A diagnosis of kidney disease is not a death sentence (remember, you can live well with kidney disease), but it does mean that caring for your kidneys is now more important than ever. Several factors directly influence the course of kidney disease:
Blood Glucose Level:
10%-40% of patients with diabetes develop chronic kidney disease. Usually diabetic kidney disease develops in patients who have had diabetes for at least 10 years and it typically manifests by increased protein loss in the urine. It is extremely important that diabetes be managed well and that you see a Nephrologist immediately if you are experiencing urinary protein loss. A Nephrologist will be able to work with you to diminish protein loss and slow or even stop the progression of kidney disease.
Controlling blood pressure is absolutely critical in preventing the development and progression of kidney disease. The blood pressure goal is < 140/90. Poorly controlled hypertension causes rapid deterioration of kidney function, resulting in the need for dialysis. Low salt intake (<2 gm a day) significantly improves hypertension management and allows medications to be more effective in controlling blood pressure.
Some medications are linked to an increased risk of chronic kidney disease. Examples include lithium and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen. Various herbal supplements as well as some antibiotics (penicillin group) are known to cause interstitial nephritis resulting in permanent decrease of kidney function. It is recommended not to use non-steroidal medication chronically and to always hydrate well while taking NSAIDS. If any decline of kidney function occurs while taking Lithium, NSAIDS, antibiotics, or herbal supplementations the patient must see a Nephrologist.
I recommend increasing the quantity of fresh fruits and vegetables to include 2 to 5 servings per day, as well as, incorporating more fiber from whole grains. It has been shown that the Mediterranean diet can decrease progression of chronic kidney disease, and in some cases, reverse the decline of kidney function.
Excessive consumption of alcohol can lead to an increase in blood pressure and cholesterol levels in the blood. Based on this, it is recommended to keep alcohol intake moderate to reduce the risk of CKD.
Regular exercise has been shown to be beneficial in reducing the risk of CKD by helping with blood pressure control. For the best results, at least 30 minutes of moderate exercise daily is recommended. This can be as simple as walking or riding a bike to work.
Written by Oscar Adler, MD, PHD