in the urine, especially if blood glucose is poorly controlled.
The microalbumin test checks urine for the presence of a protein called albumin. Albumin is normally found in the blood and filtered by the kidneys. When the kidneys camera are working properly, albumin is not present in the urine. But when the kidneys are damaged, small amounts of albumin leak into the urine. This condition is called microalbuminuria (or proteinuria).
Without treatment to slow the leakage of protein, the kidneys may continue to be damaged and eventually fail.
If the microalbuminuria test is positive, it indicates that the blood vessels to your kidneys are damaged. It also reflects more widespread blood vessel disease that can increase your risk of heart problems.
Warning! Don't Wait Until It's Too Late! 

If you have been diagnosed with protein leaking in your urine, it is imperative that you take action! You need to change to a plant-based diet immediately to protect your kidneys from further damage and possible kidney disease (nephropathy)

Otherwise, you will eventually end up on kidney dialysis or have to get a kidney transplant! It's not fun to be put on a transplant list and wait for a viable transplant. In addition, the number of foods and the specific foods that you can't eat will increase as your kidneys get worse.  In most cases, you will have to go on a very restrictive diet, such as a low sodium-low potassium diet.

Consequently, start with the Death to Diabetes diet, and add raw juicing, wholefood nutritional supplements and herbal tinctures to nourish and protect the kidneys from further damage. 

There may or may not be signs of other diabetic complications. High blood pressure may be present or develop rapidly and may be difficult to control. Serum creatinine and BUN (blood urea nitrogen) may increase as kidney damage progresses. If there is any doubt in the diagnosis, a kidney biopsy may be performed to confirm the diagnosis and to study the extent of the disease. 

In general, for good kidney health, avoid the processed foods, drink raw vegetable juices, and eat more green vegetables such as spinach, kale, and broccoli. Also, eat wild salmon and sardines for the Omega-3s. Foods and nutrients such as filtered water, celery, cucumbers, lemons, limes, and cranberries nourish, protect and cleanse the kidneys and the bladder. 

Refer to the wellness protocol section in Chapter 15  of the Death to Diabetes  book and the Power of Juicing ebook for more details about kidney health.

Please Note: There are a lot more restrictions on the foods that you can eat as your kidneys get worse. That's why it's so important not wait too long to get your diabetes and blood sugar under control.

Unfortunately, some of the foods that can help you with your diabetes may be a problem if your kidneys have become severely damaged -- from the diabetes and the drugs. Foods such as  spinach and other green, leafy vegetables tend to contain potassium and phosphorus, two minerals that may be harmful to your (damaged) kidneys.  However, there are still enough healthy foods that you can eat to maintain good blood sugar control -- so that you can safely wean off the diabetic drugs.

Weaning off the diabetic drugs and the high blood pressure drugs is important because these drugs can cause further damage to your kidneys. Consequently, it is imperative that you work with a nephrologist and a naturopathic doctor to ensure that you're receiving optimum treatment that will prevent you from having to face kidney failure, dialysis, and/or a kidney transplant.

Symptoms of Diabetic Nephropathy

Early stage diabetic nephropathy has no symptoms. But, over time, the kidney's ability to function starts to decline. Symptoms develop late in the disease and may include:
  • Fatigue
  • Foamy appearance or excessive frothing of the urine
  • Frequent hiccups
  • General ill feeling
  • Generalized itching
  • Headache
  • Nausea and vomiting
  • Poor appetite
  • Swelling of the legs (edema)
  • Swelling, usually around the eyes in the mornings; general body swelling may occur with late-stage disease
  • Unintentional weight gain (from fluid buildup)

Medical Exams and Tests

The main sign of diabetic nephropathy is persistent protein in the urine (proteinuria). Protein may appear in the urine for 5 to 10 years before other symptoms develop. If your doctor thinks you might have this condition, a microalbuminuria test will be done. A positive test often means you have at least some damage to the kidney from diabetes. Damage at this stage may be reversible with a plant-based diet such as the Death to Diabetes diet. The test results can be high for other reasons, so it needs to be repeated for confirmation.
High blood pressure often goes along with diabetic nephropathy. You may have high blood pressure that develops rapidly or is difficult to control.
Laboratory tests that may be done include:
  • microalbumin
  • BUN
  • Serum creatinine
The levels of these tests will increase as kidney damage gets worse. Other laboratory tests that may be done include:
  • 24-hour urine protein
  • Blood levels of phosphorus, calcium, bicarbonate, PTH, and potassium
  • Hemoglobin
  • Hematocrit
  • Protein electrophoresis - urine
kidney biopsy confirms the diagnosis. However, your doctor can diagnose the condition without a biopsy if you meet the following three conditions:
  • Persistent protein in the urine
  • Diabetic retinopathy
  • No other kidney or renal tract disease
A biopsy may be done, however, if there is any doubt in the diagnosis.

Treatment for Kidney Disease

The goals of treatment are to keep the kidney disease from getting worse and prevent complications. This involves keeping your blood pressure under control (under 130/80). Controlling high blood pressure and blood sugar are the most effective ways of slowing kidney damage from diabetic nephropathy.
Your doctor may prescribe the following medicines to lower your blood pressure and protect your kidneys from damage:
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin receptor blockers (ARBs)
Unfortunately, these drugs do not work over the long term. Instead, eat more vegetables, avoid animal meat, and follow a superior wellness program like the Death to Diabetes program.
It is also very important to control lipid levels, maintain a healthy weight, and engage in regular physical activity.
You should closely monitor and control your blood sugar levels with a superior diet, including raw vegetable juicing. Doing so may help slow down kidney damage, especially in the very early stages of the disease. 
Urinary tract and other infections are common and can be treated with appropriate antibiotics.
Dialysis may be necessary once end-stage kidney disease develops. At this stage, akidney transplant may be considered. Another option for patients with type 1 diabetes is a combined kidney-pancreas transplant.Kidney dialysis

Outlook (Prognosis)

Nephropathy is a major cause of sickness and death in persons with diabetes. It is the leading cause of long-term kidney failure and end-stage kidney disease in the United States, and often leads to the need for dialysis or kidney transplantation.
The condition slowly continues to get worse once large amounts of protein begin to appear in the urine or levels of creatinine in the blood begin to rise.
Complications due to chronic kidney failure are more likely to occur earlier, and get worse more rapidly, when it is caused by diabetes than other causes. Even after dialysis or transplantation, persons with diabetes tend to do worse than those without diabetes.

Note: For more information about kidney dialysis, read the Death to Diabetes blog post about kidney dialysis.

Possible Complications

Possible complications due to kidney failure include:
  • Anemia
  • Chronic kidney failure (rapidly gets worse)
  • Dialysis complications
  • End-stage kidney disease
  • Hyperkalemia
  • Severe hypertension
  • Hypoglycemia
  • Infections
  • Kidney transplant complications
  • Peritonitis (if peritoneal dialysis used)

When to Contact a Medical Professional

Call your health care provider if you have diabetes and a routine urinalysis shows protein.
Call your health care provider if you develop symptoms of diabetic nephropathy, or if new symptoms develop, including little or no urine output.
But, don't wait for this to occur!! Take action -- be proactive!
 

Stages of Chronic Kidney Disease

About chronic kidney disease (CKD)

With chronic kidney disease, the kidneys don’t usually fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, medicines and lifestyle changes may help slow its progress and keep you feeling your best for as long as possible.

Five stages of chronic kidney disease

To help improve the quality of care for people with kidney disease, the National Kidney Foundation (NKF) created a guideline to help doctors identify each level of kidney disease. The NKF divided kidney disease into five stages. When the doctor knows what stage of kidney disease a person has they can provide the best care, as each stage calls for different tests and treatments.

Glomerular Filtration Rate (GFR)

Glomerular filtration rate (GFR) is the best measure of kidney function. The GFR is the number used to figure out a person’s stage of kidney disease. A math formula using the person’s age, race, gender and their serum creatinine is used to calculate a GFR. A doctor will order a blood test to measure the serum creatinine level. Creatinine is a waste product that comes from muscle activity. When kidneys are working well they remove creatinine from the blood. As kidney function slows, blood levels of creatinine rise.
Below shows the five stages of CKD and GFR for each stage:
  • Stage 1 with normal or high GFR (GFR > 90 mL/min)
  • Stage 2 Mild CKD (GFR = 60-89 mL/min)
  • Stage 3A Moderate CKD (GFR = 45-59 mL/min)
  • Stage 3B Moderate CKD (GFR = 30-44 mL/min
  • Stage 4 Severe CKD (GFR = 15-29 mL/min)
  • Stage 5 End Stage CKD (GFR <15 li="" min="" ml="">
Dialysis or a kidney transplant needed in order to maintain health.
Once you know the GFR you can determine a stage of kidney disease and read about that particular stage by clicking on a link below:

Stage 1 of Chronic Kidney Disease

A person with stage 1 chronic kidney disease (CKD) has kidney damage with a glomerular filtration rate (GFR) at a normal or high level greater than 90 ml/min. There are usually no symptoms to indicate the kidneys are damaged. Because kidneys do a good job even when they’re not functioning at 100%, most people will not know they have stage 1 CKD. If they do find out they’re in stage 1, it is usually because they were being tested for another condition such as diabetes or high blood pressure (the two leading causes of kidney disease).
Other ways a person may discover they are in stage 1 CKD include:
  • Higher than normal levels of creatinine or urea in the blood
  • Blood or protein in the urine
  • Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
  • A family history of polycystic kidney disease (PKD)
Regular testing for protein in the urine and serum creatinine can show whether the kidney damage is progressing. Living a healthy lifestyle can help slow the progression of kidney disease

It is recommended that people in Stage 1 CKD:
  • Eat a healthy diet:
    • Include a variety of grains, especially whole grains, fresh fruits and vegetables
    • Choose a diet that is low in saturated fat and cholesterol and moderate in total fats
    • Limit intake of refined and processed foods high in sugar and sodium
    • Choose and prepare foods with less salt or high sodium ingredients
    • Aim for a healthy weight and include physical activity each day
    •  Keep protein intake at the Daily Reference Intake (DRI) level .8 grams protein per kilogram body weight per day.
    • Consume adequate calories
    • Consume the DRI for vitamins and minerals
    • Potassium and phosphorus are usually not restricted unless blood levels are above normal
  • Keep their blood pressure at a healthy level
    • 125/75 for those with diabetes
    • 130/85 for non-diabetes and non-proteinuria
    • 125/75 for non-diabetes with proteinuria
  • Keep their blood sugar or diabetes under control
  • Have regular checkups with their doctor and include a serum creatinine test to measure GFR
  • Take medicines as prescribed by their doctor
  • Exercise regularly
  • Stop smoking 
There is no cure for kidney disease,, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.

Stage 2 of Chronic Kidney Disease

A person with stage 2 chronic kidney disease (CKD) has kidney damage with a mild decrease in their glomerular filtration rate (GFR) of 60-89 ml/min. There are usually no symptoms to indicate the kidneys are damaged. Because kidneys do a good job even when they’re not functioning at 100%, most people will not know they have stage 2 CKD. If they do find out they’re in stage 2, it’s usually because they were being tested for another condition such as diabetes or high blood pressure (the two leading causes of kidney disease).
Other ways a person may discover they are in stage 2 CKD include:
  • Higher than normal levels of creatinine or urea in the blood
  • Blood or protein in the urine
  • Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
  • A family history of polycystic kidney disease (PKD)
Regular testing for protein in the urine and serum creatinine can show whether the kidney damage is progressing. Living a healthy lifestyle can help slow progression of kidney disease. It is recommended that people in stage 2 CKD:
  1. Eat a healthy diet:
    • Include a variety of grains, especially whole grains, fresh fruits and vegetables
    • Choose a diet that is low in saturated fat and cholesterol and moderate in total fats
    • Limit intake of refined and processed foods high in sugar and sodium
    • Choose and prepare foods with less salt or high sodium ingredients
    • Aim for a healthy weight, consume adequate calories and include physical activity each day
    • Keep protein intake within the Daily Reference Intake (DRI) level recommended for healthy people
    • Consum the DRI for vitamins and minerals
    • Potassium and phosphorus are usually not restricted unless blood levels are above normal
  2. Keep their blood pressure at a healthy level
    • 125/75 for those with diabetes
    • 130/85 for non-diabetes and non-proteinuria
    • 125/75 for non-diabetes with proteinuria
  3. Keep their blood sugar or diabetes under control
  4. Have regular checkups with their doctor and include a serum creatinine test to measure GFR
  5. Take medicines as prescribed by their doctor
  6. Exercise regularly
  7. Stop smoking 

Stage 3 of Chronic Kidney Disease

A person with stage 3 chronic kidney disease (CKD) has moderate kidney damage. This stage is broken up into two: a decrease in glomerular filtration rate (GFR) for Stage 3A is 45-59 mL/min and a decrease in GFR for Stage 3B is 30-44 mL/min. As kidney function declines waste products can build up in the blood causing a condition known as “uremia.” In stage 3 a person is more likely to develop complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells) and/or early bone disease.
Symptoms may start to become present in stage 3, such as:
  • Fatigue: Feeling tired is common for people with CKD and is often caused by anemia.
  • Too much fluid: The kidneys may lose their ability to control how much fluid stays in the body. A person may notice swelling (edema) in their lower legs, hands or face around the eyes. With too much fluid someone could even feel short of breath.
  • Urination changes: Urine may be foamy if there is protein in it, or dark orange, brown, tea colored or red if it contains blood. A person may urinate more or less, or get up at night to go to the bathroom.
  • Kidney pain: Most people with CKD do not have kidney pain, but with some kinds of kidney problems, such as polycystic kidney disease (PKD) or infections, they may have pain in their back where the kidneys are.
  • Sleep problems: Some people have trouble falling asleep or staying asleep. Itching, muscle cramps or restless legs can keep them awake.
As stage 3 progresses, the NKF recommends the patient see a nephrologist (a doctor who specializes in treating kidney disease). Nephrologists examine kidney patients and perform lab tests so they can gather information about their condition to offer the best advice for treatment. The nephrologist’s goal is to help their patient keep their kidneys working as long as possible.
Someone in stage 3 may also be referred to a dietitian. Because diet is such an important part of treatment, the dietitian will review a person’s lab work results and recommend a meal plan individualized for their needs. Eating a proper diet can help preserve kidney function and overall health.

For stage 3 a dietitian will usually recommend eating a healthy diet with protein at the Daily Reference Intake (DRI) level of 0.8 grams protein per kilogram body, the same level recommended for all healthy people. Special attention may be given to the quality of protein eaten.

Phosphorus may be limited to help keep blood phosphorus or PTH normal and prevent renal bone disease. Controlling phosphorus may also help preserve existing kidney function.

Calcium may be limited if blood levels are too high. Potassium is usually not restricted in stage 3 CKD unless blood levels are high.

The dietitian will also take into consideration if the patient has diabetes and provide tips on limiting carbohydrates in their diet. They may also recommend a diet low in sodium for those with high blood pressure or fluid retention.

Supplementation with water soluble vitamins may be recommended. Vitamin C may be limited to 100 mg per day from supplements. Nutrients like Vitamin A and some minerals may not be recommended because levels can build up in the blood as kidney function declines. The dietitian may recommend avoiding over the counter dietary supplements unless approved by the nephrologist. It is helpful to work with a registered renal dietitian because as the stages of CKD change, so will the diet.

Note: For organic herbal tinctures that can help kidney health, refer to the Herbdoc.comwebsite.
A healthy diet for stage 3 CKD may recommend:
  • Including a variety of grains, fruits and vegetables, but whole grains and some fruits and vegetables may be limited if blood tests show phosphorus or potassium levels are above normal.
  • A diet that is low in saturated fat and cholesterol and moderate in total fats, especially if cholesterol is high or if you have diabetes or heart disease
  • Limiting intake of refined and processed foods high in sodium and prepare foods with less salt or high sodium ingredients
  • Aiming for a healthy weight by consuming adequate calories and including physical activity each day
  • Keeping protein intake within the DRI level recommended for healthy people with attention to high quality protein.
  • Consuming the DRI for the water soluble vitamin B complex and C.
  • Vitamin D and iron may be tailored to individual requirements
  • Limiting phosphorus if blood levels of phosphorus or PTH are above normal
  • Limiting calcium if blood levels are above normal
  • Potassium is usually not restricted unless blood levels are above normal
Many people who develop CKD have diabetes or high blood pressure. By keeping their glucose level under control and maintaining a healthy blood pressure, this can help them preserve their kidney function. For both of these conditions, a doctor will likely prescribe a blood pressure medicine. Studies have shown that ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) help slow the progression of kidney disease even in people with diabetes who do not have high blood pressure.Patients should ask their doctors about all of their medicines and take them exactly as prescribed.

In addition to eating right and taking prescribed medicines, exercising regularly and not smoking are helpful to prolonging kidney health. Patients should talk to their doctors about an exercise plan. Doctors can also provide tips on how to stop smoking.
People in Stage 3 CKD will usually visit their doctor every 3-6 months. Blood tests for creatinine, hemoglobin, calcium and phosphorus levels will be performed to see how well the kidneys are functioning. The doctor will also monitor other conditions such as high blood pressure and diabetes.
There is no cure for kidney disease, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.

Stage 4 of Chronic Kidney Disease

A person with stage 4 chronic kidney disease (CKD) has advanced kidney damage with a severe decrease in the glomerular filtration rate (GFR) to 15-30 ml/min. It is likely someone with stage 4 CKD will need dialysis or a kidney transplant in the near future.

As kidney function declines waste products build up in the blood causing a condition known as “uremia.” In stage 4 a person is likely to develop complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells), bone disease, heart disease and other cardiovascular diseases.
Symptoms that are experienced in stage 4 include:
  • Fatigue: Feeling tired is common for people with CKD and is often caused by anemia.
  • Too much fluid: The kidneys may lose their ability to control how much fluid stays in the body. A person may notice swelling (edema) in their lower legs, hands or face around the eyes. With too much fluid someone, could even feel short of breath.
  • Urination changes: Urine may be foamy if there is protein in it, or dark orange, brown, tea colored or red if it contains blood. A person may urinate more or less than normal, or get up at night to go to the bathroom.
  • Kidney pain: Most people with CKD do not have kidney pain, but with some kinds of kidney problems, such as polycystic kidney disease (PKD) or infections,  they may have pain in their back where the kidneys are located.
  • Sleep problems: Some people have trouble falling asleep or staying asleep. Itching, muscle cramps or restless legs can keep them awake.
  • Nausea: Vomiting or feeling nauseated may occur with CKD.
  • Taste changes: Food may not taste like it usually does, or may have a metallic taste.
  • Uremic breath: As urea builds up in the blood, it may be detected in the breathing causing bad breath.
  • Loss of appetite: People in this stage may not feel like eating, and some people report having a metallic taste in their mouth or bad breath.
  • Difficulty in concentrating: Having trouble balancing a checkbook or focusing on reading the newspaper can happen with CKD.
  • Nerve problems: Numbness or tingling in your toes or fingers is a symptom of CKD.
At stage 4 it is necessary to see a nephrologist (a doctor who specializes in treating kidney disease). The nephrologist examines the patient and orders lab tests to gather information to recommend treatment.

People in stage 4 CKD will usually visit their doctor at least every three months. Blood tests for creatinine, hemoglobin, calcium and phosphorus levels will be done to see how well the kidneys are working. The doctor will also monitor other conditions such as high blood pressure and diabetes. In addition to helping the patient keep their kidneys working as long as possible, the nephrologist will also help prepare the patient for dialysis or a kidney transplant.

Those with stage 4 CKD who will need treatment are told about their choices, which are hemodialysis, peritoneal dialysis (PD) or a kidney transplant. For those who choose hemodialysis they will learn about getting a vascular access. The vascular access allows the patient’s blood to travel to and from the dialysis machine at a large volume and high speed so that toxins, waste and extra fluid can be removed from the body. The AV (arteriovenous) fistula and AV graft are created surgically and need a few months or so to mature. The nephrologist will inform their Stage 4 patient about the procedure to have the access placed and the advantages of having an AV fistula in place before beginning dialysis.

Someone in stage 4 may also be referred to a dietitian. Because diet is such an important part of treatment, the dietitian will review a person’s lab work results and recommend a meal plan individualized for their needs. Eating a proper diet can help preserve kidney function and overall health. 

For stage 4 a dietitian will usually recommend eating a healthy diet with reduced amounts of protein to help decrease build up of protein waste. Phosphorus may be limited to help keep blood phosphorus or PTH normal and prevent renal bone disease. Controlling phosphorus may also help preserve existing kidney function. 

Calcium may be limited if blood levels are too high. Potassium may be restricted in stage 4 CKD if blood levels are above normal. 

The dietitian will also take into consideration if the patient has diabetes and provide tips on limiting carbohydrates in their diet. They may also recommend a diet low in sodium for those with high blood pressure or fluid retention. 

Supplementation with water soluble vitamins may be recommended. Vitamin C may be limited to 100 mg per day from supplements. Nutrients like Vitamin A and some minerals may not be recommended because levels can build up in the blood as kidney function declines. The dietitian may recommend avoiding over the counter dietary supplements unless approved by the nephrologist. It is helpful to work with a registered renal dietitian because as the stages of CKD change, so will the diet.
A healthy diet for stage 4 CKD may recommend:
  • Including grains, fruits and vegetables, but limiting whole grains and certain fruits and vegetables if blood tests show phosphorus or potassium levels are above normal.
  • A diet that is low in saturated fat and cholesterol and moderate in total fats, especially if cholesterol is high or if you have diabetes or heart disease.
  • Limiting intake of refined and processed foods high in sodium and prepare foods with less salt or high sodium ingredients.
  • Aiming for a healthy weight by consuming adequate calories and including physical activity each day within your ability.
  • Limiting protein intake to the level determined by the dietitian’s assessment of individual needs.
  • Consuming the DRI for the water soluble vitamin B complex and C.
  • Vitamin D and iron may be tailored to individual requirements.
  • Limiting phosphorus if blood levels of phosphorus or PTH are above normal.
  • Limiting calcium if blood levels are above normal.
  • Limiting potassium if blood levels are above normal.
It is recommended that people in stage 4 keep their blood pressure at a healthy level and those with diabetes keep their glucose level under control. Taking all the medicines as prescribed by the doctor may help prolong kidney function.

In addition to eating right and taking prescribed medicines, exercising regularly and not smoking are helpful in maintaining health. Patients should talk to their doctors about an exercise plan. Doctors can also provide tips on how to stop smoking.
The NKF guidelines recommend starting dialysis when kidney function drops to 15% or less. By doing everything possible to help prolong kidney function and overall health, the goal is to put off dialysis or transplant for as long as possible.

Stage 5 of Chronic Kidney Disease

A person with stage 5 chronic kidney disease (CKD) has end stage renal disease (ESRD) with a glomerular filtration rate (GFR) of 15 ml/min or less. At this advanced stage of kidney disease, the kidneys have lost nearly all their ability to do their job effectively, and eventually dialysis or a kidney transplant is needed to live.
Symptoms that can occur in stage 5 CKD include:
  • Loss of appetite
  • Nausea or vomiting
  • Headaches
  • Being tired
  • Being unable to concentrate
  • Itching
  • Making little or no urine
  • Swelling, especially around the eyes and ankles
  • Muscle cramps
  • Tingling in hands or feet
  • Changes in skin color
  • Increased skin pigmentation
Because the kidneys are no longer able to remove waste and fluids from the body, toxins build up in the blood, causing an overall ill feeling. Kidneys also have other functions they are no longer able to perform such as regulating blood pressure, producing the hormone that helps make red blood cells and activating vitamin D for healthy bones.

If you are diagnosed with stage 5 CKD, you will need to see a nephrologist immediately. This is a doctor who is trained in kidney disease, kidney dialysis and transplant. The doctor will help you decide which treatment is best for you— hemodialysis, peritoneal dialysis (PD) or kidney transplant—and will recommend an access for dialysis. Your nephrologist will develop your overall care plan and manage your healthcare team.

There are two types of dialysis: hemodialysis and peritoneal dialysis

Hemodialysis requires that an access be created to get the blood from your body to the dialyzer (artificial kidney) so it can be cleaned and then go back into your body. Because in stage 5 the kidneys are no longer working, dialysis must begin soon. A catheter will be placed into a vein in the neck, chest or groin. This is considered a temporary access. If you decide to remain on hemodialysis, your nephrologist will likely recommend you get a fistula created, which is a permanent access. To create a fistula, an artery and vein are surgically connected in the forearm. It takes a few months for the fistula to mature so that it can be used for dialysis. There is another type of access called a graft that uses artificial tubing to connect the artery and vein. It takes three to six weeks to heal so that it can be used for dialysis.
For PD, a catheter access is placed in the abdomen. PD is performed by running dialysate solution through the catheter into the peritoneum and then removing the solution after a time and replacing it with new dialysate. The peritoneal membrane that lines the peritoneum is a semipermeable membrane that does the filtering for the kidney. There are different methods of performing PD. Some people manually drain and fill their abdomen every four to six hours, which is called continuous ambulatory peritoneal dialysis (CAPD). Others use an automated machine, called a cycler, which works while they sleep and then do a manual exchange in the morning. This is called continuous cycler peritoneal dialysis (CCPD). There is another choice called nocturnal intermittent peritoneal dialysis (NIPD) where PD is performed at night while sleeping. With NIPD, no exchanges are done during the day.
Most people report feeling much better once they begin dialysis. As the toxins are removed from their blood and they receive medicines that replace the functions the kidneys can no longer perform, they find they can enjoy a good quality of life.

Changes in the diet

Once you begin dialysis, you will need to make changes in what you eat and drink. Your diet is a big part of your treatment, so you will be working with a dietitian who will coach you on how you should eat. Depending on the dialysis treatment you choose and your lab test results, your dietitian will help create a meal plan based on your individual requirements to keep you feeling your best. People on hemodialysis generally need to increase their protein, and limit fluids, sodium, potassium and phosphorus, and in some cases, calcium. Those who choose PD usually need to increase their protein and limit phosphorus, but may have fewer limits on fluid and potassium. Your dietitian will explain what foods are restricted and which ones are recommended on the renal diet.
A healthy diet for stage 5 CKD may recommend:
  • Including grains, fruits and vegetables, but limiting or avoiding whole grains and certain fruits and vegetables that are high in phosphorus or potassium
  • A diet that is low in saturated fat and cholesterol and moderate in total fats, especially if cholesterol is high or if you have diabetes or heart disease
  • Limiting intake of refined and processed foods high in sodium and prepare foods with less salt or high sodium ingredients
  • Aiming for a healthy weight by consuming adequate calories and including physical activity each day within your ability
  • Increasing protein intake to the level determined by the dietitian’s assessment of individual needs and to replace losses in the dialysis treatment
  • Taking special renal vitamins high in water soluble B vitamins and limited to 100 mg of vitamin C
  • Vitamin D and iron tailored to individual requirements
  • Limiting phosphorus to1000 mg or based on individual requirements
  • Limiting calcium to 2000 mg (no more than 1500 mg from calcium based phosphorus binders).
  • Limiting potassium to 2000 to 3000 mg or bases on individual requirements

Kidney transplant

If you wish to have a kidney transplant, tell your nephrologist. Your nephrologist will explain the process of how to get on a waiting list for a cadaverous kidney or how to find a living donor.
When at stage 5 CKD, either dialysis or a kidney transplant is necessary to continue living.

What Is End Stage Renal Disease?

Kidneys are significant organs that contribute to your overall well-being. But when kidneys function at only below 10 to 15 percent of their normal capacity, they cannot effectively do their job, such as remove waste or excess fluid from your blood. End stage renal disease (ESRD) is the last stage (stage five) of chronic kidney disease (CKD). When CKD, polycystic kidney disease (PKD) or other kidney diseases develop into ESRD, dialysis or a kidney transplant is necessary to live.

What happens to my body when I have ESRD?

Reduced urination

Fully functioning kidneys clean the blood of wastes and excess fluid. These items are eliminated through urine. Because kidneys with ESRD do a very poor job of removing these items, waste and fluid build up to unhealthy levels in the body and can make you feel sick. This is a condition called uremia. When fluid is not removed from the body, tissues will swell and lead to a condition called edema. Excess fluid in the bloodstream can also increase blood pressure.

Unbalanced electrolytes

Electrolytes are minerals and salts such as magnesium, sodium and potassium. They are found in foods you eat and are essential to good health. However, too much or too little of these electrolytes can make you sick. Kidneys affected with ESRD cannot regulate the levels of electrolytes and changes in your body’s functions occur. Sodium can cause tissues to retain water. Excess potassium can cause an abnormal heart rhythm, which may lead to cardiac arrest. Too little magnesium can affect your heartbeat and cause changes in your mental state; too much can leave you feeling weak.

Hormone changes

Healthy kidneys make certain hormones. One is a parathyroid hormone (PTH) that activates vitamin D into a substance called calcitriol, helping your body absorb calcium. If your body cannot absorb calcium, your bones become fragile and may break. Another hormone your kidneys create is erythropoietin. Erythropoietin tells your body to make red blood cells, which carry oxygen to the cells throughout your body. If your red blood cell count is low, you may develop  anemia, leaving you feeling weak and fatigued.

Abnormal enzyme production

Renin is an enzyme kidneys produce, and helps regulate sodium and potassium levels in the blood, as well as regulate blood pressure. When blood pressure drops, renin is released and starts a chemical reaction in the body that will produce a substance called angiotensin. Angiotensin causes your blood vessels to narrow, raising blood pressure. Angiotensin also signals the adrenal glands (found at the top of your kidneys) to release a hormone called aldosterone. Aldosterone tells the kidneys to retain salt (sodium) and excrete potassium. By retaining salt, the body keeps more water in the system. This water raises the blood volume and blood pressure. Kidneys affected by ESRD sometimes make too much renin, which keeps blood pressure levels high. This kind of high blood pressure can be difficult to treat.

What can I do to live better with ESRD?

Regular dialysis treatment, following your renal diet and taking prescribed medications can go a long way in managing ESRD. If you have been diagnosed with end stage renal disease, it is important to follow your healthcare team’s advice regarding treatment.

Prevention of Kidney Failure                                       

Follow a plant-based diet with raw salads, plant oils such as olive oil, and raw vegetable juices. Get the Power of Juicing ebook and/or the Raw Diet ebook to help you.

Also, take wholefood nutritional supplements and/or organic herbal tinctures to help nourish, detox, and protect the kidneys from further damage.
All persons with diabetes should have a yearly checkup with their doctor to have their blood and urine tested for signs of possible kidney problems.
Persons with kidney disease should avoid contrast dyes that contain iodine, if possible. These dyes are removed through the kidneys and can worsen kidney function. Certain imaging tests use these types of dyes. If they must be used, fluids should be given through a vein for several hours before the test. This allows for rapid removal of the dyes from the body.
Commonly used nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen, and prescription COX-2 inhibitors such as celecoxib (Celebrex), may injure the weakened kidney. You should always talk to your health care provider before using any drugs.

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Proteinuria and How to Treat It                                  

Proteinuria - also called albuminuria or urine albumin - is a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body.  

As blood passes through healthy kidneys, they filter out the waste products and leave in the things the body needs, like albumin and other proteins. Most proteins are too big to pass through the kidneys’ filters into the urine. However, proteins from the blood can leak into the urine when the filters of the kidney, called glomeruli, are damaged.

When the blood vessels of the kidneys are damaged, protein can leak from your blood into your urine. Normally, kidneys filter out waste products and proteins, most of which are too big to pass through the kidney's filters. If they are damaged and your kidneys cannot properly filter waste, some of the protein may be found in your urine. Abnormal amounts of protein in your urine is called proteinuria. Depending on the types and amounts of protein leaking from your kidneys, you may be at risk for kidney failure.

If you have proteinuria, chances are you show no symptoms. When protein loss gets excessive, your urine might look foamy and you may notice swelling in your hands, feet, abdomen, or face. The only way to determine how much protein is in your urine is to have it tested regularly.

Proteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure, and diseases that cause inflammation in the kidneys. For this reason, testing for albumin in the urine is part of a routine medical assessment for everyone. Kidney disease is sometimes called renal disease. If CKD progresses, it can lead to end-stage renal disease (ESRD), when the kidneys fail completely. A person with ESRD must receive a kidney transplant or regular blood-cleansing treatments called dialysis.

Note: Microalbuminuria is referred to as excretion of 30-300 mg of albumin daily or 20-200 µg of albumin per minute; by routine dipstick screening methods, these amounts are too small to be detected.

Pathophysiology of Proteinuria
The filtration of albumin and nonalbumin proteins across the abnormal glomerular capillary wall (GCW) exposes mesangial and tubular cells to these proteins. Albumin and nonalbumin proteins are normally reabsorbed from the glomerular filtrate in the proximal convoluted tubule (PCT).

Heavy proteinuria may exceed the capacity of lysosomes in the PCT cells to metabolize reabsorbed protein, and toxic enzymes may leak into the cells and the surrounding renal interstitium[1] as a consequence of lysosomal degranulation. Whether the nephrotoxic protein is albumin, nonalbumin protein, or both remains unclear.

Other proteins, such as transferrin, complement components, and low-density lipoproteins (LDLs), also appear to be directly toxic to tubular cells. In addition, lipoproteins appear to be toxic to mesangial cells and may contribute to the development of glomerular sclerosis.

A consequence of protein-mediated cytotoxicity is the production of chemokines and cytokines that initiate an inflammatory response and ultimately lead to sclerosis and fibrosis.

Prognosis
The prognosis for patients with proteinuria depends on the cause, duration, and degree of the proteinuria. Young adults with transient or orthostatic proteinuria have a benign prognosis, while patients with hypertension and microalbuminuria (or higher degrees of albuminuria) have a significantly increased risk of cardiovascular disease.

Microalbuminuria
In addition to being a predictor of outcome in patients with renal disease, microalbuminuria also is a predictor of morbidity and mortality in patients who do not have evidence of significant renal disease. In patients with hypertension, the presence of microalbuminuria is correlated to the presence of left ventricular hypertrophy. In hypertensive patients and normotensive patients, the presence of microalbuminuria predicts an increased risk of cardiovascular morbidity and mortality.

Urinary-to-creatinine ratio
In a study of 2310 patients, Jackson et al concluded that spot urinary-to-creatinine ratios (UACRs) in persons with heart failure have significant prognostic value.[5] The authors determined that compared with patients with normoalbuminuria, individuals with an increased UACR tended to be older, had higher rates of cardiovascular comorbidity and diabetes mellitus, and suffered from worse renal function.

Even after adjustment for variables such as renal function and diabetes, it was determined that an increased UACR was associated with a greater mortality risk. The authors concluded that elevated UACR has significant value as a prognostic indicator for patients with heart failure. 

Natural Treatments for Proteinuria                
Note: Ensure that you visit a nephrologist if you develop proteinuria, or any adverse prognostic markers (e.g. rise in albumin excretion of >1 g/day), or any worsening in renal function.

A natural treatment strategy for proteinuria should be customized to address your specific health needs. Some of those strategies may include the following:
 
Eat anti-inflammatory foods and take wholefood supplements. Since inflammation is a key problem, eat more anti-inflammatory foods; and, avoid the "dead" foods that cause inflammation. Key foods and supplements that can protect and nourish your kidneys include filtered water, lemons, limes, organic apple cider vinegar, parsley, cabbage ginger, cranberry, chlorella, CoQ10, and raw juices.
Note: You will have to limit your intake of various foods if your kidney disease gets worse.  See below for foods to avoid.

Lessen salt intake. Remember that when you have proteinuria, your problem is not just the blood that comes with your urine. You will experience swelling as well. Cure this swelling by making sure that your body is kept hydrated. Lessening your salt intake can help your body maintain the right hydration because salt actually lessens your body's water.

Use organic herbal tincturesThese herbal tinctures (designed specifically for kidney health) are absorbed a lot easier and can protect your kidneys from further damage. Look for tinctures from reputable companies that contain Uva Ursi Leaf, Juniper Berry, Horsetail Herb, Burdock Root, Corn Silk, Parsley Root. If you didn't wait too long long, these herbal tinctures can help your kidneys before you lose a larger percentage of kidney function. So, don't wait until you have to face kidney dialysis or a kidney transplant! -- Take action now!

Note: Get the Nutritional Supplements Brand Names ebook for a list of reputable companies and quality supplements.
Perform cleansing/detox. A cleansing/detox can help to remove the buildup and accumulation of toxins and other chemicals in the kidneys.

Treat your blood sugar problems. If you are suffering from diabetes, be sure to address sugar problems effectively. Keep your sugar levels under control with a plant-based diet. Through this, you would also be able to control your proteinuria.

Maintain a low blood pressure. Treating your high blood pressure would be a good starting point in treating your proteinuria because this illness is, most of the time, accompanied by high blood pressure. This is because high blood pressure greatly affects the capacity of the kidney to filter the protein in the blood. In other words, treating high blood pressure is one way to treat proteinuria. Read our web page for treating high blood pressure or read Chapter 15 of Death to Diabetes.

Avoid prescription drugs and OTC drugs such as NSAIDs. These drugs take a toll on your kidneys, so be careful with taking too many drugs. Talk to your doctor about non-drug alternatives.

Lessen your protein intake. Your kidneys are already having trouble filtering proteins from your blood. Do not worsen this problem by taking more protein. Be more sensitive on the kinds of foods you eat, particularly on the protein level of such foods. You can check the National Kidney Foundation's site to see menus that could help you lessen your protein intake.

Address urinary tract infection (UTI)  issues. UTI actually prolongs your proteinuria. This is because a person who has UTI is more prone to the possibility of the spread of bacteria. Treating your UTI would be another way of treating proteinuria.

As a last resort, consult a doctor about the possibility of using Angiotensin-Converting Enzyme (ACE) drugs to treat your proteinuria. These are inhibitors used to relatively decrease the protein in the urine. You can use this to treat your proteinuria. But remember not to self-medicate. Always ask your doctor first before trying this one.

Minor proteinuria. Proteinuria does not always have to be treated. If it were not serious, no treatment would be necessary. This is because minor proteinuria may be caused by severe stress or dehydration.

Eastern Medicine Treatment
In Eastern Medicine, instead of prescribing western medicine based treatments or prescribing medications for kidney related symptoms, eastern medicine physicians give their patients natural herbal formulas that offer support and balance to the body as a whole. Their goal is to detoxify the body while supporting the kidney and other key organs in order for the body to heal itself and restore proper kidney filtration and function. We feel this approach to be better and more natural since you are not treating the disease but rather supporting the body's ability to heal.

Traditional Chinese Medicinal (TCM) recommends herbs such as Alisma, Astragalus, Cyperus, Dioscorea, Poria, Rehmannia, Ganoderma.

Animal studies have shown the simple combination of astragalus root and cooked rehmannia root to be a markedly effective treatment for protein and blood in the urine, causing improvement and recovery of renal functions, and reduction of edema, anemia, and anorexia.  The combination had no adverse effects on functions of the liver, kidney, heart and GI tract (Su 1993).

A variation containing many of the ingredients of the well-known TCM formula called Rehmannia 6 has been shown to be effective for nephritis, according to Chinese researchers. The variation contained cooked rehmannia root, astragalus root, cornus fruit (shan zhu yu or C.  officinalis), moutan bark (mu dan pi or Paeonia suffruticosa), water plantain rhizome (Ze xie or Alisma plantago-aquatica) and wild yam root (han yao or Dioscorea opposita). Other useful TCM herbs include cordyceps mushroom, rhubarb root and salvia root.

Dietary changes are often recommended as a form of proteinuria treatment. If kidney function has been compromised, a diet low in protein and sodium may be advisable. Those with diabetes should eat a healthy plant-based diet in order to maintain normal blood sugar levels. A doctor or nutritionist can help the patient develop a healthy meal plan on an individual basis.

Dietary Changes for Kidney Disease                           

Dietary changes for Kidney Disease include the following:

Eat More:
Raw foods, apples, asparagus, bananas, cauliflower, celery, cranberries, cucumbers, garlic, legumes, onions, papaya, parsley, potatoes, pumpkin, red bell peppers, sprouts, seeds, spirulina, strawberries, acidophilus, Lecithin, watercress, watermelon

Drink clean water (6-8 glass’s per day), eat smaller portions of meat, do small mild cleanses

Eat Less:
Potassium, phosphates, beet greens, meat, spinach, rhubarb, swiss chard

Do Not Eat:
Processed foods, chocolate, cocoa, eggs, dairy, salt, ham, lunch meats

 

Low Sodium and Low Potassium Diet Guidelines       

Food Restrictions as Kidney Disease Worsens  

Reducing potassium intake is only necessary if your kidney function drops to below 20 percent, according to the Association of Kidney Patients. Cut back on the amount of fruits and vegetables you consume to reduce potassium. Eat no more than a total of five servings of fruits and vegetables per day. This includes limiting the amounts of textured vegetable protein (TVP) and legumes (beans) for vegetarians.

Potassium: If you have normal kidney function, your serum potassium levels remain between 3.5 and 5.0 mEq/L. Keeping these levels within a narrow range is critical because the concentration of potassium controls the firing of nerves, which in turn control the beating of the heart. When levels get too high, you are at risk for irregular heartbeat and heart attack. One symptom of advanced kidney disease is elevated potassium levels. Nephrologists treat this by recommending a low-potassium diet. The amount of potassium that is safe to eat varies from patient to patient, but it's usually between 2,000 and 3,000 mg. A one cup serving of cooked spinach has 839 mg of potassium, an amount that is incompatible with a low-potassium diet.  Foods high in potassium include: Bananas, Oranges, Orange Juice, Raisins, Figs, Avocados, Dried Apricots, Spinach, Greens, Prunes, Prune Juice, Tomato Juice, Tomato Sauce, Nuts, Chocolate Dried, Peas and Beans. 

Note: You can reduce the amount of potassium in certain processed foods by following a few recommendations from the Greenwich Hospital. Cooking frozen fruits and vegetables in water and draining the water before eating them can help reduce the potassium content of the produce. Rinsing and draining canned fruits and vegetables may also remove some potassium. Some foods contain hidden potassium in the form of artificial sweeteners, so check labels of processed foods and avoid foods that are made with potassium-containing ingredients.

Low Potassium and Low Sodium Foods: If you ignore your diabetes, you will eventually lose kidney function and will probably have to go on a low sodium and low potassium diet. Foods that are low in sodium and potassium include spinach, kale, lettuce, cucumbers, bell peppers, carrots, bean sprouts, garliic, and onions.

Since most foods contain potassium, the key is to select those lowest in potassium including vegetables such as asparagus, cooked cabbage and carrots, cauliflower, peas, green peppers and spinach; fruits such as apples, blackberries, blueberries, cherries, peaches, pears and plums. Protein foods that are permitted include a serving of chicken or turkey, tuna, eggs, shrimp, nuts and seeds.
To further help your diabetes and protect your kidneys, we recommend that, after you have read and used the Death to Diabetes book, you need to go beyond that book. Specifically, it may be necessary for you to go on a vegan plant-based diet with lots ofraw foods and raw juicing.

If you decide to go on a raw food diet, we would recommend that you get the Death to Diabetes Raw Food Diet book and Power of Raw Juicing book.

In addition, if you want more information about following a vegan diet (plus lots of vegan recipes), we recommend the 3-in-1 Death to Diabetes Cookbook.

How to Avoid Potassium-rich Foods:1. Review all food labels: High potassium foods are considered to be those that contain 250 mg of potassium per serving. When reading the label, pay close attention to serving size. While a food label may indicate that a food contains 125 mg of potassium per one-half cup serving, if your recipe calls for one cup, this will make the final dish high in potassium.

2. Remove all water, juice or other fluids from canned vegetables, fruits and meats before serving. These fluids contain potassium and will add to your overall potassium intake.
3. Avoid consuming salt substitutes or foods containing salt substitutes because they contain high amounts of potassium, according to the University of Rochester Medical Center. Potassium chloride is commonly substituted for sodium chloride in these salt substitute products.
4. Avoid or restrict your dairy intake---including milk, buttermilk, yogurt or ice cream---to one-half cup per day, according to the University of Rochester Medical Center. Because dairy products tend to be high in potassium, this reduces your overall potassium intake.
5. Avoid consuming the following foods completely because each contains more than 600 mg of potassium per serving: Dried apricots, carrot juice, prune juice, baked beans, white beans, spinach, lima beans, winter squash and potatoes.
6. Leach all fruits and vegetables, when possible, to reduce overall potassium intake. Leaching is a process that involves soaking vegetables or fruits in water to draw potassium away from the food and into the water. Use 10 parts water to 1 part vegetable for maximum potassium removal. Drain the water away from the food after leaching and prepare as usual, being sure to use unsalted water.
Here is a list of the top potassium-rich foods:
www.healthaliciousness.com/articles/food-sources-of-potassium.php
Animal Proteins: The American Association of Kidney Patients recommends reducing animal proteins which are high in purines that convert to uric acid in the kidneys. Urine then becomes too acidic, which leads to the formation of uric acid crystals that are deposited in the kidneys as kidney stones. Uric acid crystals also deposit in joints, causing gouty arthritis. Replace poultry, red meats and fish with vegetarian sources of protein, such as soy or legumes, combined with whole grains to form complete proteins.
High Oxalate Foods: Limit foods high in oxalic acid, recommends the National Kidney Foundation, to avoid developing a variety of kidney stones. These foods include dark leafy green vegetables (i.e. spinach, Romaine lettuce), beans, berries, oranges, Concord grapes, sweet potatoes, tea, chocolate, instant coffee, tofu, beets, peanuts, and draft beer.
Canned, Processed, Frozen and Fast Foods: The kidneys' role in maintaining blood pressure is closely involved with the body's sodium balance. One of the causes of kidney disease is hypertension, and it is also one of the side effects of kidney disease. Too much sodium intake can trigger high blood pressure, with renal function going haywire, according to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). Lower salt intake and all foods that are high in sodium, all canned foods (unless they are labeled "low sodium"), canned and dried soups, vegetable broths, soy-based cheeses, convenience foods, chips, fast foods, boullion, frozen meals, bacon, ham, corned beef, hot dogs, sausage, processed cheese slices, salt, soy sauce, processed meats, pickled foods, pizza, tamari, ketchup, potato chips, Fritos, Cheetos, marinades and anything that has the words "sodium added" on the label.
Chocolate, Dairy and Nuts: The body's electrolyte balance is controlled by the kidneys. If they are not working properly due to disease or other conditions impacting their function, electrolytes must be reduced to avoid straining the kidneys. Phosphorus blocks the absorption of calcium, so reducing the following high-phosphorus foods will help retain needed calcium, recommends the American Association of Kidney Patients. Cut back on cocoa, nuts, chocolate, vegetables, carbonated drinks and dairy products. Eat only one portion of these foods per day, especially cottage cheese, yogurt, milk, soy cheese, soy yogurt and hard cheeses, which are high in phosphorus.

Phosphorus: Patients with low kidney function also often have problems with high serum phosphorus levels. This is dangerous because the phosphorus leaches calcium from the bones. It weakens the skeleton and creates calcium deposits on vascular tissues, muscles and organs. One cup of cooked spinach has 101 mg of phosphorus. The National Kidney Foundation recommends that patients with high phosphorus levels limit their phosphorus consumption to between 800 and 1,000 mg a day. While eating a leaf or two of spinach in a salad won't do any harm, it would be difficult to incorporate larger servings into a low-phosphorus diet. Phosphorous-rich foods include: bran, seeds, parsley, chives, Brazil nuts, potatoes, whole wheat baked goods, cottage cheese, corn, broccoli, spinach, currants, avocados.

Here is a list of phosphorus-rich foods:
www.healthaliciousness.com/articles/high-phosphorus-foods.php

Fluids. Diseased kidneys may not be able to function adequately, causing excess fluids to collect in various parts of the body causing edema or swelling and increased weight. The build-up of fluids also affects heart as it must exert more pressure on it to pump larger volumes of blood, as discussed by The National Kidney and Urologic Diseases Information Clearinghouse. Water intake should therefore be calculated with the use of small sized cups for drinking. Certain foods such as melon, grapes, apples, oranges, lettuce, tomatoes, celery, soup, ice creams and juices should be also be avoided or decrease to reduce fluid levels in the body.
Consequently, if you are on a low-phosphorus or low-potassium diet, you should keep a daily food journal that tracks your consumption of these minerals. Since labels do not indicate how much phosphorus and potassium are in foods, you should use a resource such as the USDA National Nutrient Database to determine what foods are safe for you to eat.
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Nutritional Supplementation for Kidney Disease
The following is a list of the key nutrients that your kidneys require. However, you should get most of these nutrients via your food -- not from nutritional supplements.

If you decide to take any supplements, make certain that they are whole food supplements, not synthetic, as synthetic supplements are not good for the kidneys. If necessary, get the Nutritional Supplements & Super Foods ebook to help you.

Vitamins for Kidney Disease:
-- Vitamin A – helps healing process of urinary tract lining
-- Vitamin B complex – helps fluid metabolism
-- Vitamin C – boosts immunity and elevates urine acidity
-- Vitamin E – elevates immune system
-- Zinc – immunostimulant

Minerals for Kidney Disease:
-- Calcium – helps body use all minerals in synergy
-- Magnesium – see calcium
-- L – Arginine – aids kidneys
-- L-Methionine – helps circulation within kidneys
-- Multi-enzyme complex – aids digestion
-- Potassium – stimulates kidney function, but may need to be avoided

Herbs for Kidney Disease:
-- Buchu Tea
-- Dandelion Root (pu gong ying) – aids kidney excretion function of waste
-- Cranberry – acidifies urine and kills bacteria
-- Celery and Parsley – diuretic (decreases uric acid)
-- Hydrangea – natural diuretic – cleanses urinary tract
-- Uva Ursi – natural diuretic – cleanses urinary tract – germicidal
-- Marshmallow Tea – cleanses kidneys
-- Goldenrod tea, juniper berries, stinging nettle, parsley, red clover, watermelon seed tea are all good for kidney disease.

Note: HerbDoc has powerful herbal tinctures for the kidneys, liver and other organs:http://www.herbdoc.com/
                                                                                                          

Chinese Medicine and Kidney Disease

A healthy exercise program can be an important part of proteinuria treatment, especially if high blood pressure is a concern. Staying in good physical shape can often reduce blood pressure levels and may sometimes keep the patient from needing to take prescription blood pressure medications. A naturopathic doctor can help the patient decide on a healthy exercise plan based on the overall health of the patient. Any questions or concerns related to proteinuria treatment options should always be directed to a doctor or other medical professional.

Patients with nephrotic syndrome and fluid overload should have a salt-restricted diet. A "no-added-salt" diet usually is sufficient, although some patients may need restrictions of up to 40 mmol/day.

The issue of dietary protein restrictions is controversial. Evidence indicates that protein restriction may slow the rate of deterioration in the GFR in patients with glomerular diseases, including diabetic nephropathy. The presumed mechanism is a reduction in intraglomerular pressure.
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Wellness Protocols to Prevent Diabetic Complications        

The Death to Diabetes Wellness Program consists of 10 steps, 6 stages, and 3 levels of discipline that includes a detailed set of wellness protocols that can stop the rot and reverse many of these diabetic complications -- as long as you don't wait too long to start the program.

If you are experiencing one or more of the major diabetic complications, you should follow a very strict program that requires you to use Level 3 of the program and implement all 10 steps of the program [Ref: Chapter 16, Page 329]. This is mandatory if you want to protect your eyes, kidneys, legs, and other organs from further damage!

Implementing Level 3 and all 10 steps includes increasing your intake of raw foods, adding high quality nutritional supplements such as CoQ10, alpha lipoic acid, evening primrose oil, and Omega-3 EFAs; and, adding super foods such as flaxseed, wheat grass, and chlorella. Also, you must eliminate your intake of the 5 "dead" foods, including wheat, flour, sugar, vegetable oils, processed foods, and animal meat.

You should also go through a major detox/cleanse and, if necessary, use organic herbal tinctures for your eyes, kidneys, and nerves to complement your raw food nutritional program. If you don't know where to purchase herbal tinctures and high quality supplements, contact our office or get the Nutritional Supplements Brand Names ebook.

In addition, it is imperative that you work with a knowledgeable diabetes health coach and gradually wean off as many of the toxic diabetic drugs and other drugs as soon as possible -- to prevent further damage to your eyes, kidneys, nerves, heart, etc.

Refer to Chapter 15 of the Death to Diabetes book, which provides a detailed step-by-step procedure that addresses each of the major diabetic complications; and, identifies the key foods, nutrients and supplements for each diabetic complication.

Prescription Drugs -- The Answer?

Prescription drugs help to (artificially) lower your blood pressure, blood glucose, and cholesterol -- but, are they really the answer to you improving your health? Go to the following web pages for more information about the danger of prescription drugs:
Note: If you want to safely wean off these dangerous drugs, start a sound nutritional program and get the How to Wean Off Drugs Safely ebook.

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  1. Parving H, Mauer M, Ritz E. Diabetic Nephropathy. In: Brenner BM. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 36.
  2. American Diabetes Association. Standards of medical care in diabetes--2010.Diabetes Care. 2010 Jan;33 Suppl 1:S11-61.
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  8. a b The ONTARGET Investigators; Yusuf, S; Teo, KK; Pogue, J; Dyal, L; Copland, I; Schumacher, H; Dagenais, G et al. (2008). "Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events". New England Journal of Medicine 358 (15): 1547–59. doi:10.1056/NEJMoa0801317PMID 18378520.
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