I would like to introduce to you to a fellow naturopath, Joel Le Blac. Joel hails from the land of Hobbits, Elves, and Wizards… New Zealand (for those of you who don’t know, the Lord of the Rings was filmed here).

I am really excited to welcome Joel’s expertise on my website, as it adds further experience and knowledge for you to benefit from. Why have I decided to welcome Joel in particular to my website? Well, Joel is a practicing herbalist and owner of a natural health clinic in NZ, he is an accomplished writer in many health magazines and journals (and poet I might add), and has a particular interest in kidney health.

So if you could please give Joel a huge welcome…

Organic fruit and vegetables seem to be a cleaner and greener food choice, but does choosing organic actually provide any health benefits for your kidneys? For years, the research on whether or not organic foods are better for you has vacillated. I’ve seen studies that shown purchasing organic foods makes absolutely no benefit to human health, while still yet there are studies that show organic foods are significantly higher in antioxidants, vitamins, minerals, while also being lower in pesticides and bacteria.

In one particular study that always stayed with me, scientists in Spain found that organic strawberries had 76% more vitamin C than non-organic strawberries. Considering that many people eat strawberries for their high vitamin C and antioxidant levels, it’s good to know.

Recently, though, Stanford University came along and burst the bubble of organic foodies everywhere. After looking at a whopping 223 studies on organic foods, the boys (and girls) at Standford University concluded that there was little difference in the nutrition of organic vs. non-organic foods. With two exceptions — phosphorus and omega-3. (keep reading if you want to know why it is important to go organic).

Are High Phosphorus Levels Dangerous?

Some corners have expressed concern that organic fruits and vegetables are higher in phosphorus than their non-organic counter-parts. And it is true; a high phosphorus intake can be dangerous in some cases where chronic kidney disease is present. But you have to take it into perspective. There is lot more phosphorus from carbonated beverages than from organic vegetables, not to mention the phosphorus present in certain food preservatives, meats and dairy. Organic fruits and vegetables contain a range of vitamins, minerals, fibre, water, and antioxidants — all beneficial things if you are looking after the health of your kidneys.

If you are suffering from a late-stage kidney problem, are currently on dialysis, or have been warned by your doctor about your phosphorus intake, then it is good to stay on top of what is high in phosphorus and what is not. But the researchers from Stanford University confirmed, the increase in phosphorus in organic foods was noticeable, but not clinically significantly — meaning, it is unlikely to affect human health.

Omega-3 — Not Just a Panacea

Omega-3 seems to fix just about everything these days, doesn’t? It does matter if you have a broken bone or a migraine; omega-3 is the answer. While fruits and vegetables do not contain much in the way of omega-3, other sources, such as free range eggs and wild fish, are good sources of omega-3. A few years ago scientists noticed that free range eggs were more nutritious than conventional eggs from caged hens. Free range eggs were higher in omega-3, omega-6, vitamin E, A and antioxidants. A more diverse diet consisting of seeds, weeds, grass and bugs is likely the cause.

This isn’t just significant for children with eczema — it affects adults with kidney problems as well. Studies show that omega-3 supports a wide variety of kidney problems. Older adults in Italy with the highest levels of omega-3 in the blood had the lowest creatinine clearance levels. Omega-3 supplements are also known to prevent skin problems associated with dialysis, and to reduce protein in the urine in patients with nephropathy.

So, if you are looking to protect your kidneys with omega-3, it may pay to reach for that little bit dearer brand of free-range eggs next time you are in the supermarket.

Pesticide Residues and Kidney Health

Organic fruits and vegetables have 30% less pesticide residues. So what? Many types of pesticides, including DDT and dioxin which are still present in the environment, are absorbed into human fat cells, and stay stored there for years, if not decades. No one yet fully knows the effects of multiple types of pesticide interacting with each other inside the human body. Men and women exposed to pesticides through their jobs, such as workers on seasonal farms or in chemical plants, have shown in studies to have impairment of both liver and kidney function. Various studies have already linked environmental pesticides in the body with an increased risk of type II diabetes, heart disease, neurological disease and obesity. And you know what? Maybe more data and research is still needed, but I don’t expect to see a study anytime soon explaining how the pesticides on our apples and strawberries are good for us.

Where To Go From Here?

Organic foods are way more expensive to purchase than conventional foods, which is prohibiting for a lot of people. If you are suffering from kidney problems, it is important to take what steps you can to reduce exposure to environmental toxins. If you don’t feel you can eat organic 100% of the time, then focus on some of the “dirty dozen,” as labelled by the Environmental Working Group in the USA.

Currently the dirty dozen list includes (in descending order) apples, celery, sweet bell peppers, peaches, strawberries, nectarines, grapes, spinach, lettuce, cucumbers, blueberries and potatoes. These foods contain more pesticide residues than others (notice strawberries in the top 5!), so taking a look at this list will give you a good place to begin your journey towards organic living.

You may be living with one kidney and not even know it.

Being born with just one kidney isn’t common, but it does occur in about 1 in 1000 people, according to the National Kidney Foundation. Having half of your renal system missing might sound like something you, or somebody, would notice. But in actual fact, you can live quite a normal, healthy life with a solitary kidney.

That’s not to say that you don’t have to take some special care of yourself, in order to keep your kidney strong and healthy. But it certainly is not a death sentence. Playing sport, traveling, having children, having fun — it’s all possible.

The trick is to maintain a kidney-friendly lifestyle, go for regular kidney function tests, and avoid sports or activities (e.g. skiing, kickboxing, cliff diving, gladiators, etc.) that may put the kidneys in danger of being injured accidentally.

If you take care of your kidney, there is no reason for it not to serve you well for the rest of your long life.

How does it affect overall health?

I’m not going to lie — people with just one kidney, either from birth defect or surgery, have extra health issues to face. When born with a solitary kidney, often it functions perfectly well for a number of years. However, as the years goes on, kidney function begins to deteriorate.

The New York University School of Medicine funded a study on adults with solitary kidney, showing:

– 8% have increased protein in the urine,
– 21% have increased creatinine levels,
– 20%-50% have high blood pressure.

Oddly, though, having one kidney is not linked to a shorter life expectancy.

Nevertheless, these statistics from show that a single kidney can slowly begin to deteriorate over the course of a lifetime. While children may show normal kidney function, the lifestyle of an adult with alcohol, smoking, medications, obesity, malnourishment, little exercise and poor dietary choices takes its toll.

There is only one kidney to handle all the waste products, acids, toxins, and fluids that the body has to process. To compensate, the remaining kidney nearly doubles in size. I don’t know about you, but that really knocked me when I learned that!

Luckily, the kidney handles all this added pressure beautifully. Under normal circumstances when subjected to a healthy lifestyle, there is no reason for one kidney not being able to do the job of two. It’s an amazingly resilient organ. Put too much pressure on it, ask too much of it, and it will eventually wear out.

Lifestyle Protocols

Do you enjoy playing sport? Or are you concerned that one of your children, or someone else you know, has only one kidney and may not be able to play sport? Well, the good news is that sports are not off the menu. For years doctors have told parents of children with solitary kidney not to let them play sport, for fear of causing physical damage to the kidney. When you think about football, rugby, and how violent these sports can get, it’s no wonder.

However, the University of Virginia School of Medicine published a recent study showing that the risk of damage to the kidneys during such contact sports were “extraordinarily small.” Some physical activities, such as horseback riding, skiing and bicycling, were actually much riskier to the kidneys than sports like football, which doctors are often focused more on discouraging.

It’s great to play sport and have a fit and active lifestyle. Just be careful if you are playing contact sports. It’s not risk free, but it is a relief for many people to know that (according to the researchers) the risk of physical injury to the kidneys is incredibly low.

Dietary Advice

Diet is something that should take up a much more significant amount of time and thinking. While sport may or may not cause problems in the future, it is possible to do harm to your kidney each and every single day, on a smaller scale, with your choices of food and drink.

Doctors often put patients with one kidney onto a low-protein (or protein restriction diet). The idea behind this is to reduce the extra burden that protein places on the kidneys, as well as the load of acids that the kidneys have to process each day. While it sounds like a good idea, it is not actually based on any evidence. Restricting proteins is a dietary measure intended for people with proven kidney disease or dysfunction, as shown via a creatinine clearance test. It does not benefit a healthy kidney, and the risk of malnutrition causes more problems than it fixes.

Here are some more specific dietary ideas that are more likely to support long-term solitary kidney health:

• Drink NO soft drinks whatsoever. Phosphorus, artificial sweeteners, sugar, colouring, and preservatives are all problematic for the kidneys to excrete.
• Reduce red meat intake to twice a week.
• Avoid alcohol and tobacco. They are toxic to the kidneys.
• Control sodium intake. Sodium is not just in “salty foods” like seafood, snacks, meats, crackers, and chips, but also hidden in bread, muesli bars, pre-packaged meals, sauces, soups, and sports drinks.
• Reduce or eliminate refined carbohydrates (think white: white sugar, white flour, white rice, etc) which are linked with decreasing kidney function.
• Eat plenty of oily fish, linseed, chia seed, and dark leafy greens. Omega-3 oils from these foods have shown to protect kidney function substantially.
• Avoid recreational drugs, and use medications only when necessary and prescribed by a doctor. Even common over-the-counter medications, such as aspirin, is toxic to the kidneys. Many prescription medications, including NSAID’s and antibiotics, are also toxic to the kidneys.
• Opt for herbal tea instead of coffee or black tea, which are irritating to the bladder and kidneys. Nettle, goldenrod, raspberry leaf, yarrow, marshmallow root, cornsilk, and green tea may be beneficial for overall kidney function.

Onwards and Upwards

The U.S. National Kidney and Urologic Diseases Information Clearinghouse recommends having frequent checkups with your doctor to keep track of kidney function. It’s important to have regular renal function tests (urine analysis, eGFR and creatinine clearance) from your physician to see how your kidneys are doing, as well as blood pressure tests.

There is no reason you can’t live a perfectly normal life with one kidney, just like all the people around you who stroll around leisurely with their two-kidneys. It’s just about looking after yourself, and being sensible. Eat well, avoid injury, and keep track of your kidney function. Don’t wait for kidney problems to arise. Be a friend to your kidney and look after it, and it will look after you.

I would like to introduce to you once again, registered nurse, Lynda Lampert. Lynda’s article The Definitive Guide To Dialysis: Types Of Dialysis, Indications, Side-Effects And More got a great reponse, so I have asked her back to continue where she left off. I have asked her talk to about the guidelines for a healthy hemodialysis diet. She jumped at the chance to talk to you, so please welcome Lynda back…

As a nurse in a hospital, I got the chance to see many patients come and go who were on hemodialysis for kidney failure. Most of the time, patients go to dialysis and have no problems with it, but when I got to see them, it was usually because something went wrong.

Unfortunately, this is often caused by patient noncompliance with treatment. The number one reason for patients to end up in my hospital, in my unit was because they skipped a dialysis day. The close second reason was that they did not follow their hemodialysis diet plan.

Hemodialysis and diet go hand in hand. If you do not follow the recommendations set down for you by your kidney doctor and your dietician, you will end up in the hospital. It’s just that simple. Your kidneys are the organ that filters all the waste and fluid from your body. They regulate the various chemicals that can harm you when present in great amounts. When you don’t have your kidneys to protect you, you have to carefully monitor what you put into your system. Don’t give your kidneys more problems than they already have. If you follow these guidelines for eating correctly on hemodialysis, you will have a smooth sailing treatment experience.

Fluid Restrictions

When you are told you have kidney disease, your doctor will most likely put you on a fluid restriction. This is because the kidneys are just not able to move the fluid off of your body. When you drink too much fluid, a number of symptoms will appear:

• Weight gain
• Shortness of breath
• Congestive heart failure
• High blood pressure
• Swelling

These symptoms are all because the fluid is backing up in your system and causing it to work harder than it normally would have to. This is why it is so important to follow the hemodialysis diet restrictions that your care team sets for you. You could literally drown yourself with water if you do not heed your restrictions. Common restrictions are for:

• 1000 mL
• 1500 mL
• 2000 mL
• 2500 mL

Your doctor will determine which level you need by evaluating your kidney function and how well hemodialysis will remove water from your body. You cannot move these numbers about or learn from the internet how much to drink. Instead, you must have an honest discussion with your doctor about how much you can drink. They use a complicated algorithm based on your medical history to determine your fluid levels. Remember, fluids includes:

• Milk
• Water
• Soda
• Soup
• Jell-O
• Some fruits and vegetables

Sodium

Your sodium intake is another important consideration when thinking about your fluid levels. Sodium is like a sponge, and it will hold on to water and cause you symptoms of retention despite restricting fluid. Again, you doctor will determine for you how much sodium you are allowed to have per day. Most doctors recommend a level between 2,000 and 3,000 mg, depending on your kidney function. Obviously using a salt shaker will increase your sodium intake, but some foods have hidden sodium, such as:

• Soups
• Luncheon meats
• Fast food
• Processed food
• Canned food
• Dressings
• Sauces

You don’t have to eat a bland diet, but you do have to exercise caution when cooking. Don’t reach for salt substitutes, either, as these are often high in potassium. Instead, look into herbs and seasonings that don’t have a high sodium or potassium content. For instance, you could try basil instead of salt on your foods.

Calorie Requirements

Your calorie requirement will depend a great deal on your weight and diabetic status. If you are overweight, your doctor may ask you to restrict your calories to lose the weight and take some pressure off of your body. Most doctors recommend calorie restrictions in the following categories:

• 2200 calories
• 2000 calories
• 1800 calories

You should not attempt to eat any less than these guidelines because your body needs the nutrients from food to function after hemodialysis. The procedure can take a toll on a person, and eating enough calories is sometimes the only thing that gives you enough energy. However, overeating is bad for your kidneys because you gain weight, you exacerbate your diabetes, and you run the risk of eating too many nutrients, such as potassium or sodium.

One important consideration to make in planning your meals is the amount of protein you are taking in. Your body needs protein for muscle building, energy, and repair. In fact, your body is incapable of making certain chemicals, called amino acids, on its own. It needs to get them from proteins every day. Some foods that are high in protein are:

• Beef
• Chicken
• Fish
• Milk
• Cheese
• Beans

Unfortunately, the processing of proteins causes a waste product to accumulate in the body. The kidneys are responsible for removing this waste product, and if they are not working correctly, your body can build up toxic amounts. For patients who have kidney disease that does not require dialysis, your protein should be restricted to between 10 and 15 percent of your total calories. On dialysis, though, your body needs the extra protein to repair cells damaged in the procedure. Your doctor and dietician will likely recommend higher amounts of protein in this case.

Requirements of Major Nutrients

Potassium

Potassium is another nutrient that can build up in your body to toxic amounts. Usually, the kidneys filter the blood and keep the potassium regulated. On hemodialysis, your blood is also filtered to remove excess potassium, but you still should keep your potassium intake low because your kidneys are just not able to process it. Some dangers of high potassium levels include:

• Nausea
• Weakness
• Numbness
• Irregular heartbeats
• Heart failure
• Sudden death

As you can see, you need to be careful when planning your meals to avoid getting too much in your diet. Many foods are high in potassium, so you need to watch your intake of them very carefully. Your doctor will tell you just the right amount of potassium to eat each day, but usually less is better. Your kidneys won’t filter it out the potassium, and hemodialysis only occurs every other day. This is long enough to cause dangerously high potassium levels. Stay away from foods such as:

• Salt substitute
• Bananas
• Oranges and Orange Juice
• Prune Juice
• Dried Peas
• Potatoes
• Tomatoes
• Cooked Spinach
• Vegetable Juice
• Milk
• Yogurt
• Chocolate
• Nuts

Some tips for foods you can at that are low in potassium include:

• Apples
• Grapes
• Peaches
• Carrots
• Lettuce
• Green Beans

Phosphorus

Another nutrient that you need to watch when on hemodialysis is phosphorus. Your body can build up a toxic amount of this nutrient which can cause problems with the bones. In fact, some doctors even prescribe a drug that binds to phosphorus in foods to prevent it from building up in your bloodstream. Some side effects of high phosphorus include:

• Bone pain
• Heart problems
• Low calcium levels
• Itching
• Hardening of soft tissue

You should stay away from foods that are high in phosphorus, such as:

• Milk
• Cheese
• Cola
• Chocolate
• Bran
• Whole grain breads
• Pizza
• Nuts
• Processed meats

Some of these foods are on other restricted lists, too, so it makes it easier to plan meals. However, it is often difficult to plan a hemodialysis diet that takes all of these restrictions into consideration. That’s why a good dietician will help you to plan your diet to incorporate your favorite foods and still stay in compliance with your doctor’s restrictions. Some foods that are low in phosphorus include:

• Fresh fruits and vegetables
• Unsalted popcorn
• Corn and rice cereals
• White rice
• Rice milk
• Home-brewed iced tea

Importance of Alkalizing Foods

One more important job your kidneys do for you is regulating your acid-base balance. Your body requires a specific pH to function. In fact, it prefers to be just slightly alkaline – or towards the base end of the spectrum. Your kidney filters out nutrients, such as potassium, that make your blood become too acidic. Some signs of acidosis include:

• Chest pain
• Palpitations
• Headache
• Nausea
• Vomiting
• Weight loss
• Confusion

When your kidneys are failing, they are unable to keep your blood in this tightly controlled range. You can help your body by not giving it foods that are likely to cause your pH to dip towards the acidic end of the range. Some foods that are alkaline, yet low in phosphorus and potassium, are:

• Apples
• Cucumbers
• Lettuce
• Cabbage
• Green beans
• Carrots
• Grapes
• Pears
• Cauliflower
• Cherries

Planning a hemodialysis diet can be challenging, especially if you have to control other processes like diabetes and weight loss. For this reason, it is absolutely vital that you are comfortable with your kidney team, including your doctor and dietician. You need to express to them the challenges you are facing as you approach your hemodialysis diet plan and come up with strategies to minimize these problems.

References

DaVita; The Hemodialysis Diet
http://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/the-hemodialysis-diet/e/5314

Polycystic Kidney Disease Diet; Alkaline Diet List
http://www.pkdiet.com/pages/diet/dietalkalinelist.htm

DaVita; Fruits and vegetables help delay kidney disease progression in early stages
http://www.davita.com/kidney-diet-tips/?tag=fruits-and-vegetables-in-kidney-disease

I would like to introduce to you to registered nurse, Lynda Lampert. I’ve invited Lynda to share some of her experiences and knowledge as a nurse in a busy city hospital for today’s article on all things ‘dialysis’. I’ve never accepted a guest post on this blog before, but when I have access to someone who has been in the “trenches” of a busy hospital, working with dialysis patients, and can present this information in a way that can help those in the kidneycoach community… well, I’d be crazy not too.

Lynda graduated top of her class in nursing school, and has enjoyed researching ever since. Lynda: “I’ve written for Livestrong and Ehow, in addition to numerous private clients. I am currently working on an query for a national magazine and interviewing experts, such as doctors and patients. I enjoy researching health, supplements, diet, fitness, and other medical related topics.”

And so I welcome the first of hopefully many guest posts by Lynda, to help give fresh insights into kidney disease in the hope to better your health and living.

Take it away Lynda!

Your doctor looks at you kindly, but you can sense a hesitation in his eyes. You get the foreboding feeling that what he has to say next is not going to be something you want to hear. You have kidney failure. In fact, your kidneys are not working very much at all. I can tell you that I have treated many patients who have come to me with the same dire warning from their doctor. It isn’t the end of the world, however. It means that you need to start dialysis.

Dialysis is likely a dirty word to anyone who has ever had problems with their kidneys. You think, “If only I could avoid dialysis.” It is true that it is a complex, sometimes intrusive procedure, but it can actually save your life. You shouldn’t think of dialysis as something to be feared. Of course, it would be great if you could preserve your kidney function. Rather, you need a thorough understanding of what dialysis is and how it will affect your life.

What is Dialysis?

Now, let’s imagine here for a moment that your kidney is not working at all. I mean, it does so many useful things for your body: filtering wastes, controlling electrolytes, and balancing the water in your body. When you have failing kidneys, all these processes go haywire. What’s the solution? Simple: find something to take the place of the kidneys that can no longer do their job. One way – the obvious way, I suppose – is to simply put in another flesh and blood kidney to do the work. This is a great solution, but honestly, there just aren’t enough kidneys to go around.

In this modern age, to save lives that would otherwise be lost to complete kidney failure, someone invented a machine to do the exact same things that the anatomical kidneys do. Great age we live in, huh?

The dialysis machine:
• Takes all the blood from your body
• Filters the blood
• Removes water
• Balances electrolytes
• Returns that blood safely into circulation

Some systems, such as peritoneal dialysis, don’t require a machine, but a special catheter inside your abdomen. Even now, these machines are becoming so sophisticated that they have home hemodialysis machines. If you have kidney failure, you are in luck with these treatments around to help you.

Indications for Dialysis

You may wonder just what your doctor saw in your history to indicate that you need dialysis. Indications for dialysis are usually when your kidneys are at the end of their working life. You have reached a point called “end stage” kidney disease, which means that the organs are functioning at only 10 to 15 percent of their normal workload. Your doctor determines this mostly by lab work, such as:
• Blood urea nitrogen,
• Creatinine,
• Creatinine clearance
• Estimated glomerular filtration rate

These lab tests show how well your kidneys are able to remove wastes from the body and how well it filters your blood.

Among other indications for dialysis include physical symptoms, such as:
• Swelling and edema in your legs and hands.
• High blood pressure
• High Potassium

Swelling indicates that your kidneys are not adequately balancing the fluids in your body and allowing them to accumulate. Too much potassium can lead to deadly heart rhythm disorders, and a high blood pressure can result in stroke, in addition to weakening the heart muscle.

Types of Dialysis

The two most common types of dialysis are hemodialysis and peritoneal dialysis. However, home hemodialysis is now becoming an option with the advent of smaller, less expensive hemodialysis machines. For most patients, though, you will have to go to a hospital or hemodialysis center two to three times per week to remove fluid and filter your blood. If you miss your appointment for dialysis, it can cause a dangerous build-up of wastes and fluid.

Hemodialysis is the most common of all types of dialysis. It generally takes three to five hours because the entire volume of your blood is run through the machine. Peritoneal dialysis is another type of dialysis that is often used, and it is much more convenient than hemodialysis. You can actually perform peritoneal dialysis at home without the need for a dialysis center. It involves a catheter placed in your abdomen, and you essentially put the dialysis material into your body through this portal. The dialysate dwells in your body, exchanging fluids and wastes by osmosis, and then you drain the fluid out. Many more people are opting for peritoneal dialysis now that many of the peritoneal dialysis side effects have been addressed.

How Hemodialysis Works

Hemodialysis is a complex procedure, and it really is a wonder of modern medicine. Using an access port somewhere on the body, two needles are inserted to access the blood stream. One needle is the outflow needle, and the second needle returns the blood to the body in the hemodialysis procedure. The hemodialysis machine takes small amounts of your blood out from this access port, and it brings the blood into the machine.

Once the blood is in the machine, it runs through a series of tubes and filters to change the electrolyte balance in your body, remove waste, and take off some fluids. The blood passes through an apparatus known as a dialyzer, and this cartridge holds the dialysis solution, or dialysate. It is this solution that pulls the wastes and electrolytes from your body. It does this by the force of osmosis. Basically, this means that the concentration of the chemicals in the dialyzer is lower than the concentration in the blood. That difference causes the chemicals in your blood to move across a membrane with holes in it, and the dialysate catches the particles and holds them. The blood is then returned safely to your body through the return port. The machine removes blood and fluid very slowly to ensure that your blood pressure does not drop too low and you pass out.

Hemodialysis Side Effects

Hemodialysis side effects can be separated into two categories: short-term and long-term. In the short-term, the most common side effect is low blood pressure. When the machine pulls water out of your blood, your veins and arteries don’t have time to accommodate the drop in fluid. This causes you to have a “big container,” or your blood stream, and not enough fluid to fill it. Usually, your blood pressure will stabilize later in the day after dialysis, but it can be quite uncomfortable, inconvenient, and scary for some.

Other short-term dialysis side effects include:
• Nausea
• Vomiting
• Cramps
• Electrolyte imbalances
• Infection
• Bleeding at the access site
• An air bubble that makes it into your bloodstream

Your doctor can prescribe medications for nausea or you can use natural remedies, such as ginger. You might have cramps and electrolyte imbalances if the machine pulls off too much sodium or potassium. These can lead to irregular heartbeat, dehydration, and heart palpitations. On the whole, most people feel better after a dialysis run.

Long-term dialysis side effects include anemia, or a drop in the hemoglobin that carries oxygen to your cells. This is because the red blood cells get damaged from passing through the machine and are no longer usable. You might need a shot to help with anemia, iron transfusions, or even blood products.

Other long-term dialysis side effects include:
• Itching
• Weakening of the bones from calcium depletion
• Difficulty sleeping

Access for Hemodialysis

One of the most important cogs in the dialysis process is maintaining access for the blood transfer to occur. A few different ways exist to accomplish this task. One of the most popular is the arterio-venous fistula, or AV fistula. This is a vein in your arm that is surgically joined to an artery. It causes a rounded nub in your arm, usually at the bend of the elbow, which feels like a cat purring from the rush of arterial blood past it. AV fistulas are great because with just two needles, the dialysis nurse can quickly and easily establish access and perform dialysis. The problems with AV fistula are that they have to be surgically created, and sometimes they clot off and stop working. This can be very frustrating for dialysis patients because they have to resort to other methods to establish access.

Another way to gain access to the bloodstream is through an internal jugular vein catheter. This is a port that is placed just under your collarbone and has two floppy access ports protruding from it. Again, clotting of this catheter can happen, but it is not as common as with AV fistulas. With a dialysis catheter, you just get a new one placed. Unfortunately, these catheters are prone to infections that can lead to sepsis, or blood infection. This is a life threatening situation, and all precautions must be taken to avoid it. That is why the preferred method is the AV fistula.

Tips for Hemodialysis

If you are getting hemodialysis or want to know how to get through it a little easier, you should keep a few things in mind. You don’t want to eat foods that contain a great deal of potassium, such as bananas, oranges, and potatoes, because this only makes the levels of potassium higher in your blood. This can lead to you feeling sick, but it can also increase your risk for heart irregularities.

To raise your blood pressure post-dialysis, you could drink more water to add volume to your veins, but many kidney patients are on a fluid restriction. You should only do this if your doctor is okay with you drinking more water than your allowance. For problems with low blood pressure, change positions carefully. Sit up from a lying position then dangle your feet off the side of the bed for a few minutes. Stand up slowly and hold on to something stable. This should keep you from passing out.

When you have an AV fistula or access port, you have to take precautions to keep those access sites viable for dialysis. Without them, you would have no way to receive your life-sustaining treatment. With AV fistulas, make sure that you don’t allow anyone to take a blood pressure or draw blood from the arm that has the fistula. This can interfere with the blood flow and possibly lead to a clot. Also, don’t wear tight sleeves, tight jewelry, or anything restrictive on your fistula arm. With an access port, you should make sure that you and your caretakers wear a mask and gloves when accessing your port to prevent the spread of infection. Protecting your port from infection could save your life.

How Peritoneal Dialysis Works

Peritoneal dialysis is a whole different system. You would almost think that it wouldn’t work when you hear of it, but it is actually an effective way of cleaning and filtering the blood just like hemodialysis. The idea for peritoneal dialysis is based on the anatomical configuration of the abdomen. All of the organs in your belly – intestines, liver, and spleen – are covered with a thick membrane known as the peritoneum. This membrane is highly vascular, which means that it has a great deal of blood vessels running through it. It is also semi-permeable, which means that wastes, electrolytes, and fluid can pass easily through it.

When you get surgically set up for the peritoneal dialysis procedure, the surgeon inserts a catheter into this membrane and brings the hub of it to the surface. The hub is locked down under rigorous, anti-infective clamps to keep bugs out of your belly. For dialysis, you take the dialysate, much like the solution that is in the machine in hemodialysis, and allow the solution to drain into your abdomen by gravity. That solution sits inside your abdomen and pulls the wastes and fluid from your body by way of the blood that is coursing through the peritoneum. After five or six hours, you hook up to another bag and drain all of the solution out. You simply discard the bag. Most doctors want you to do four to six “exchanges” like this per day to maintain your health.

Peritoneal Dialysis Side Effects

The most common and severe peritoneal dialysis side effects are:
• Infection
• Weight gain
• Weakening of abdominal muscles

Since you have a port that is open to your abdomen – normally a sterile space – and the blood flow through it is so great, it is a place where bacteria can enter your body and quickly become a problem. As for your abdominal muscles, they become strained and give out from holding the fluid in your abdomen for hours at a time.

You may wonder if you are a good candidate for this type of dialysis. If you cannot handle the rapid fluid changes caused by hemodialysis, this may be an option for you. It is also a great alternative if you don’t want to upset your lifestyle and you are able to care for yourself. If you have scarring in the abdomen or are debilitated to the point that you cannot effectively care for yourself, then hemodialysis is the way to go. Talk to your doctor and see if peritoneal dialysis is right for your level of kidney function, overall health, and social constraints.

Access for Peritoneal Dialysis

Like the access with hemodialysis, a surgeon needs to establish your access for this type of dialysis. It will involve a short surgery, usually same day, and the surgeon will put the small catheter inside your abdomen. You will have a single port with a universal adapter on the end to attach to the dialysate bags for your exchanges. It is important to keep this area and the port scrupulously clean because any bacteria that get inside your peritoneum will wreak havoc with you system.

Be on the lookout for signs of infection, such as:
• Chills
• Fever
• Redness
• Swelling
• Drainage
• Nausea
• Vomiting

If you notice that the cuff from the port is pushed out, you need to let your doctor know you are having trouble with your dialysis.

When you are manipulating your port, such as taking the cap off, cleaning the cap, or attaching to the dialysate, be sure that you and those around you wear masks to prevent breathing bacteria onto the port. In addition, if you are doing the transfer, you should wear gloves and wash your hands prior to touching the port’s dressing. Keeping clean and maintaining a sterile environment is absolutely essential to effective, long-term, complication-free peritoneal dialysis.

Tips for Peritoneal Dialysis

Besides wearing a mask and gloves to take care of your exchanges, you can easily work peritoneal dialysis into your life. You can do this type of dialysis in two ways: continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis. With the ambulatory type, you drain in the dialysate and go about your daily life. With cycling, you are hooked up to a machine while you sleep and the machine does the cycling for you. Whatever method you and your doctor choose, it takes less time and inconvenience than hemodialysis.

When performing your exchanges, you should make sure you warm the bags of dialysate before allowing them to dwell. If the solution is cold or even room temperature, it can make your stomach cramp from the changes between room temperature and body temperature. Most doctors will also recommend that you change the universal adapter with every exchange to prevent it from harboring bacteria. When you are done with your exchange, you should weigh and record the weight of the discard bag. This is so that you and your doctor can keep track of how much fluid the solution is pulling from your body.

Peritoneal Dialysis vs. Hemodialysis

Now that you know a little about each type of dialysis, you might be wondering what the best dialysis is for you. What are the pros and cons when looking at peritoneal dialysis vs. hemodialysis? Hemodialysis is a gold standard for all dialysis. It is the best process and the one with the most data behind it. It is actually the dialysis most doctors prefer because the rates of peritoneal dialysis are not high. However, it is intrusive, inconvenient, and sometimes physically demanding. The change in blood pressure can sometimes cause side effects, such as vertigo and passing out, that make this type of dialysis contraindicated.

Peritoneal dialysis seems like the star. You can do it on your own time, when you want to, and you don’t have to be bothered with going to a dialysis center. However, sometimes it is easy to get lax with your exchanges and become non-compliant. In other words, you feel fine so you just stop doing it. This can lead to dangerous consequences, so if you are not responsible or able to perform the manual tasks on your own, you can end up risking your kidneys and your life. Peritoneal dialysis is also well known for infections, and for some patients, the risk of that is just too great to even try this type of dialysis.

Thanks for reading, I sincerely hope my post was useful for you!

Final Message from Duncan:
Once again Lynda, thank you for taking the time to write this massive post and share it with the Kidney Coach community! If you have any questions, comments, or thoughts, please leave them below. I look forward to next week’s article where we dicuss the foundations of a healthy dialysis diet.

Oh! And please don’t forget to ‘LIKE’, ‘Tweet’ or ‘Share’ this article if you have enjoyed it, or if it has been of help to you. Many thanks!!!

References:
National Kidney & Urologic Diseases Information Clearinghouse; Treatment Methods for Kidney Failure: Hemodialysis; December 2011
http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysis/index.aspx

National Kidney & Urologic Diseases Information Clearinghouse; Treatment Methods for Kidney Failure: Peritoneal Dialysis; September 2010
http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal/

National Kidney Foundation; Dialysis; 2012
http://www.kidney.org/atoz/content/dialysisinfo.cfm

MedlinePlus; Dialysis; David Zieve, MD, MHA and Herbert Y. Lin, MD, PHD; September 2011
http://www.nlm.nih.gov/medlineplus/ency/article/007434.htm

Mayo Clinic; Peritoneal Dialysis; December 2010
http://www.mayoclinic.com/print/peritoneal-dialysis/MY00282/METHOD=print&DSECTION=all

Confused because it goes against everything you have read and have been told? Don’t be, there is good reason, and I’ll do my best to explain…

The purpose of this article: to dispel the mis-conceptions around lowering potassium in kidney disease; detail simple easy to follow steps on how to lower potassium levels naturally through diet and other techniques; to educate you on all things potassium, so the next time you are in front of your doctor you can keep up, and maybe even teach him or her a thing or two.

What Is Potassium And Why Do I Need It?

If you are new to this blog, it is important to know that before I start to get too deep into subject matter, I like first to bring it back a little so I can discuss the fundamentals. This gives you a good frame work to understand some of the principles that I talk about, and allows you to make better judgment calls when I, or your doctor, says something. This allows you to be in control of your health. The way it should be, yes?

What is potassium?
• Potassium at its most basic level is a soft silvery-white metal (mineral), sharing a very similar chemical structure to sodium. Behind only to calcium and phosphorus, it is the most abundant of all the minerals totalling 225 grams of your body weight – that’s the weight of the palm of your hand.
• Potassium is also known as an ‘electrolyte’, due to its ability to be electrically conductive. An important feature in the human body, considering you and I are a network of electrical pulses.
• Potassium naturally occurs in nature, and is found present in many foods (see further on for a list of foods).
• Potassium is 19th on the periodic table (K is the chemical symbol for Potassium in Latin)
• Fact: 1/3 of the body’s total energy is required to hold the location of potassium and sodium in and around our cells.
• Note: Normal serum potassium levels are: 3.5 and 5.5 mEq/L (reference range)

Why do I need it?
Our body depends on this mineral for its survival… no potassium, no humans. Amazingly through our evolution we have utilized the earth from which we have sprung to carry out and allow certain functions to occur in the body. You may have heard that potassium is good for the heart, good for muscle contractions, and therefore good for lowering blood pressure, and even that it is beneficial in nerve conduction. All of which are true, but there is so much more that this mineral does for you.

Here is a list of other health benefits and actions of Potassium:
• Regulates pH balance
• Helps to thin the blood
• Maintains water/fluid balance
• Eye health
• Increases secretion of hormones: ADH, FSH and aldosterone
• Regulates blood sugar
• Aids protein synthesis
• Regulates cell permeability
• Acts as a capacitor within our cells to store energy

Want more proof of the necessity of potassium? Here is a list of symptoms that occur due to potassium deficiency.

Symptoms of Potassium Deficiency:
• Kidney damage – yup, weren’t expecting that were you?
• Lung problems
• Rheumatoid arthritis
• Thirst
• Death
• Tachycardia
• Fatigue
• Mental confusion
• Metabolic acidosis
• Bone fragility
• Joint and bone pain
• Edema
• Constipation
• Headaches
• Insomnia
• Abnormal heart beat
• Paralysis
• Muscle weakness

As you can see potassium=good.

The Dilemma: High Potassium Levels In Kidney Disease

Ordinarily the body can absorb, assimilate, and utilise potassium til its heart’s content, and then when finished, excrete this life giving mineral out via the urine. Easy.

However when you have chronic kidney disease, this can POSSIBLY change. For a lot of kidney disease sufferers, just like the myriad of other substances the body could once excrete via the kidneys and urine (creatinine, uric acid, and metabolic wastes), potassium cannot move across the filtering membrane within the kidneys nephrons, and cross over into the urine collection “funnels” (renal pelvis) that eventually lead to the bladder.

And because of this inability to “cross-over” and be eliminated, the potassium levels increase within the blood and open the body up to many health problems.

Adverse Effects Caused By High Potassium Levels:

• Paralysis
• Renal necrosis
• Heart arrhythmia
• Diarrhoea
• Convulsions
• Depression
• Mental confusion
• Tingling
• Kidney failure
• Dehydration
• Adrenal exhaustion
• Weakness
• Fever
But this is not always the case. In fact a LOT of kidney disease patients have normal potassium levels.

Which leads me to this…

Why You Possibly Do Not Need To Listen To Your Doctors

Therefore the most important you can do for yourself when treating this condition is to become aware, listen to your body, and track and monitor your blood work like you were a doctor. This is ONLY way you will know who to listen to.

All too often I find doctors are advising their clients incorrectly, and potassium is one of the most common. It has become a ‘throw away’ prescription: “You have kidney? Oh, then you must avoid potassium and go on a low potassium diet.”

But this is so not true as you have seen. You only need to reduce potassium levels if you have high potassium levels. Remember potassium is important, so eat potassium foods freely until your blood work says otherwise.

How Do I Reduce High Potassium Levels In My Blood?

OK, you have waited long enough, you have high potassium levels and you want to know what to do about it.

Firstly it is all about eating the right amount of potassium. You cannot completely avoid potassium, nor that you want to, so it is a good idea to know the guidelines on eating the correct amount of potassium for your stage of kidney disease; in other words, eat a low potassium diet.

Typically the recommended daily allowance for potassium in a healthy individual is 2 to 5 grams a day (some institutions state 4.7 grams a day).In kidney disease this changes depending on your stage of kidney disease…

Low Potassium Diet: Potassium Recommendations
• Kidney Disease Stages 1 to 2 (eGFR of 60 to 90+): 2 to 5g a day
• Kidney Disease Stages 3 to 4 (eGFR of 20 to 60): 2 to 4g a day
• Kidney Disease Stages 4 to 5 (eGFR of 5 to 20): No more than 2 to 2.5g a day

Remember the above is only a rough guide, so if you have very high levels and you are in only stage 1 or 2 kidney disease then it is prudent to eat a low potassium diet to match your blood potassium levels.

What is a safe level of potassium in my blood?
A better way to eat a low potassium diet is in accordance with your blood potassium levels.

Potassium Reference Range
• Low Range: less than 3.5 mEq/L
• Safe range: 3.5 – 5.5 mEq/L
• Unsafe range: 5.6 – 6.0 mEq/L
• Dangerous: more than 6.0 mEq/L

Normal serum potassium levels are 3.5 to 5.5 mEq/L (though some labs quote a reference range of 3.5 to 5.0), and so if you are slightly over that, try eating no more than 4 grams a day of potassium. If it is at a level of say, 6.0 to 7.0, you definitely not be eating more than 2 grams a day until your high potassium levels have been corrected.

Although this can be a challenge, eating a low potassium diet is probably the easiest, and single most important way to reduce blood potassium levels – so it is definitely worth the effort.

Potassium Content Food List – Low Potassium Diet

Below is a list of common foods that have been organised under ‘low potassium’ or ‘high potassium’. This is just a quick a quick guide and therefore does not contain all foods, nor does it contain the amount of potassium contained within each food. For a more in-depth food list, plus the amount amount of potassium contained within, please refer to the end of this article for your Free Potassium Food List to download.

Why Avoiding Fruits and Vegetables Maybe The End Of You

After glancing over the above list of foods, it would seem very logical to decide that fruits and vegetables need to be avoided for your health to improve, heck even your doctor has probably told you this enough. But I can assure you this is madness. But not only that, it is this belief that is keeping you from getting well!

OK so hear me out… Fruit and vegetables are healthiest foods available, packed with healing vitamins and minerals; we all know this, ask any kid. *Potassium aside* So why would you ever dream of cutting these foods out altogether, and live off empty foods, such as rice, pasta, breads (empty foods= non nutrient dense foods)?

“Phytonutrients in specific plant foods are some of the most powerful biological response modifiers scientists have yet discovered.” (Jeffrey Bland Ph.D.) Phytonutrients can be defined as plant derived nutrients.”

And secondly fruits and vegetables are also chock-full of phytonutrients. Phytonutrients can be defined as: chemical compounds such as isoflavones that occur naturally in plants. Plants produce these substances for various reasons, including, structure, chemical messengers, protection from harmful organisms or insects or even attracting pollinating insects. Once eaten by humans though, these substances take on a new role. Using isoflavones as an example, isoflavones can balance the female hormonal system and protect them from breast cancer.

Convinced yet? No? How about the people have cured themselves from kidney disease using juicing alone! (Albeit rarely)

Great I have got your attention! My point with all this is this: eat a well balanced diet using healthy foods, do not forgo foods that are high in potassium, most of these are the very foods that calp heal you and reverse your condition. Just make sure when you do eat them, that you factor the potassium content in for the day. Great!

11 More Quick Tips To Reduce Potassium Levels

1. Consult your naturopath, dietician, or doctor, and get them to do all the hard work and get them to devise a plan for you.

2. Speak to your doctor about your current medications. Certain medications can increase serum potassium levels, for example: nonsteroidal anti-inflammatory drugs, ACE inhibitors, angiotensin II receptor blockers (ARBs), and potassium sparing diuretics.

3. Keep a food diary for 8 weeks; keep note and monitor your daily intake of potassium. By the end of 8 weeks (or sooner) you will know what to eat without this aid, and have a sense of freedom as you live day by day.

4. Fresh is best, but when you are using canned fruits and vegetables always drain the liquid.

5. Avoid salt substitutes as they commonly use potassium salt (potassium chloride) as an alternative.

6. Read food labels. Especially ‘low salt’ or ‘low sodium’ packaged foods, these foods also use potassium chloride as a salt substitute. Look on labels for symbols listed as KCl, K+ or potassium and avoid these foods.

7. Be aware of portion sizes when consulting potassium content food lists. When a food is listed as a low sodium food, ask yourself “what serving size is this for?”. Don’t eat a pound of something, when it is listed as an ounce.

8. When eating high potassium, leach out the potassium first. Leaching is a technique that removes some of the potassium. For detailed instruction on how to do this, refer to this page: http://www.kidneycoach.com/356/potassium-leaching-study-shows-not-all-leaching-methods-work/

9. Treat underlying conditions: it is all to easy to get obessesed out reducing potassium from the diet, without looking at the bigger picture… what caused your potassium to rise in the first place? You have high potassium levels because your kidneys are not functioning properly, therefore it is wise to treat your kidneys first.

10. Exercise regularly: exercising regularly helps reduce excess potassium levels in the blood. The mechanism is that through act of sweating potassium is lost through the skin. Exercise a minimum of 3 times a week, at 30 minutes each time. Build up a sweat, and shed that potassium.

11. Completely avoid dairy: not only is dairy high in potassium, but it is also harmful to your kidneys. That includes dairy from milk, cheese, yoghurt, cream, ice-cream, spreads, dressings, etc. Note: it is also high in phosphorus – another problematic mineral for a lot of kidney disease patients.

In more serious cases however, you will need to employ the helping hand of natural therapies to bring your potassium levels down.

Natural Remedies To Lower Potassium Levels

1. Magnesium: magnesium works by balancing the potassium levels in the blood.
2. Garlic: reduces the absorption of potassium via the digestive tract.
3. Calcium: reduces the absorption of potassium via the digestive tract. Caution: Do not use if you have high calcium levels, get tested first.
4. Note: Licorice is an excellent herb to lower potassium levels (maybe the best), but it comes with its own problems. Firstly licorice is contraindicated in kidney disease for periods exceeding 4 weeks, and licorice also has the potential to increase blood pressure. Do not use this herb unless under the guidance of a health professional.

Summary

Remember potassium is important for your survival, but like most things, too much can cause problems. The trick is to get your potassium consumption matched up with your blood potassium levels, to still eat a balanced diet, to have regular blood tests, and to monitor, monitor, monitor your potassium intake for the day. Here is a fantastic KidneyDiet app for your iPhone to do just that.

I hope this article answers all your potassium questions, but most importantly dispels a lot of the mis-conceptions around potassium and its relationship to kidney disease.

I would love to hear your comments or questions, so don’t be shy please scroll down and let me hear from you! I would REALLY appreciate it.

Oh and don’t forget, I have put together a Potassium Food Content Chart for you to download, it is there make your journey a whole lot easier! So please scroll down, follow the instructions on how to download your food chart, and enjoy.

Thank you for taking the time to read my post on high potassium levels!

See you next time.

To your amazing health,
Duncan

How To Download the Free Potassium Food Content Chart
Step 1. LIKE, Share, Twitter, or Stumble this article. You don’t have to, but I would appreciate it.
Step 2. Right Click the following, and select Save As to download: Click Here to Download Your Free Potassium Food Content Chart

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Welcome to my third edition of KidneyCoach.com News Weekly! The place where I do a round-up of all the top stories related to kidneys, kidney health and kidney disease for the week.

This edition covers many interesting stories where you will discover how low levels of vitamin D is linked to kidney disease complications, new insights into the cause of chronic inflammatioin in kidney disease sufferers, how gene mutations may hold the key for a certain kidney disease, a mystery kidney disease epidemic in Central America, among many others.

…There are plently of interesting and eyeopening news stories below that will both help and inform you.

Here are the top 8 news stories for the week:

News Story #1

Gene mutation play a major role in 1 cause of kidney disease …
Mutations in a gene called INF2 are by far the most common cause of a dominantly inherited condition that leads to kidney failure, according to a study appearing in an upcoming issue of the Journal of the American …
http://www.breakthroughdigest.com/

News Story #2

Low Vitamin D Linked to Kidney Disease Complications in Children
CINCINNATI—Vitamin D deficiency is more common in children who suffer from kidney disease and contributes to thryroid problems and inflammation. These findings were published online ahead of print in the journal Kidney International. …
www.naturalproductsinsider.com

News Story #3

Scientists discover new susceptibility genes for kidney disease
Singapore and Chinese scientists have identified new susceptibility genes for a specific kidney disease and found risk variants that could influence the clinical symptoms of patients. Their discovery is related to the disease immunoglobulin A …
health.asiaone.com

News Story #4

Mystery Kidney Disease in Central America
Kidney disease has killed so many men here that locals now call their community not simply La Isla – which means “The Island” – but La Isla de las Viudas – “The Island of the Widows.” The epidemic extends far beyond Nicaragua. It’s prevalent along the …
www.theworld.org

News Story #5

Scientists Identify Potential Drug Target For Kidney Cancer
by VR Sreeraman on December 31, 2011 at 1:21 PM Drug News Scientists have laid the foundation of completely understanding the intricacies of distinct kidney cancer subtypes, which could lead to better treatments for the disease. …
m.medindia.net

News Story #6

Another Problem With Red Meat: It Might Lead to Kidney Cancer
By Genevra Pittman Red meat is an important source of protein, but eating too much of it could result in various health problems, including renal cancer. People who eat lots of red meat may have a higher risk of some types of kidney cancer, …
www.theatlantic.com

News Story #7

Comment: I find this one of the most interesting of all the news stories listed here. In naturopathic philosphy the digestive system is seen as the “seat” of health, and many, many disorders (seemingly unrelated) stem from an unhealthy digestive tract. This usually occurs because of harmful microbes entering the digestive tract. Now kidney disease may be other condition to add to this list of known conditions.

Chronic Kidney Disease-related Inflammation’s Key Cause, Identified
by Nancy Needhima on December 16, 2011 at 8:49 PM General Health News Vital source of inflammation found in chronic kidney disease patients, which is increasingly common due to obesity-related diabetes and hypertension has been unveiled by UC Irvine …
www.medindia.net

News Story #8

Comment: A great online tool for those struggling with managing their kidney disease diet.

New web resource helps kidney patients with complex burden of diet planning
Foods that most of us are urged to eat — fruits and vegetables, brown rice and whole grain pastas — are not kidney diet friendly. Even something as simple as mashed potatoes are a no-no, unless the water is changed several times during the boiling, …
www.winnipegfreepress.com

I would really like  to hear some of your thoughts and comments on these news stories, so please tell me what you think. What story did you find the most interesting? Thought provoking? Or useful?

Please “LIKE”  this page and share it with anyone that might find it of benefit, thank you!

To YOUR amazing health in 2012!

When you are first diagnosed with kidney failure (eGFR of 15 ml/min or below), many emotions may arise: anger, shock, panic, despair, and a feeling of complete hopelessness. You try to hold your composure and recount the past days, weeks, and months that lead up to this event to see if there were any signs or past actions that may have caused this.

You draw a blank and the only thing you are left wondering is “how do we fix this?”

This is when disbelief really sets in. The only form of treatment that your doctor provides you is either kidney dialysis or kidney transplantation. Both of which are highly invasive and complicated.

For the purposes of this article we will be discussing kidney dialysis as a treatment option, as this is the most common treatment choice for most sufferers of kidney failure.

The life changing effects that these treatments have on your life are both profound, but unfortunately even these drastic measures do not offer healthy increases to life expectancy for the “average” person once they are diagnosed with kidney failure.

Kidney Failure Life Expectancy

Kidney failure life expectancy, like anything depends on many variables, some of which you can control, and others that you cannot control: age, gender, genes, race, diet, lifestyle choices, what caused your condition (etiology), the type of treatment you choose, etc.

It is therefore prudent to exercise your will to give yourself the best chance of being the “lucky*” ones that live for 20+ years on dialysis. (*luck definition = where preparation and action meet)

Once again it should be noted that we are discussing life expectancy in relationship to kidney failure. This means that the kidneys are now functioning at or below 15% – also termed as End-Stage-Kidney-Failure or Stage 5 Kidney Failure. It is important to make this distinction, because the life expectancy severely drops once at this level.

Let’s take a look at some of the stats…
• The life expectancy of a kidney failure patient with an eGFR of 10ml/min or less, ranges from 1 to 12 months without treatment of any kind (e.g. dialysis, transplant, natural medicine). The average is 6 months.
(Szeto CC, et el. Nephrology (Carlton). 2011 Nov;16(8):715-9. doi: 10.1111/j.1440-1797.2011.01504.x.)
• The average life expectancy of someone receiving kidney dialysis is 4.25 years.
• The 10 year kidney dialysis life expectancy is 23%.
(Mailloux LU,et el. Clin Nephrol. 1994 Aug;42(2):127-35.)

Kidney Dialysis Life Expectancy

It might be hard to read such statistics, but I believe knowing such statistics can give you a chance to change your life.

How? Well it gives us a clue that dialysis is not your winning ticket home to health. That although dialysis is helpful in severe cases of kidney failure, it is not a complete solution and therefore begs the questions “why is this the case?”, and “how can I change my outcome?”

There are many reasons why this is the case, among them are:

Complications Caused by Kidney Failure
• Anemia
• Bleeding from the stomach or intestines
• Bone, joint, and muscle pain
• Congestive heart failure
• Coronary artery disease
• Dementia
• Edema
• Fluid buildup around the lungs (pleural effusion)
• High blood pressure
• Hyperparathyroidism
• Increased risk of infections
• Liver damage or failure
• Malnutrition
• Miscarriages and infertility
• Pericarditis
• Seizures
• Stroke
• Weakening of the bones and increased risk of fractures

Complications Caused by Dialysis
• Anemia
• Bleeding, from the access point
• Dementia
• Fever
• Headaches
• Infection
• Loss of nutrition
• Low blood pressure
• Muscle cramps
• Nausea
• Rare: diseases like Hepatitis B and Hepatitis C
• Seizure
• Weight gain

Other Common Health Influences Found In Dialysis Patients:
• Poor dietary choices
• Patients often “give up”. Due to loss of freedom; dialysis schedules can be mentally, emotionally and physically taxing; feelings of alienation, and separateness from loved ones; etc.
• Lack of exercise
• Plus many, many more.

It is easy to see why then that the mortality rate for dialysis patients reduces quite substantially. And truth be told, kidney failure sufferers are more likely to pass away from cardiovascular disease, than from the actual kidneys completely shutting down.

Therefore we come two question number two “how can I change my outcome?”.

Top 5 Tips to Extend Your Kidney Dialysis Life Expectancy

1. Diet

Protein
During the dialysis process a large amount of protein is lost. Protein is one of the building blocks of the body, and therefore it is critical to get ample quantities through the diet to re-stock on what has been lost to allow the body to repair itself. This is usually a joy for dialysis patients as the lead up to dialysis requires heavy dietary protein restriction.

Daily Protein Intake Recommendation:
• Hemodialysis: 1.2 to 1.5 grams per kilo of body weight (e.g. 72 to 90 grams for a 60 kg (130 lb) individual)
• Peritoneal Dialysis: 1.5 to 2.0 grams per kilo of body weight (e.g. 90 to 120 grams for a 60 kg (130 lb) individual)

Please note: that these figures are a “general rule”, and therefore subject to change depending on your requirements and blood work. This means that you may need to consume more or need to consume less depending on your current situation and blood test results. I recommend having your renal dietician personally tailor your dietary requirements for this and the below dietary nutrients.

Protein ‘type’ recommendation:
50 % of your protein intake for the day must be from animal protein, the best sources include: chicken, fish, eggs, and turkey. 50% must be from animal protein because animal protein contains all the essential amino acids required for health. However that is not to say plant proteins (grains, legumes, nuts, seeds, vegetables) are not recommended, far from it. It is important to get a variety of sources as plants contain essential vitamins, minerals and phytonutrients that animal sources do not. Simply eat a 50/50 split, and you can’t go wrong!

To monitor if you are eating enough protein throughout the day, you need to monitor your Albumin levels in your blood work. Albumin is you body’s storage protein. Blood levels should be 4.0 or higher. Though please be aware that Albumin levels can take 1 – 2 months to show a change in your blood results.

Phosphorus, Potassium and Sodium
The minerals phosphorus, potassium and sodium all need to be closely monitored during dialysis. This is because each of these minerals has the potential to rise to dangerous levels (though in some people they can get too low) and cause a myriad of health problems. Cardiovascular disease is the most common side-effect of these.

Phosphorus
Unfortunately very little phosphorus is removed during dialysis. Dialysis is an excellent treatment to remove toxins from the body, but there are some things that it cannot remove, and phosphorus is one of them.

Daily Phosphorus Intake Recommendation: up to 7mg per kg of body weight (e.g. up to 420mg for a 60 kg (130 lb) individual)

Hidden Phosphorus: phosphorus is used widely in food manufacturing, because it lends itself in so many ways, from preserving foods all the way to improving the consistency of foods. Please keep a look out for these food additives on your next supermarket shop:
• Dicalcium phosphate
• Hexametaphosphate
• Monocalcium phosphate
• Phosphoric acid
• Polyphosphates
• Pyrophosphates
• Sodium phosphate

Side-effects of high blood phosphorus levels: bone and teeth problems, abnormal bone and tissue calcification, hardening of the arteries, hyperparathyroidism, low calcium levels, bone pain, and itching.

Potassium
Unlike phosphorus, potassium is easily removed via dialysis, so it can be managed a great deal easier than phosphorus. However between dialysis visits, it is easy for potassium levels to spike to high levels and cause unnecessary problems for your health. Therefore limiting you daily intake will help prevent this.

Daily Potassium Intake Recommendation:
• Hemodialysis: 1500mg to 2000mg a day
• Peritoneal dialysis: 2000mg to 4000mg a day

Side-effects of high blood potassium levels: nausea, weakness, numbness or tingling, slow pulse, irregular heartbeat, heart failure, sudden death

Sodium
Sodium is only removed in low to moderate amounts by dialysis, so it too needs to be monitored.

Daily Sodium Intake Recommendation:
• Hemodialysis: 1500mg to 2500mg a day
• Peritoneal dialysis: 2500mg to 4000mg a day

Side-effects of high blood sodium levels: high blood pressure, edema, cardiovascular disease, nausea, vomiting, weakness, fatigue, insomnia, irritability, confusion, seizures, coma.

For more information on how to improve your health, and essentials of a healthy renal diet, see my article: Top 7 Tips For A Healthy Renal Diet

2. Nutrition
There are MANY nutrients that I could recommend to improve the life-span and life quality of someone of dialysis, but in many cases it is not wise to overload the body with too many substances, plus it would also overload your bank account! Please see below for what I believe are the key nutrients for dialysis patients – based on the complications listed earlier:
• CoQ10: improves heart and cardiovascular function, helps improve energy levels and fight fatigue
• Iron: treats anemia and low haemoglobin levels
• Multivitamin and mineral supplement: improves the overall nutrient status of the body (dialysis depletes the body of many vital nutrients); contains B6, B12, and folate to improve hemoglobin levels and reduce anemia
• Magnesium: alleviates headaches, cramps, muscle pain and tension, helps improve energy levels, balances blood sugar levels, and improves cardiovascular health

3. Herbal Medicine
Like the nutrient section above, I have tried to be very conservative here, and try to list only the key herbal medicines that will treat the common problems associated with dialysis, and also extend the kidney dialysis life expectancy. I have come up with three:
• Hawthorn: best herbal cardiovascular tonic, improves heart function, reduces cholesterol, helps treat arterial plaque, increases circulation, treats high or low blood pressure
• Olive Leaf: helps fight infections of all kinds (bacteria, parasites, fungus, viruses), useful for treating dialysis access point infections, cardiovascular tonic, lowers cholesterol
• St Mary’s Thistle (aka Milk Thistle): Protects liver from liver damage and associated conditions, anti-nausea/anti-vomiting action, improves hunger levels for those with low to no appetite, and balances blood sugar levels

4. Exercise
Even on dialysis it is still very much important to exercise. Movement is the definition of being alive, without movement we die a small death every day. The key component here is knowing what type of exercise is best for you, and what intensity is best for you. You don’t have to be entering strongman competitions, but as long as you are regularly moving that body of yours at a moderate intensity 5 times a week, then you are doing the very best for you health. I have put together a list of activities to help you get an idea of what constitutes “moderate” exercise” below, but another way of saying moderate intensity is: you are lightly huffing and puffing, but can talk without difficulty.
• Bicycling 5 miles in 30 minutes
• Climbing stairs for 15 minutes
• Gardening for 30 to 45 minutes
• Swimming laps for 25 minutes
• Walking 1.75 miles in 35 minutes
• Water aerobics for 30 minutes

For information on exercising, please see my stellar article here (scroll down to the “exercise” section).

5. Optimal Dialysis
This may sound obvious, but having your blood work frequently assessed to evaluate the effectiveness of your dialysis treatments is crucial. By calculating the reductions of toxins removed from your blood stream, your doctor can determine if the time you are on dialysis is adequate to keep you healthy.

Not only that, but the growing consensus is that the more frequently one has dialysis, the better patients will feel and the longer they will live. Though this of course has a play-off with your spare time. Studies have found those receiving inadequate dialysis, experience higher than normal death rate, reduced appetite, and counter-intuitive, increased number of days per year spent in the hospital. Make sure you hold yourself and your doctor accountable to get your dialysis times right.

Final Note
People can get bogged down with all the statistics out there; in fact you may have found yourself searching the web endlessly for statistics on dialysis and kidney dialysis life expectancy trying to get a gauge on your life expectancy. But what is that really going to tell you about you and your health? I am here to tell you, nothing. Statistics do not apply to you. It is how you live each day that determines your life and health.

A famous line from the financial author and radio host Dave Ramsey says “If you live like no one else, you will live like no one else”, meaning if you do the things that the “average” person does you will get average results, but if you do things that most do not do (eating a healthy renal diet, exercising, taking supplements, etc.), then you will be the one of the “lucky” exceptions, and not the rule. People can and do live for decades with kidney failure, but it doesn’t happen by accident.

So please do not spend your time worrying about how you may die sooner because of kidney failure, any of us could encounter an accident tomorrow. Instead, why not focus your energy on how you can best enhance your life through natural treatments and healthy a lifestyle, but most importantly, focus on living.

To your optimum health!
Duncan

P.S. Please click the “LIKE” button if you have found this article on kidney dialysis life expectancy useful and/or enjoyable. I greatly tremedously ridicously appreciate it!

Welcome to my second edition of KidneyCoach.com News Weekly! The place where I do a round up of all the top stories related to kidneys, kidney health and kidney failure for the week.

The featured news stories for this week cover everything from a potential new treatment that may halt the progression of kidney failure; feel-good stories where family members give their loved ones a new lease of life; clinical studies on how diet impacts the progression of kidney failure, and many more. But rather than me tell you about them…

Here are the top 6 news stories for the week:

News Story #1

Research aims to prevent diabetic kidney failure
The enzyme arginase-2 plays a major role in kidney failure, and blocking the action of this enzyme might lead to protection against renal disease in diabetes, according to researchers. “We believe these arginase inhibitors may be one of the new targets …
www.virtualmedicalcentre.com

News Story #2

Comment: Here are two articles on the same story. The first is for the more technically minded, the second is in plain english. The articles are a another great example of the power that diet has on the human body in preventing and treating kidney disease.

Intensive treatment preserves kidney function in patients with type 1 diabetes

“Our primary outcome was an estimated GFR less than 60 milliliters per minute, which represents a substantial loss of kidney function and is known to confer an increased risk of cardiovascular disease and death; essentially, it’s stage-III chronic …
www.endocrinetoday.com

Intense Kidney Protection
People can develop end-stage renal disease (the complete or almost complete failure of the kidneys) when they have an impaired glomerular filtration rate (GFR) – the volume of fluid filtered from the kidney. Dr. de Boer and colleagues wanted find out …
www.dailyrx.com

News Story #3

Comment: Here is a feel good story where a 14 y.o. daughter was able to save her mother’s life.

News Story #4

Comment: A lesson on NEVER giving up.

A donation of a lifetime: Local woman donates kidney to her cousin
Four years ago Jan’s kidneys began to be affected, not an uncommon side effect from the diabetes. She soon was legally blind. The hikes up Mount LeConte, the camping trips, the time on the lake — activities the two liked to share — were over. …
themountainpress.com

News Story #5

Comment: Medical advancements.

Kidney-friendly stent being tested
The Ventana Fenestrated Stent Graft System, in white, allows blood to keep flowing to the kidneys after it is used to repair an aneurysm in the area of the abdominal aorta. Following training sessions for researchers this month at the Methodist …
suncoastpinellas.tbo.com

News Story #6

Comment: If only these people knew the true value of their own kidneys.

Kidney trading gang jailed for 5 to 6 years
CAN THO — The People’s Court in Can Tho City on Tuesday sentenced four members of a kidney-trading ring to prison for five to six years each on charges of “organising people to flee the country”. Organ trading is a crime in Viet Nam, but in this case, …
vietnamnews.vnagency.com.vn

…If you know of any other stories that we many find interesting here at kidneycoach.com, please shoot us an email, or post a comment below together with a link. We would loved to hear from you.

Again I hope you find this new ‘regular’ post interesting and helpful. Please give it a “LIKE” below, thank you!

I thought I would do something a little different today. I thought I would do a weekly round-up of the all the top news related to the kidneys and kidney health. But further to that, I plan to do this as a regular featured post each and every week to keep you up to date with all the latest (and best) information on the web. The web is a big place, and so by doing this I would like to make it a little smaller by “distilling” all the information for you, making this the place to go to when you want the facts. Any news related to community events, scientific breakthroughs, diet, medicines, treatments, etc. related to kidney health, I will report it here!

But I won’t just leave it there, my goal will also to report on other stories that I feel that you might find interesting, inspiring, funny, and/or enlightening. In fact it is my hope that it gives you and me the opportunity to get off the beaten path and explore the many facets of life, health, and kidneys.

So here is how it will generally work:

1. I will post the links to the main news stories of the past week with a small description, and if needed, a few comments by myself to give you further insight.

2. You click on the link, and it will take you to the website that is reporting the news. Done!

OK, so let’s get on with it shall we? Excellent.

News Story #1

New Study in NEJM Offers Hope to Lupus Patients with Kidney Disease
Nephrologists at the Miller School of Medicine have played a key role in an international study that has uncovered an effective therapy for treating patients with lupus nephritis, a debilitating kidney disease linked to lupus. …
www.healthcanal.com

News Story #2

Vitamin B derivative helps diabetics with mild kidney disease
A vitamin B6 derivative may help slow or prevent the progression of mild kidney disease in patients with diabetes, according to a study appearing in an issue of the Journal of the American Society Nephrology (JASN). The drug may benefit increasing …
www.stlamerican.com

News Story #3

ASN: Calcium Score Predicts CVD Risk in Kidney Disease
Explain that in patients with chronic kidney disease (CKD), coronary artery calcification predicted the risk of cardiovascular disease (CVD) events, especially in those with no history of CVD. Point out that a coronary artery calcification (CAC) score …
www.medpagetoday.com

News Story #4

Intensive Type 1 Diabetes Therapy Lowers Kidney Failure Risk
November 12, 2011 (Philadelphia, Pennsylvania) — Intensive therapy for type 1 diabetes mellitus lowers the long-term risk for impaired glomerular filtration rate (GFR), a predictor of end-stage kidney disease and a risk factor for cardiovascular …
www.medscape.com

News Story #5

Study Shows Association of Elevated Galectin-3 Levels With Poor Outcomes in …
“Heart failure is commonly complicated by declining kidney function with kidney disease markedly contributing to the morbidity and mortality of heart failure patients,” said Pieter Muntendam, MD, President and CEO of BG Medicine. …
www.marketwatch.com

Well there you have it! Let me know what you think of this idea, and let me know if there is anything particular you would like to see in this type of post.

I always love to hear from you.

To your health,

Duncan