Symptoms, Causes & Treatment
Kidney disease (or nephropathy) can refer to a number of conditions affecting the kidney.
Acute kidney disease is usually caused by an infective agent and is generally of relatively short duration. It often needs antibiotics if caused by infection.
Chronic kidney disease (CKD) is defined as loss of 1/3 of kidney function for more than 3 months. It may eventually lead to kidney failure, requiring kidney dialysis or kidney transplant. As kidney function deteriorates, wastes begin to build up in the blood.
Kidney function in CKD may be classified into stages, depending on the glomerular filtration rate (GFR):
- Stage 1: GFR ≥ 90
- Stage 2: GFR = 60-89
- Stage 3: GFR = 30-59
- Stage 4: GFR = 15-29
- Stage 5: GFR ≤ 15. This is end-stage renal disease and usually requires dialysis or kidney transplant
Specific kidney conditions
- Nephritis: acute or chronic inflammation of the nephrons in the kidneys. Most common caused by auto-immune disease (e.g. lupus), but may also be caused by infection or toxins.
Nephritis is a serious medical condition and can be life-threatening due to the excretion of protein (e.g. blood-thinning proteins) from the body. Nephritis causes reduced glomerular blood flow, leading to reduced urine output, protein in the urine, edema, hypertension and retention of waste products. Specific categories of nephritis include:
- Glomerulonephritis: inflammation of the glomeruli or small blood vessels in the kidneys. May be caused by problems within the kidney itself, infections, drugs, systemic disorders or diabetes. Glomerulonephritis may be a complication of strep throat.
- Interstitial nephritis: inflammation of the spaces between renal tubules
- Pyelonephritis: caused by ascending UTI that has reached the kidney. This is a life-threatening medical emergency, requiring immediate antibiotic treatment.
- Lupus nephritis: nephritis as a result of Lupus
- Chronic analgesic nephritis: nephritis resulting from long-term use of analgesics such as aspirin and NSAIDs
- Kidney stones: crystal aggregation of dietary minerals in the kidneys
- Polycystic kidney disease: a genetic disorder characterised by the formation of fluid-filled cysts within the kidney that increase in size with age.
- Renal tubular acidosis: failure of the kidney to recover sufficient bicarbonate from the filtrate, causing systemic acidosis. Cause depends on type.
- Nephrotic syndrome: a non-specific disorder in which the kidneys are damaged, causing them to leak large amounts of protein from the blood into the urine. Causes may be primary or secondary (e.g. hepatitis, auto-immune disease, diabetes, drugs, cancer, infection)
Causes of Kidney Disease
The kidneys may be damaged by a number of agents including:
- Exposure to drugs e.g. analgesics, chemotherapy
- Exposure to toxins e.g., heavy metals, solvents, pesticides
- Auto-immune disease
- Diabetes mellitus
- Hypertension / congestive cardiac failure
- Liver disease
- Snake or insect venom
Signs & symptoms of Kidney Disease
Signs and symptoms of kidney disease may include any of the following:
- Acute kidney disease
- Fever and chills (when an infection is involved)
- Sudden, intense pain in the groin
- blood in the urine
- excess serum proteins in the urine (foamy urine)
- reduced output of urine
- Cloudy urine: indicates pus in the urine (infection)
- Urinary urgency: infection, pressure
- Fluid retention
- Nausea and vomiting
- Chronic kidney disease (CKD)
- Proteinurea (protein in the urine)
- Generalised edema: accumulation of fluid in beneath in the skin or in the body cavities. Caused by reduced output of urine in kidney disease
- Hypertension: due to fluid overload
- Hyperkalaemia (High potassium) leading to malaise and cardiac arrhythmias
- Anaemia: due to reduced erythropoietin synthesis
- Metabolic acidosis
- Retention of waste products can cause a wide range of neurological, muscular, endocrine and metabolic symptoms.
NB: Acute medical care is essential with any kind of kidney disease supporting options include;
Diet plan guidelines for Kidney Disease
- Fresh, organic, additive-free, alkaline diet: diet should be high in fruit and vegetables, whole grains and healthy sources of fat and protein
- Restrict protein intake:
- High protein increases renal blood flow and glomerular filtration rate i.e. increases the load on the kidney.
- At least 60% of protein consumed should come from sources with high biological value to minimise waste i.e. lean meats, eggs, fish, poultry
- The amount of protein depends on the stage of CKD:
*Stages 1, 2 or 3: restrict protein to 12-15% of total kJ per day
* Stage 4: restrict protein to 10% of total kJ per day
* Stage 5: as the patient will now be on dialysis, protein restriction is no longer necessary
- Adequate carbohydrate intake: to prevent ketosis, which can harm kidneys
- Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
- Emphasise antioxidant-rich foods to support immune function: berries, green tea, turmeric, fruits and vegetables
- Minimise pro-inflammatory foods: sugar, refined carbohydrates, trans fats, excessive red meat, saturated fats, omega-6 fatty acids, caffeine and alcohol
- 2 L filtered water daily (NB in some chronic kidney disease, may need to limit fluid intake)
- Limit sodium intake to < 2.4 g/day
- Limit phosphorus intake to 800-1000 mg/day: found in soft drinks, dairy products, legumes, nuts, peanut butter, chocolate
- Limit potassium intake: legumes, chocolate, nuts, seeds, bananas, starchy vegetables, tomatoes, avocado, spinach, mushrooms, vegetable and fruit juices, dried fruits, stone fruits
- Avoid caffeine, alcohol
Supplements that support Kidney Disease
In major kidney disease, avoid high-dose vitamins and minerals as they may further irritate the kidneys and the kidneys have reduced ability to prevent toxic overload of vitamins.
Fat-soluble vitamins, especially vitamin A, should not be taken as supplements (except vitamin D which is often indicated)
- Omega-3 EFA’s: to reduce inflammation
- Vitamin C: often low in chronic kidney disease (CKD). Helps to reduce inflammation and oxidative stress and support immune function. Excess intake may cause oxalate deposits in bones and soft tissues
- B-complex: often deficient due to low protein intake
- Biotin 30-100 ug/day: often deficient due to low protein intake
- Vitamin D: CKD patients are at risk of vitamin D deficiency. If serum vitamin D is < 75 nmol/L, then supplementation is recommended
- Iron: CKD patients are at risk of iron-deficiency anemia. This should be regularly monitored.
- B6, B12 and methylfolate or folinic acid: if high homocysteine levels
Herbal medicine treatment that supports Kidney Disease
- Nephrotic syndrome: astragalus and dong quai
- Immune stimulants / antimicrobials: andrographis, echinacea, cranberry
- Immune suppressants (in auto-immune disease): hemidesmus, astragalus
- Support kidney function: bugleweed, uva ursi, buchu, polygonum
- Protein in urine: goldenrod (caution in sub-acute or chronic kidney disease)
- Excessive sweating: yarrow
- Diuretic: dandelion leaf, celery, parsley, uva ursi
Lifestyle / physical measures to support Kidney Disease
- Quit smoking (cadmium is toxic to the kidneys)
- Avoid exposure to environmental and occupational pollutants (esp heavy metals, solvents, pesticides)
- Avoid unnecessary drugs and medications (e.g. analgesics)
FUNCTIONAL MEDICINE TREATMENT OF KIDNEY DISEASE
The above nutritional and herbal considerations may assist with kidney disease. Long term management and reversal of chronic kidney disease requires a comprehensive, functional medicine approach to address underlying body system dysfunctions.
There have been a number of studies released recently that connect poor long term gut health as a contributing factor to kidney disease.
Various scientific studies indicate lower levels of beneficial bacteria lactobacillus and Bifidobacterium adversely affect kidney health. In addition, the same studies show that the presence of pathogenic bacteria such as Klebsiella pneumonia and Clostridium perfringens can be harmful to the kidneys.
A gluten containing diet and other common foods that cause immune antibody creation are also detrimental in kidney disease.
At our Perth clinic of Advanced Functional Medicine we have experience supporting patients with various types of Kidney Disease
If you or a family member are require assistance with Kidney Disease or other urinary system condition we would love to hear from you, please write a comment below.