An Integrative Medicine Approach to Kidney Disease

According to the National Kidney Foundation, about 37 million people in the United States have kidney disease, with many of them not aware of it. Additionally, kidney disease is the ninth leading cause of death in the country. Therefore, it is essential to raise awareness about kidney disease and encourage regular kidney screenings.

Kidney disease is a serious condition that affects the normal functioning of the kidneys, two vital organs responsible for removing waste products and excess fluids from the body. The condition can lead to a buildup of toxins in the body, which can cause serious health complications, including kidney failure, that can be life-threatening. A variety of factors, including genetics, underlying medical conditions, and environmental factors, can cause kidney disease. This article will discuss what kidney disease is, the causes of kidney disease, the various treatments for kidney disease, and how to test and monitor it. 

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What is Kidney Disease?

Kidney disease, also known as renal disease, is a condition that affects the normal functioning of the kidneys. The kidneys are two small bean-shaped organs located on either side of the spine and are essential organs responsible for removing waste products and excess fluids from the body. When the kidneys are damaged or diseased, they can no longer perform their vital functions, leading to a buildup of toxins in the body. This can cause serious health complications, including kidney failure, which can be life-threatening. Kidney disease can affect people of all ages and can be caused by a variety of factors, including genetics, underlying medical conditions, and environmental factors. 

There are two main types of kidney disease: acute kidney injury (AKI) and chronic kidney disease (CKD). AKI occurs suddenly and can be caused by a severe infection, a blocked urine flow, or a medication or drug that harms the kidneys. CKD, on the other hand, is a long-term condition that develops over time and can lead to permanent kidney damage. Diabetes, high blood pressure, and obesity are common causes of CKD. 

There are five stages of CKD, ranging from mild kidney damage (Stage 1) to complete kidney failure (Stage 5). In Stage 1, there is kidney damage, but the kidneys still function normally. In Stage 2, kidney function is slightly reduced, but most people do not experience any symptoms. In Stage 3, kidney function is significantly reduced, and symptoms may start to appear. In Stage 4, kidney function is severely reduced, and patients may need to start preparing for dialysis or a kidney transplant. In Stage 5, also known as end-stage renal disease, the kidneys have failed, and patients require dialysis or a kidney transplant to survive.

It is essential to diagnose and manage CKD early to help prevent further damage and complications. Regular kidney function tests can help detect CKD in its early stages, allowing for early intervention and management. 

Kidney Disease Symptoms

Kidney disease can cause a range of signs and symptoms that may vary depending on the underlying cause. These may include fatigue, swelling in the legs, ankles, feet, or face, shortness of breath, difficulty concentrating, increased or decreased urination, blood in the urine, foamy or bubbly urine, high blood pressure, loss of appetite, nausea and vomiting, and itching. However, in the early stages, kidney disease may not produce any symptoms, making it difficult to detect without regular medical checkups.

It is important to note that these symptoms may also be attributed to other health conditions. Therefore, if experiencing any of these symptoms or have any concerns about kidney function, it is essential to speak with a healthcare professional. If left unmanaged, kidney disease can lead to kidney failure, which can be life-threatening. 

What Causes Kidney Disease?

A range of factors, including genetics, lifestyle, and diet, can contribute to kidney disease. Some people may be more susceptible to developing kidney disease due to a family history of the condition. Inherited genetic disorders, such as polycystic kidney disease, can also lead to kidney damage and disease. However, two of the most common contributors to kidney disease are diabetes and high blood pressure. These conditions can affect the blood vessels in the kidneys, leading to reduced kidney function over time.

Lifestyle factors, such as smoking, alcohol consumption, and lack of exercise, can also contribute to the development of kidney disease. Diet is also an important factor in kidney disease. A diet high in sodium and processed foods can increase the risk of high blood pressure, which can affect the kidneys. Additionally, diets high in protein can put a strain on the kidneys and lead to kidney damage over time. Other causes include medications that are toxic to the kidney, infections, and heavy metal exposure. 

Functional Medicine Labs to Test for Root Cause of Kidney Disease

Early detection and intervention are key to slowing the progression of kidney disease and preventing complications. Healthcare providers use two main tests to check for kidney disease: a blood test and a urine test. The blood test measures the glomerular filtration rate (GFR), which indicates how well your kidneys are filtering your blood. The GFR is an important indicator of kidney function, and a low GFR can be a sign of kidney disease.

The urine test checks for the presence of albumin, a protein that can pass into the urine when the kidneys are affected. This test is important because early kidney disease may not cause any symptoms, but the presence of albumin in the urine can indicate early changes in the kidneys.

Functional medicine lab tests can help detect early signs of kidney disease and can provide valuable insights into kidney function and overall health, allowing for personalized management approaches and improved outcomes. Some of the key functional lab tests used to assess kidney function include:

Comprehensive Metabolic Panel (CMP) 

A CMP is a blood test that measures various substances, including electrolytes, glucose, and proteins. It is often used to assess kidney function, as the levels of certain electrolytes, such as sodium, potassium, and calcium, can indicate how well the kidneys are working to maintain a balance of these substances in the body. It will also contain information on BUN (blood urea nitrogen) and creatinine, which are waste products filtered out of the blood by the kidneys. These levels show how well the kidneys are working.

The Glomerular filtration rate (GFR) will also be included in this test which is one of the primary tests for kidney function. GFR is a measure of how well the kidneys are filtering waste products from the blood. A GFR below 60 mL/min/1.73m2 is an indicator of reduced kidney function. A CMP will also assess Albumin levels. Albumin is a protein found in the blood. A healthy kidney doesn't let albumin pass from the blood into the urine. A damaged kidney lets some albumin pass into the urine. A CMP may also be used to monitor the side effects of certain medicines, which can be a contributing factor to kidney disease. 

Microalbumin Urinalysis 

This test examines a urine sample for the presence of albumin, mentioned above, that may indicate kidney changes.

Urine Culture 

This urine test will assess for pathogens that can cause urinary tract infections which can lead to kidney disease if not properly managed.

Hair Elements Test 

This hair analysis can assess exposure to toxic metals, including lead. Lead exposure is one of the contributors to kidney disease. 

Diabetes Panel 

This panel can assess markers of diabetes to help prevent or monitor diabetes. This test should be utilized if diabetes is considered to be a contributor to kidney disease. 

If you are diagnosed with kidney disease, your healthcare provider will continue to use the GFR test along with albumin to monitor your kidney function and to ensure that your management plan is working effectively. Regular monitoring of kidney function is crucial in preventing further changes and complications associated with kidney disease.

Conventional Management for Kidney Disease

Prevention is key in managing kidney disease. Individuals can reduce their risk of developing kidney disease by maintaining a healthy weight, controlling their blood pressure and blood sugar levels, and avoiding smoking and excessive alcohol consumption. Early detection and management of kidney disease are crucial to prevent complications such as heart disease, anemia, and bone disease.

Management may include medication, lifestyle changes, and in some cases, dialysis or a kidney transplant. In the early stages of kidney disease, medication and lifestyle changes can often slow down the progression of the disease and help prevent further changes to the kidneys.

Conventional management for kidney disease varies depending on the stage and underlying cause of the condition. Some common management strategies include:

Medications 

Medications may be prescribed to control blood pressure, reduce proteinuria (caused by high blood pressure or diabetes), and manage symptoms associated with kidney disease.

Dialysis 

Dialysis is a medical procedure that involves removing waste products and excess fluid from the blood when the kidneys are no longer able to do so on their own.

Kidney Transplant 

In some cases, a kidney transplant may be recommended for individuals with end-stage kidney disease.

Lifestyle Changes 

Lifestyle changes, such as maintaining a healthy diet, getting regular exercise, and quitting smoking, can help slow the progression of kidney disease and improve overall health.

Management of Underlying Conditions 

Management of underlying conditions, such as diabetes and high blood pressure, is essential in managing kidney disease.

It is important to work closely with a healthcare provider to determine the most appropriate management plan based on individual needs and circumstances.

Integrative Nutrition for Kidney Disease

Diet plays a critical role in the prevention and management of kidney disease. The National Institute of Diabetes and Digestive and Kidney Diseases recommends several dietary strategies to help manage chronic kidney disease (CKD) and reduce the risk of complications:

Limit Protein Intake 

Consuming too much protein can increase the workload on the kidneys and accelerate the progression of kidney disease. Limiting protein intake to a moderate amount can help slow the progression of CKD. A low-protein diet consisting of 0.6–0.8 g/kg/day is often recommended for the management of CKD. 

Monitor Sodium Intake 

High sodium intake can contribute to high blood pressure, which can affect the kidneys. It is recommended to limit sodium intake to less than 2,300 mg per day.

Increase Intake of Fruits and Vegetables 

Fruits and vegetables are rich in vitamins and minerals that are important for kidney health. Aim to consume a variety of fruits and vegetables each day. It is recommended to eat more than 6 servings per day to have the most improvement in risks associated with kidney disease. 

Limit Potassium and Phosphorus Intake 

In advanced stages of CKD, the kidneys may have difficulty regulating potassium and phosphorus levels in the blood. Limiting the intake of high-potassium and high-phosphorus foods can help prevent complications. High potassium foods are those that contain more than 200 milligrams of potassium per serving. Some examples of high potassium foods include bananas, oranges, avocados, tomatoes, spinach, potatoes, and yogurt. High phosphorus foods are those that contain more than 100 milligrams of phosphorus per serving. Some examples of high phosphorus foods include dairy products, such as milk, cheese, and yogurt, as well as meats, fish, poultry, beans, nuts, and whole grains.

Limit Fluid Intake 

In advanced stages of CKD, the kidneys may have difficulty regulating fluid levels in the body. Limiting fluid intake can help prevent complications such as edema and shortness of breath.

In addition to the general dietary strategies mentioned earlier, there are specific diets that have been shown to be beneficial for kidney health.

Mediterranean Diet 

The Mediterranean diet is a heart-healthy diet that emphasizes fruits, vegetables, whole grains, fish, and healthy fats such as olive oil. This diet has been shown to support kidney function and reduce the risk of kidney disease.

DASH Diet 

The Dietary Approaches to Stop Hypertension (DASH) diet is another heart-healthy diet that emphasizes fruits, vegetables, whole grains, and low-fat dairy products while limiting salt, sugar, and saturated fats. The DASH diet has been shown to help manage blood pressure and support kidney function.

Low-Protein Diet 

In the advanced stages of kidney disease, a low-protein diet may be recommended to reduce the workload on the kidneys. This type of diet limits protein intake to a moderate amount and emphasizes fruits, vegetables, and healthy carbohydrates.

It is important to note that dietary strategies should be individualized based on an individual's health status and medical history. Working closely with a healthcare provider that specializes in clinical nutrition or a registered dietitian to develop an individualized nutrition plan based on individual needs and health status is key to developing a safe and effective nutrition plan for managing kidney disease.

Overall, a healthy diet and lifestyle are essential for preventing and managing kidney disease. By making dietary changes and working closely with healthcare providers, individuals with kidney disease can take control of their health and improve outcomes.

Supplements & Herbs for Kidney Disease

Patients with kidney disease need to exercise caution when taking herbal supplements or avoid them altogether, as some of them can be harmful to the kidneys and worsen the disease. While herbal supplements are marketed as natural and safe, this is not always the case. Therefore, the National Kidney Foundation and Academy of Nutrition and Dietetics recommend avoiding certain herbal supplements that are particularly risky for people with kidney disease, such as astragalus, barberry, cat's claw, Apium graveolens, creatine, goldenrod, horsetail, huperzinea, java tea leaf, licorice root, nettle, stinging nettle, Oregon grape root, parsley root, pennyroyal, Ruta graveolens, uva ursi, and Yohimbe. There are also many herbal supplements that contain phosphorus and potassium, such as feverfew, bitter melon, and American ginseng. 

In addition to herbal supplements, certain vitamins and minerals should also be avoided or taken in moderation by people with kidney disease. For instance, vitamins E, A, K, and C, and calcium can be harmful to people with kidney disease. 

Although most supplemental herbs and vitamins should be used with extreme caution or avoided by individuals with kidney disease. Some supplements have been shown to be helpful. 

Omega-3 Fatty Acids 

Omega-3 fatty acids at 1-6 grams have properties that may help support kidney health by reducing inflammation in the kidneys. 

Vitamin D 

Vitamin D is important for bone health and has also been shown to have benefits for kidney function. Many people with chronic kidney disease are deficient in vitamin D and are at a suboptimal level. Vitamin D supplementation may help support kidney health by attaining serum levels of 40-80 ng/ml.

Probiotics 

Probiotics are beneficial bacteria that can help improve gut health. Some research has suggested that probiotics may also have benefits for kidney health by supporting a healthy inflammatory response and oxidative stress. The main strains for CKD management were Lactobacillus and Bifidobacterium genera in doses of 2 to 10 billion CFUs. 

Patients with kidney disease should consult with their healthcare provider before taking any dietary supplements, including vitamins and minerals, to ensure that they are safe and do not interfere with other medications or treatments. Patients must inform their healthcare provider about any supplements they are taking, as this information can help prevent potential harm and improve overall care. It is important to note that these should not be used as a substitute for conventional medical management and should only be used under the guidance of a healthcare provider.

Complementary and Alternative Medicine for Kidney Disease

Complementary and alternative medicine (CAM) is a term that refers to medical therapies or practices that are outside of conventional Western medicine. CAM therapies such as yoga, meditation, and acupuncture can be used as supportive therapy to conventional management for kidney disease. These therapies have been shown to reduce stress, improve quality of life, and alleviate some symptoms associated with kidney disease.

UCLA Health found that regular practice of yoga and mindfulness meditation supported kidney function and quality of life in patients with chronic kidney disease. Acupuncture has also been shown to support kidney function and elevate lab values associated with kidney disease. Acupuncture is gaining attention among clinicians and scientists as an inexpensive and convenient complementary therapy for CKD. While clinical trials and meta-analysis have shown that acupuncture can reduce albuminuria, improve glomerular filtration rate, relieve symptoms, and enhance the quality of life of CKD patients, the underlying mechanisms are not fully comprehended. It is important to consult with a healthcare professional before using CAM therapies, especially if you have kidney disease, as some therapies may not be safe or effective for everyone.

Summary

Kidney disease, whether acute or chronic, can lead to severe complications, including kidney failure, which can be life-threatening. Various factors, such as genetics, underlying medical conditions, environmental factors, and lifestyle choices, can contribute to it. Regular kidney function tests can help detect the condition early, enabling early intervention and management. 

Preventative measures such as maintaining a healthy weight, controlling blood pressure and blood sugar levels, avoiding smoking and excessive alcohol consumption, regular physical activity, and a low-salt, low-processed food diet can significantly reduce the risk of developing kidney disease. Management for kidney disease may involve medication, dialysis, kidney transplant, and lifestyle changes. 

Working closely with a healthcare provider to determine the most appropriate management plan based on individual needs and circumstances is essential. Early detection and management of kidney disease are crucial in preventing complications such as heart disease, anemia, and bone disease. If you are at risk or suspect you may have kidney disease, speak to your healthcare provider about getting tested.