Kidney Diseases and Diet | Dr. Vinod Kumar K

Dr. Vinod Kumar K
Consultant, Department of Nephrology
Aster Medcity, Kochi

The kidneys play a very vital role in the body; it acts as the body`s filtering system. It consists of millions of microscopic units called as 'nephrons', which acts as the filtering units. Most important function of the kidney is to remove waste products from the body produced from the breakdown of food particles we eat and also to remove excess water from the body. This excess water combined with waste products forms the urine. The kidneys also produce three important hormones: 'Erythropoetin' – stimulates bone marrow to produce red blood cells; 'Renin' – which regulate blood pressure; and the active form of Vitamin D, which helps to control the calcium balance in the body and maintain healthy bones. When the kidney fails, all the toxic substances and excess water builds up in the body and makes the person very sick. 

Kidney diseases are of two types:

Acute Kidney injury (also called acute renal failure) may occur due to severe infections (commonly leptospirosis, malaria or other bacterial infections), acute gastroenteritis and shock, poisoning or drug over dosage, following snake bite and heart failure. It is of sudden onset and usually temporary. Kidney functions recovers either completely or partially over a period of time, once the cause of kidney injury is corrected.

Chronic Kidney Disease (also called chronic renal failure) results from progressive and gradual loss of kidney function happening over time and this type of kidney damage is permanent. Chronic kidney disease (CKD) is common, often unrecognized, and expensive to treat and is associated with increased risk of death at all ages. 

CKD is a worldwide public health problem, both for the number of patients and the cost of treatment involved. 10% of the Indian population suffers from Chronic Kidney disease and this figure is expected to increase as there is surge in the number of patients suffering from diabetes and high blood pressure.

Hypertension and diabetes are responsible for up to two thirds of the cases of CKD. Other risk factors includes, advancing age, obesity, family history of kidney disease (Eg; Polycystic kidney disease), birth defects of the kidneys (in children), Urological problems involving the prostate or stone disease and chronic drug abuse (commonly pain killers).

A simple screening with a blood creatinine test and urine test for protein leak would help you to identify the disease early. People who are at risk of kidney disease, as mentioned above, should undergo screening at least once a year. This simple blood and urine test would cost them less than Rs 150 in any private laboratory available in all small towns. If these tests are found abnormal, an imaging test such as ultrasound, can provide the picture of kidneys and urinary tract.

Symptoms of CKD are usually subtle and are not recognized until the late stages of the disease. 'One warning signs is frothy or bubbly urine, usually a sign that kidneys are leaking protein'. In the late stages they can have swelling of the legs, puffiness of eyes, blood in the urine, loss of appetite, nausea, vomiting, hiccups, muscle cramps, shortness of breath, insomnia or disturbed sleep, nocturia (excessive urination in the night), persistent itching and chest pain.CKD almost always progresses into end-stage renal disease, which necessitates renal replacement therapy (RRT). Three forms of RRT are available currently that includes hemodialysis (done in the hospital setting), peritoneal dialysis (done at home) or kidney transplantation operation. Dialysis is a process of purifying the blood wherein the toxic substances accumulated in the blood is removed to keep the patient symptom-free and healthy. Once the CKD is established, there is no current cure for the disease. However, there are therapies that can help control the signs and symptoms, reduce the risk of complications, and slow the progression of the disease.

How to reduce the risk of developing kidney disease or slowing the disease progression?

• If you have diabetes, keep the blood sugar under control.
• Maintain the blood pressure at near normal, by adjusting the dose of BP medicines as per the doctor's advice.
• Medications to control the protein leak can be taken in the early stages after consulting the nephrologist.
• Exercise regularly, at least for 30 to 45 minutes/day for five days in a week.
• Set a healthy weight goal.
• Stop smoking.
• Have regular checkups with the Nephrologist and monitor your kidney functions.
• Have a healthy renal diet (talk to your Nephrologist and dietician).
• Avoid taking over-the counter medicines, especially pain killers (Diclofenac, Brufen, Nimuselide etc). Talk to your nephrologist before taking such medicines.

Renal Diet: 

• Following a proper diet is vital for effective kidney failure treatment.
• Restricting the amount of protein in the diet may help slow down the progression of the disease. Most importantly reduce the intake of animal protein, avoid organ meat and red meat (mutton, beef, pork). 
• Salt intake has to be restricted to have better control of blood pressure. Avoid pappad, pickles, salty chutneys, processed foods, canned foods and dried salty fish. 
• Reduce the intake of potassium rich food like fruits, fruit juices, green leafy vegetables, tomato, tender coconut water, coconut, ragi and nuts. Fruits with low potassium content includes apple, papaya, guava and pear and can be consumed at limited amounts.
• Reduce the intake of oily food and fried items and follow a meal plan that is low in saturated fat and cholesterol.

World Kidney Day aim to raise awareness of the importance of our kidneys to our overall health.