Chronic Kidney Disease

What is Chronic Kidney Disease?

Chronic kidney disease is a slow and progressive loss of kidney function over a period of several years. Eventually, a person will develop permanent kidney failure. Chronic kidney disease, also known as chronic renal failure, chronic renal disease, or chronic kidney failure, is much more widespread than people realize; it often goes undetected and undiagnosed until the disease is well advanced. 

Risk factors for CKD include but are not limited to high blood pressure, diabetes, family history of kidney disease, certain ethnicities, age, repeated urinary tract infections, and polycystic kidney disease (PKD), a genetic condition. Complications of CKD are not limited to high blood pressure, stroke, heart disease, weak bones, nerve damage and anemia. Therefore, management strategies may involve kidney-friendly diet, medication, blood pressure control, lifestyle changes, blood sugar management, dialysis. 

Chronic kidney disease cannot be cured, although detecting it early and controlling it is important in order to slow down its progress and avoid any other complications.

What are the Stages in Chronic Kidney Failure?

Kidneys are responsible for filtering our blood, removing waste, toxins, and surplus fluids. Individuals with CKD have damaged kidneys and cannot filter blood as they should, which can lead to a variety of serious health concerns. 

There are five stages of chronic kidney disease. 

• Stage 1: At the first stage of chronic kidney disease, there is very mild damage, allowing the kidney to keep performing at 90 percent or better.
• Stage 2: A mild decline in kidney function is visible, and it is advisable to get in touch with a kidney specialist. 
• Stage 3: A moderate decline in kidney function. Stage 3A means the kidney is functioning between 45 and 59 percent, and Stage 3B means kidney function is between 30 and 44 percent. 
• Stage 4: A severe decline in kidney function and functioning is between 15 and 29 percent, which may lead to building up more waste, toxins, and fluids in the body. 
• Stage 5: Kidney failure or end-stage renal disease (ESRD) requiring dialysis. The kidney’s functioning is at less than 15 percent capacity and can lead to kidney failure.

When that happens, the buildup of waste and toxins becomes life-threatening. This is end-stage renal disease.

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What are the symptoms of Chronic Kidney Disease?

The symptoms of chronic kidney disease develop over time and progress slowly. Witnessing the below symptoms can be a sign of serious kidney problems, and one must not delay their treatment. 

• Nausea and vomiting
• Loss of appetite and weight loss 
• Fatigue and weakness
• Sleep problems
• Changes in urination
• Muscle twitches and cramps
• Swelling of feet and ankles as a result of water retention
• Chest pain
• Shortness of breath
• Uncontrollable High blood pressure 

It is crucial to catch a kidney disease early in order to prevent kidney failure. The signs and symptoms may not appear until irreversible damage has occurred. For treatment of chronic kidney disease, one will need dialysis or a kidney transplant to survive.

Kidney Friendly Diet And Dietary Regulations For Chronic Kidney Disease

How Do You Maintain A Good Diet For Healthy Kidneys?

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Our kidneys filter waste and excess fluids from the blood, which are then excreted in our urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes, and waste can build up in your body.

Around 10% of the population worldwide is affected by chronic kidney disease (CKD). This happens because the kidneys fail to remove waste products from the body the way they should. It is important to follow a kidney-friendly diet that helps decrease the amount of waste in the blood. This diet is often referred to as a renal diet.

As every patient’s case details are different and have different nutrition requirements, the dietary restrictions may vary. It is always advised to talk to a renal dietitian (an expert in diet and nutrition for patients with kidney diseases). This information should be used as a basic guide.

Food For Kidney Patients: What Are Some Dietary Suggestions For Someone With Kidney Disease?

One should change their diet and follow a meal plan set up by a registered dietitian so as to enjoy meals that will also maintain kidney health in order to manage chronic kidney disease (CKD).

• Energy :  The recommended energy for individuals with CKD who are undergoing maintenance dialysis is 35 kcal/kg/day for 60 years and above individuals 30 kcal/kgday. We educate patients to have adequate proportions of carbohydrates from sources such as cereals, millets, root vegetables, etc. For diabetic CKD patients, only whole grains and fiber-rich grains are advised; vegetables are advised; and for non-diabetic patients, we allow them to have simple carbohydrates (boiled potatoes, sweet potatoes, etc.) to maintain their energy levels.
• Limiting salt intake: In order to manage blood pressure, the diet should consist of no more than 2,300 milligrams of sodium on a daily basis. Acquiring fresh food often and cooking it as opposed to fast food, canned food, or frozen dinners, which have high sodium contents, is the way to go. Avoid using salt during preparation, but use spices, herbs, or any other sodium-free seasoning in its place. One can always find out how much salt is present in the food package by checking the nutrition label; a more than 20% daily value means that it contains too much salt; thus, try using the low-sodium type.
• Management of protein diet: It is important to protect the kidneys by eating protein in the right levels and forms. One may strain the kidneys by eating excess proteins. One should therefore consume small amounts of proteins from both plant and animal protein sources. Such foods in animals include poultry (such as chicken), fish and other sea foods, meat, either red or white, including pork or beef, dairy products like cheese or butter, etc., with eggs being part of this category too. For instance, in terms of quantity, an average-sized serving would be two to three ounces for one person who consumes something like beef, while another person who uses cheese might take this amount as a half cup full of milk, having contained therein at least one slice from any sandwich made out of something else other than what is mentioned here.
• Consuming heart-healthy foods: Whenever possible, pick healthy foods like grilling, broiling, baking, roasting, or stir-frying instead of deep-frying. Cook with nonstick cooking spray or olive oil as opposed to butter. Before eating, get rid of the meat’s fat and skin. Avoid saturated and trans fats and go through food labels. One should eat foods that are good for the heart, such as lean cuts of beef, skinless poultry, beans, potatoes, veggies, fruits, skim or low-fat cheeses, milk, and yogurt.
• Avoiding a high-phosphorus diet: If one wants to manage CKD, then avoid consuming foods and drinks with phosphorus content to guard against weakening the bones and vessels. Sometimes too much phosphorus may lead to bone weakness as well as itchy skin and joint pain. In addition, check for the presence of phosphorus in the ingredients you buy from the butcher. There are some deli meat brands that might have been sprinkled with extra phosphorus, as well as fresh meat and poultry.
• Optimizing potassium: Opt for foods with an optimum potassium content to facilitate nerve and muscle functioning. Reduced or increased levels of potassium could result in renal or cardiac problems in extreme conditions.Ensure that potassium levels are minimized through the consumption of foods and beverages. Do not use salt substitutes because they may have a high potassium content. One should also ensure that they drain canned fruits and vegetables.
• Fluid: Excess fluid buildup can cause swelling, weight gain, and heart trouble. It’s crucial to monitor liquid intake and food sources, including gravies, sambar, rasam, soups, and porridges, to avoid these issues. Changes in blood pressure can also cause the heart to work harder.

CKD with diabetes:

The American Association ADA has recommended a lesser intake of calories, increased physical activity for promoting weight management, and monitoring of carbohydrate intake to help maintain the ABCs (A1c,, blood pressure, and cholesterol). A diet consisting of carbohydrates, especially complex carbohydrates from fruits, vegetables, whole grains, legumes, and low-fat milk, is recommended. A high-fiber diet (25 to 30 grams) per day helps to control hemoglobin A1c and blood glucose levels.

CKD and hypertension:

Blood pressure can be maintained by proper management of diet, which helps in reducing blood pressure in people with essential hypertension, as well as dietary management with moderate sodium restriction, which plays one of the most prominent roles of cause among the major population. Canned foods pickles sauces  processed foods  Fast foods should be avoided.

There is no single “best” food for healthy kidneys; some of the best foods for healthy kidneys include fruits, vegetables, fish, wholegrains, and herbs. olive oil, bread, and more.

Nutrition and Chronic Kidney Disease

Although CKD is generally progressive and irreversible, there are steps providers and patients can take to slow progression with the help of diet.The purpose of this diet is to keep the levels of electrolytes, minerals, and fluid in your body balanced when you have CKD or are on dialysis.

Treatment strategies to slow progression and reduce cardiovascular risk are similar. They include:

• Nutritional management
• Lifestyle modifications
• Medical management to control blood pressure and blood glucose, and reduce albuminuria

Screening for CKD on Hemodialysis

Patients undergoing hemodialysis belong to the end-stage Chronic Kidney Disease (CKD) group; hence, their healthcare emphasis now turns to managing complications of the ailment as well as improving dialysis treatment. Hemodialysis patients are supposed to undergo some key screening processes, including kidney function monitoring, electrolyte and mineral monitoring, and monitoring complications, on a regular basis. It is important that kidney function, electrolyte levels, and signs of complications are checked frequently so that these issues can be detected before they develop further.

 Doctors continue to monitor kidney function using tests like serum creatinine and estimated glomerular filtration rate (eGFR), which estimate the remaining kidney function’s effectiveness, and urine analysis, which can detect infections, proteinuria, and other abnormalities, despite kidney function being significantly impaired.

To make sure your health is okay, they usually watch for blood pressure, high cholesterol, and anemia. Among the complications that are prone to hemodialysis are a high rate of cardiovascular disease (CVD), which manifests as anemia and poor bone density, among other things. Additional monitors: red blood cell count and hemoglobin tests; bone health scans via radioisotopes or X-rays. A person’s dietician in renal care takes care of nutritional assessment, giving diet plans that are personalized and tailored specifically to accept the foods the patient may like.

These screening processes are crucial for ensuring the well-being of patients on hemodialysis, as they allow doctors to adapt treatment plans to optimize dialysis efficiency and improve the patient’s quality of life.

References:

1. NIDDK.NIH.GOV, Eating right for Chronic Kidney Diseases, https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/eating-nutrition, Last accessed on, 13th April,2021. 
2. Kidney Fund, Kidney Diet and Foods, https://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/kidney-friendly-diet-for-ckd.html Last accessed on, 13th April,2021. 
3. Webmd, Kidney Disease Diet, https://www.webmd.com/a-to-z-guides/diet-and-chronic-kidney-disease Last accessed on, 13th April,2021. 
4. Healthline, Stages of CKD https://www.healthline.com/health/ckd-stages Last accessed on, 13th April,2021. 
5. NHS, Treatment of CKD   https://www.nhs.uk/conditions/kidney-disease/treatment/, 19th April, 2021. 
6. Mayoclinic, Symptoms of CKD, https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521 19th April 2021.