Keep Your Kidneys Healthy: A Guide to Preventing and Treating CKDDr. Zoltan P. Rona, MD, M.Sc. November 1, 2020
Keeping your kidneys healthy is vital to your body’s well-being. Healthy kidneys ensure that your your body can filter and expel waste efficiently, while producing hormones to help your body function at its best.
Your kidneys work to filter blood, balance electrolytes, and regulate hormones that affect your bones and blood pressure. One important hormone made by the kidneys (erythropoietin) is involved in the creation of red blood cells and helps prevent anemia.
What Causes Kidney Disease
Chronic kidney disease (CKD) is a common condition that occurs most often along with (or because of) diseases like diabetes, hypertension, and cardiovascular disease. Certain genetic factors and recurrent kidney infections also increase the risk. OTC drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) — acetaminophen and aspirin – can also raise the risk. Illicit drugs like cocaine, heroin, and amphetamines can also injure kidney tissue and increase the risk of CKD.
Prescription antibiotics, antihypertensives, antivirals, and ulcer medication (PPIs – proton pump inhibitors) can all damage the kidneys and lead to CKD. Prescription laxatives, chemotherapy drugs, and contrast media for various diagnostic scans are also potentially damaging for the kidneys. According to the National Kidney Foundation, at least one in 3 adults are at risk of developing CKD.
CKD is most often diagnosed by blood and urine tests which detect high creatinine, high blood urea nitrogen (BUN), a high albumin to creatinine ratio (ACR), and a low estimated glomerular filtration rate (eGFR). Urinalysis might show excessive protein, blood, glucose or uric acid. An ultrasound of the kidneys could diagnose abnormalities in the structure or size of the kidneys, or a biopsy might reveal a chronic inflammatory condition such as an autoimmune disease.
CKD can progress without symptoms for decades, and tends to be increasingly diagnosed with advancing age. The most severe forms (kidney failure) could require regular dialysis or transplantation.
The health of the kidneys is largely determined by the health of the gut, but numerous other factors could also be involved. An abnormal balance of the gut bacteria can cause immune dysregulation, the production of gut-derived uremic toxins, and high circulating levels of bacteria-derived lipopolysaccharides (LPS).
Dysbiosis (gut flora imbalance, candidiasis, SIBO aka small intestinal bacterial overgrowth) and leaky gut syndrome are all involved in the ultimate creation of CKD. An altered gut microbiome causes a chronic systemic inflammatory state which is associated with obesity, insulin resistance, diabetes, and cardiovascular disease.
Chronic inflammation that goes untreated for decades eventually leads to fibrosis (scar tissue formation) and ultimately reduced kidney function (insufficiency) and kidney failure.
Urinary Signs and Symptoms
Clear urine: comes about from drinking excessive amounts of water.
Deep yellow urine: comes about from inadequate water intake or just an intake of supplemental B complex vitamins (especially vitamin B2) and is harmless with no other specific meaning.
Foamy or cloudy urine: can possibly be due to excess urinary protein, kidney or bladder infection, or another inflammatory condition.
Red or pink urine: can be caused by blood from a bladder or kidney stone or an infection; could also be due to a tumour; rarely from eating beets, rhubarb or blueberries.
Blue or green urine: often this is from consuming food colouring dyes.
Smelly urine: could be associated with the age of the urine and may indicate the presence of glucose and ketones. An asparagus smell in the urine occurs in most people after eating asparagus and this is normal.
Best Ways to Keep Your Kidneys Healthy
The key to improving kidney health is to follow an anti-inflammatory diet. This involves the avoidance of sugar especially fructose, alcohol, caffeine, gluten, and other foods that trigger intolerances or allergies.
The reduction of animal protein from dairy, eggs, red meats, poultry, fish and seafood will also help to reduce much of the stress on the kidneys. Over the years I have seen many patients in my practice who improved their kidney function dramatically by going more vegan with their diet, as well as eliminating all the pro-inflammatory grains.
To prevent kidney disease avoid salt, added potassium, protein, and phosphorus supplements. An ideal protein intake is likely around one-half gram of protein per pound of lean body mass, which for most adults is 40 to 70 grams a day. The American Kidney Foundation recommends restricting protein to a maximum of 50 grams if you have kidney disease.. Urine should look pale yellow. If it is dark yellow, the fluid intake needs to be increased. Urinating 7 – 8 times daily is normal as far as frequency is concerned.
Foods that enhance kidney health include: organic cabbage, cauliflower, lemons, lemon juice, garlic, onions, apples, unpasteurized apple cider vinegar, cherries, red and purple grapes, pumpkin seeds, watermelons, berries, sweet potatoes and organic kale.
Protect the Kidneys by Limiting Drugs
Avoid OTC drugs especially NSAIDS (aspirin, ibuprofen, naproxen (Aleve) and celecoxib (Celebrex)), antibiotics, antihypertensives, antivirals, and ulcer medication especially proton pump inhibitors (PPIs). Prescription laxatives, chemotherapy drugs and contrast media (e.g. gadolinium) for various diagnostic scans are all potentially kidney damaging. Illicit drugs like cocaine, heroin, and amphetamines (prescription or otherwise) are all potentially nephrotoxic.
Check for Underactive Thyroid Function
Many CKD patients suffer from cold hands and feet and have low basal body temperatures. An underactive thyroid condition could be at the bottom of this issue, so ask your doctor to check for this on lab testing. The tests to request if you have thyroid symptoms are TSH, free T3, free T4, thyroid antibodies and reverse T3.
Foods, Herbs, Supplements That Heal the Kidneys
The following supplements can enhance kidney health mainly because of their anti-inflammatory activity. Amounts recommended depend on individual needs and health status:
- ASTRAGALUS: modulates immunity to protect the kidneys.
- MILK THISTLE: is protective of both the kidneys and liver.
- CURCUMIN: and other turmeric extracts are beneficial due to their strong anti-inflammatory properties.
- MODIFIED CITRUS PECTIN: brand name (Pectasol-C) can delay the fibrosis process, extending the life of the kidneys. This is also the same nutrient used to reduce the spread of many cancers.
- REISHI MUSHROOM: makes the kidney less permeable, reduces proteinuria, and helps stop erosion of the outer membrane of the nephron (the podocyte)
- PROBIOTICS: A good broad-spectrum form can help balance the gut flora.
- CORDYCEPS MUSHROOM: Reduces fibrosis and sclerosis of the kidney, improves serum creatinine and BUN and reduces proteinuria.
- PYRIDOXYL-5-PPHOSPHATE (VITAMIN B6): helps prevent the formation of calcium oxalate kidney stones.
- MAGNESIUM: commonly deficient in those with CKD and needed by the body to prevent calcium deposits in the kidneys and other injured tissues.
- Rutin: a bioflavonoid with powerful anti-inflammatory effects.
- MELATONIN: useful because most CKD patients have been shown to have low levels of melatonin and adequate sleep is important in healing CKD. Melatonin is an important longevity hormone.
- WOBENZYME: is a digestive enzyme that has been found to reduce fibrosis in the kidneys. It is anti-inflammatory when taken on an empty stomach.
- COQ10: can help control blood pressure and is important because many of the drugs that patients with CKD take destroy CoQ10 and increase cardiovascular symptoms.
- ALPHA LIPOIC ACID: is known to help prevent high blood sugar but is also protective of kidney and liver health.
- VITAMIN C: is a strong antioxidant to prevent kidney disease.
- VITAMIN D3 & K2: is often deficient in people with CKD and is needed to improve bone density problems associated with CKD.
- VITAMIN E: Antioxidant benefits to prevent further kidney damage especially from calcium oxalate stones.
- 5-MTHF (activated folic acid): required for multiple metabolic benefits in the kidneys.
Natural Products to Use Carefully
These common nutritional supplements can potentially damage the kidneys if not monitored regularly:
– Noni juice (due to the high potassium content)
– Bulk-forming laxatives like flaxseed (due to the need to consume higher amounts of water)
– Herbal supplements from other countries (eg. Chinese herbs can be contaminated with toxic heavy metals and drugs if not purchased from a reputable TCM practitioner)
– Herbal diuretics like bucha, uva ursi, parsley, and juniper berry could be potential trouble sources since they can interact with many prescription drugs.
– Herbal supplements that can interact with drugs commonly used by CKD patients should be avoided, including: St. John’s Wort, echinacea, ginkgo, garlic, ginseng, licorice, ginger, and blue cohosh. In kidney transplant patients or those on dialysis these should be mostly avoided. This is not to say that these herbs are not beneficial. On the contrary they all can reduce inflammation and prevent further kidney disease. They just need careful monitoring for drug-nutrient interactions.
CKD manifests in different ways from individual to individual. A natural health care provider’s advice on diet and appropriate supplementation would be based on biochemical individuality, so it’s highly recommended that you don’t make any changes on your own without some professional guidance.
Chronic Kidney Disease: Natural Medicine for a Silent Epidemic. https://holisticprimarycare.net/topics/functional-medicine/chronic-kidney-disease-natural-medicine-for-a-silent-epidemic/
Usage of complementary and alternative medicine among patients with chronic kidney disease on maintenance hemodialysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766780/
Use of alternative medicine by patients with stage 5 chronic kidney disease. https://pubmed.ncbi.nlm.nih.gov/16010646/
Herb-Drug Interaction Handbook, second edition. Sharon Herrr, RD, CDN. 2002 Consumer Labs, www.consumerlabs.com National Center for Complementary and Alternative Medicine. ncam.nih.gov
Inker LA, Astor BC, Fox CH, et al. KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD. Am J Kidney Dis. 2014 Mar 16.
Herbal Supplements and Kidney Disease. https://www.kidney.org/atoz/content/herbalsupp
Natural Medicine and Kidney Disease. https://nephcure.org/wp-content/uploads/2019/01/Natural-Medicine-Kidney-Disease.pdf
What are the treatments for kidney disease? https://www.webmd.com/a-to-z-guides/understanding-kidney-disease-treatment
Astragalus (a traditional Chinese medicine) for treating chronic kidney disease. https://www.cochrane.org/CD008369/RENAL_astragalus-a-traditional-chinese-medicine-for-treating-chronic-kidney-disease
A brief study of toxic effects of some medicinal herbs on kidney. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544088/
Nayeri A, Wu S, Adams C, Acute Calcineurin Inhibitor Nephrotoxicity Secondary to Turmeric Intake: A Case Report. Nayeri, A. et al. Transplantation Proceedings. 2017; 49(1):198 – 200.
Gabardi S, Munz K, Ulbricht C: A review of dietary supplement-induced renal dysfunction. Clin J Am Soc Nephrol. 2007; 2: 757–765.
How to prevent and treat kidney problems with food. https://articles.mercola.com/sites/articles/archive/2016/02/15/foods-for-kidney-health.aspx
Urine signs: https://www.healthline.com/health/urine-color-chart
Physical characteristics of urine: https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Book%3A_Anatomy_and_Physiology_(Boundless)/24%3A__Urinary_System/24.4%3A_Urine/24.4A%3A_Physical_Characteristics_of_Urine
Dr. Zoltan P. Rona is a graduate of McGill University Medical School (1977) and has a Masters Degree in Biochemistry and Clinical Nutrition from the University of Bridgeport in Connecticut (1984). He is the author of 11 books on natural medicine – three of which are Canadian bestsellers, <a href="https://www.amazon.com/Joy-Health-Zoltan-Rona/dp/0888821301">The Joy of Health (1991)</a>, <a href="https://www.amazon.com/Return-Joy-Health-Alternative-Complaints/dp/0920470629/ref=sr_1_1?keywords=Return+to+the+Joy+of+Health+%281995%29&qid=1581538703&s=books&sr=1-1">Return to the Joy of Health (1995)</a>, and <a href="https://www.amazon.com/Childhood-Illness-Allergy-Connection-Nutritional/dp/076150611X/ref=sr_1_fkmr0_1?keywords=Childhood+Illness+and+The+Allergy+Connection+%281997%29&qid=1581538770&s=books&sr=1-1-fkmr0">Childhood Illness and The Allergy Connection (1997)</a>. He is co-author with Jeanne Marie Martin of <a href="https://www.amazon.com/Complete-Candida-Guidebook-Jeanne-1996-06-15/dp/B01K90OQ8M/ref=sr_1_1?keywords=The+Complete+Candida+Yeast+Guidebook+%281996%29&qid=1581538837&s=books&sr=1-1">The Complete Candida Yeast Guidebook (1996)</a> and is medical editor of the Benjamin Franklin Award-winning <a href="https://www.amazon.ca/Encyclopedia-natural-healing-authoritative-alternative/dp/0920470750">Encyclopedia of Natural Healing (1998)</a>. He has had a private medical practice in Toronto for the past 32 years, has appeared on radio and TV as well as lectured extensively in Canada and the U.S. Visit his <a href="https://highlevelwellness.ca/">website</a> for appointments, call (905) 764-8700; Office: 390 Steeles Ave. W. Unit 19, Thornhill, ON