Kidney Disease
Description
The term kidney disease is used to describe many conditions. Here it is used to refer to the specific disorder renal failure. This occurs when the kidneys are unable to properly clear normal biological chemical products from the bloodstream. Failure may be complete or partial, temporary, or permanent. The two major forms of renal failure are: acute renal failure and chronic renal failure.
Acute renal failure refers to the sudden onset of kidney malfunction sufficient to permit the accumulation of nitrogenous wastes in the blood. Mild attacks of the acute form are fairly common; the severe form is rarer.
Chronic renal failure refers to slow development of kidney malfunction. This is a more permanent condition than acute renal failure. The most advanced form of renal failure occurs when the kidneys perform so poorly that the condition becomes life threatening. This is referred to as end-stage renal failure and is a result of one of the aforementioned forms. Over 5% of Americans have potentially life-threatening kidney disease.
Renal failure is not itself a disease; rather, it occurs as a result of a wide variety of disorders, especially those of the urinary and cardiovascular systems. Renal failure may also result from systemic diseases which affect kidney function.
Emergency treatment may be necessary for acute renal failure. Kidney transplants and hemodialysis are treatments for end-stage renal failure. Continuous ambulatory peritoneal dialysis (CAPD) is a new technique of blood filtration. In this case, the peritoneum acts as a dialysis membrane and assists in the blood filtration and purification. Many individuals can lead relatively normal lives after treatment.
Causes
Acute renal failure
Acute glomerulonephritis
Acute tubular necrosis
Bilateral renal cortical necrosis
Papillary necrosis
Pregnancy
Hemorrhage
Burns
Pancreatitis
Peritonitis
Sudden drop in blood volume due to severe bleeding
Major heart attack
60% of the causes of renal failure in this case are trauma or surgery
Sudden and complete obstruction of urine flow due to blockage in part of the urinary tract
Chronic renal failure
| Membranous glomerulonephripathy | Analgesic nephropathy |
| Congenital nephritis | Polycystic disease |
| Medullary cystic disease | Renal hyperplasia |
| Renal tubular acidosis | Balkan nephropathy |
| Upper urinary tract obstruction | Kidney stones |
| Polyarteritis | Lupus erythematosus |
| Amyloidosis | Potassium deficiency |
| Hypercalcemia | Cystinosis |
| Oxalosis | Consumption of coagulopathies |
| Cadmium or lead poisoning | Atherosclerosis |
| Systolic emboli | Gout |
| Diabetes mellitus | Heart failure |
| Cirrhosis | Hypertension (also a symptom) |
Chronic pyelonephritis, accounting for about 21% of cases
End-stage renal failure
Any renal failure which has progressed to a point which is life threatening
Signs & Symptoms
Acute renal failure
Symptoms of the condition which caused the failure are usually more apparent than those which are due to renal failure itself. Symptoms include:
| Passing less urine than normal | Anorexia |
| Nausea | Vomiting |
| Drowsiness | Confusion |
| Convulsions | Coma |
Chronic renal failure
The symptoms appear gradually although there may be none for many years. Symptoms include:
| Hypertension (also a cause) | Increased urination |
| Lethargy | Tiredness |
| Diarrhea |
Problems due to the kidneys' inability to control blood chemical levels include: Anemia, Osteomalacia and Hyperparathyroidism
End-stage renal failure
Chemical poisoning in end-stage renal failure give rise to:
| Lethargy | Weakness |
| Headache | Furred tongue |
| Halitosis | Dry, flaky skin |
| Oral thrush | Anorexia |
| Nausea | Vomiting |
| Diarrhea | Pain in the chest or bones |
| Intense itching | Amenorrhea |
| Dry mouth | Metallic taste in the mouth |
| Uremic odor in the mouth | Bleeding tendencies |
| Peripheral neuropathy | Muscle cramps |
| Muscle twitches | Hiccoughing |
| Insomnia | Poor wound healing |
| Pancreatitis | Retinopathy due to hypertension |
| Edema in the lungs, causing dyspnea | Increased susceptibility to infection |
| Edema of the skin, causing inflammation |
Nutritional Supplements
---------------------------------
General Supplements
---------------------------------
| Adult | Child/Adolescent | ||
| Chromium | 100 - 300 mcg | 50 - 200 mcg | |
| DHEA* | |||
| Fish oils* | |||
| Ginkgo biloba* | |||
| Kelp* | |||
| Lecithin* | |||
| Silymarin* | |||
| Vitamin C | 500 - 1,000 mg | 200 - 500 mg | |
| Vitamin E | 200 - 400 IU | 100 - 200 IU | |
| Zinc | 20 - 80 mg | 10 - 30 mg |
* Please refer to the respective topic for specific nutrient amounts.
Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.
Dietary Considerations
Acute renal failure
The body cannot handle dietary protein in acute renal failure; therefore, the strategy for this individual is to provide enough carbohydrates to prevent utilization of body protein for energy requirements. If enough calories are provided in this manner, endogenous protein will not be catabolized. A high carbohydrate Low Protein Diet should be followed. An additional measure to prevent protein wastage is dietary supplementation with essential and/or nonessential amino acids. The body uses exogenous amino acids and spares the endogenous proteins. Essential amino acid supplementation may help prolong conservative treatment by deferring the need for hemodialysis. Supplementation promotes positive nitrogen balance while keeping down a serum index of toxicity, the blood urea nitrogen level.
The water and sodium output should be carefully monitored, and care taken not to overload the system with fluids. A Sodium Restricted Diet is prescribed if peripheral or pulmonary edema is observed.
Chronic renal failure
Treatment is similar to that of acute renal failure. Protein is not as severely restricted since overzealousness results in negative nitrogen balance and protein deficiency if practiced indefinitely. 15 grams of egg protein will provide the seven grams of essential amino acids needed daily by the individual. Sodium levels should be monitored closely, and a Sodium Restricted Diet is prescribed if edema occurs.
In renal osteodystrophy serum phosphate levels are elevated, calcium levels are low, and hyperparathyroidism can occur. Hence, vitamin D and calcium deficiencies must be remedied. Although vitamin D supplementation increases the absorption of phosphorous, it is prescribed to aid the absorption of calcium from the intestine and to suppress secondary hyperparathyroidism. Oral vitamin D is also taken for the treatment and prevention of renal osteodystrophy. Calcium supplements are needed to prevent bone demineralization and to protect the integrity of blood vessels and intestine. A total calcium uptake of 1,200 to 1,600 milligrams per day is recommended. The individual must restrict his or her intake of milk, milk products, and cheese to minimize consumption of phosphorus. With these considerations, it is best if the individual consumes the quota of vitamin D and calcium in pill form, rather than through foods.
Persons with renal failure should not consume magnesium-containing antacids since their impaired kidneys have difficulty clearing excess serum magnesium; symptoms of toxicity including nausea, hypotension, muscle weakness, and respiratory depression may develop.
Dialysis increases protein requirements of the body. This also filters amino acids, peptides, and proteins out of the serum through a dialytic membrane. Therefore, the individual does not experience problems with protein overload or collection of toxic urea. Dietary protein should not be restricted in them; on the contrary, children on hemodialysis should be given protein and/or amino acids if they are to grow. The nutritional goals are to minimize the occurrence of abnormal blood chemistries, by restricting sodium and supplementing with potassium, and to provide enough calories for growth or maintenance of ideal body weight.
Homeopathic Remedy
Kidney Colic
1. Serum anguillae ichthyotoxin - 30C
2. Cantharis - 30C
Kidney Shutdown
1. Zingiber officinale 3X to 30C - 3X first (2-4 weeks, then 30C)
Treatment Schedule
Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.
Legend
X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency
Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.
References
Boericke, D.E., 1988. Homeopathic Materia Medica.
Coulter, C.R., 1986. Portraits of Homeopathic Medicines.
Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.
Koehler, G., 1989. Handbook of Homeopathy.
Shingale, J.N., 1992. Bedside Prescriber.
Smith, Trevor, 1989. Homeopathic Medicine.
Ullman, Dana, 1991. The One Minute (or so) Healer.
Herbal Approaches
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Herbs
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Cranberry juice
Echinacea
Goldenseal
Queen-of-the-meadow
Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.
Aromatherapy - Essential Oils
Essential oils recommended for infectious kidney disease, include:
Related Health Conditions
References
Alpers, D.H., R.E. Clouse & W.F. Stenson. 1983. Manual of Nutritional Therapeutics. Little, Brown, and Company, Boston. 457 pp.
Arnadottir, M et al., The effects of high-dose pyridoxine and folic acid supplementation on serum lipid and plasma homocysteine concentrations in dialysis patients, Clinical Nephrology, 1993, Vol. 40, No. 4, pp. 236-240.
Beeson, P.B. & Mc Dermott, W. eds. 1975. Textbook Of Medicine. 14th ed. Saunders Pub. Co., Philadelphia. 1892 pp.
Bergstr”m J: Nutrition and mortality in hemodialysis [editorial]. J Am Soc Nephrol, 1995 Nov, 6:5, 1329-41.
Bland, Jeffrey. Nutraerobics. San Francisco: Harper & Row, 1983.
Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.
Bostom AG et al., High dose-B-vitamin treatment of hyperhomocysteinemia in dialysis patients. Kidney Int, 1996 Jan, 49:1, 147-52.
Bostom AG et al., Folate status is the major determinant of fasting total plasma homocysteine levels in maintenance dialysis patients. Atherosclerosis, 1996 Jun, 123:1-2, 193-202.
Chan W: Nutrition and chronic renal disease in children. Acta Paediatr Sin, 1996 Jul-Aug, 37:4, 244-7.
Chertow GM et al., Nutrition and the dialysis prescription. Am J Nephrol, 1996, 16:1, 79-89.
D'Amico, G.: Economic Implications of Nutritional Treatment of Chronic Renal Failure. Nutritional Treatment of Chronic Renal Failure, 1989;275-278.
Dolecek TA et al., Registered dietitian time requirements in the Modification of Diet in Renal Disease Study. J Am Diet Assoc, 1995 Nov, 95:11, 1307-12.
Dombros-NV et al: Anabolic steroids in the treatment of malnourished CAPD patients: a retrospective study. Perit-Dial-Int. 1994; 14(4): 344-7.
Eagles, J.A. & M.N. Randall. 1980. Handbook of Normal and Therapeutic Nutrition. Raven Press, New York. 323 pp.
Emenaker NJ et al., Copper-related blood indexes in kidney dialysis patients. Am J Clin Nutr, 1996 Nov, 64:5, 757-60.
Gallice, P. & A. Crevat. A Compound From Uremic Plasma and Normal Urine. Clinical Chemistry, 31. 1985.
Gillis BP et al., Nutrition intervention program of the Modification of Diet in Renal Disease Study: a self-management approach. J Am Diet Assoc, 1995 Nov, 95:11, 1288-94.
Ikizler TA et al., Spontaneous dietary protein intake during progression of chronic renal failure. J Am Soc Nephrol, 1995 Nov, 6:5, 1386-91.
Ikizler TA & Hakim RM: Nutrition in end-stage renal disease. Kidney Int, 1996 Aug, 50:2, 343-57.
Ikizler TA & Himmelfarb J: Nutrition in acute renal failure patients. Adv Ren Replace Ther, 1997 Apr, 4:2 Suppl 1, 54-63.
Jaeger-P.: [Pathogenesis of renal calculi (editorial)] Presse-Med. 1994 Jul 2-9; 23(25): 1151-2.
Kerr PG et al., Assessment of the nutritional state of dialysis patients. Blood Purif, 1996, 14:5, 382-7.
Klahr S: Primary and secondary results of the modification of diet in renal disease study. Miner Electrolyte Metab, 1996, 22:1-3, 138-42.
Klahr S: Is there still a role for a diet very low in protein, with or without supplements, in the management of patients with end-stage renal failure? Curr Opin Nephrol Hypertens, 1996 Jul, 5:4, 384-7.
Kumar BD & Krishnaswamy K: Detection of occupational lead nephropathy using early renal markers. J Toxicol Clin Toxicol, 1995, 33:4, 331-5.
Kunz, J.R.M. 1982. The American Medical Association Family Medical Guide. Random House Pub, New York. 832 pp.
Kushner RF et al., Use of bioelectrical impedance analysis measurements in the clinical management of patients undergoing dialysis. Am J Clin Nutr, 1996 Sep, 64:3 Suppl, 503S-509S.
Lusvarghi E et al., Natural history of nutrition in chronic renal failure. Nephrol Dial Transplant, 1996, 11 Suppl 9:, 75-84.
Maroni BJ & Mitch WE: Role of nutrition in prevention of the progression of renal disease. Annu Rev Nutr, 1997, 17:, 435-55.
Milas NC et al., Factors associated with adherence to the dietary protein intervention in the Modification of Diet in Renal Disease Study. J Am Diet Assoc, 1995 Nov, 95:11, 1295-300.
Mitch WE: Low-protein diets in the treatment of chronic renal failure. J Am Coll Nutr, 1995 Aug, 14:4, 311-6.
Mittman N & Avram MM: Dyslipidemia in renal disease. Semin Nephrol, 1996 May, 16:3, 202-13.
Petersdorf, R.G. & R.D. Adams. 1983. Harrison's Principles Of Internal Medicine. 10th ed. McGraw Hill Pub Co., New York. 2212pp.
Ritz-E. et al: The effect of malnutrition on cardiovascular mortality in dialysis patients: is L-arginine the answer? Nephrol-Dial-Transplant. 1994; 9(2): 129-30.
Rodriguez D & Lewis SL: Nutritional management of patients with acute renal failure. ANNA J, 1997 Apr, 24:2, 232-6, 238-41; quiz 242-3.
Russell RM: The impact of disease states as a modifying factor for nutrition toxicity. Nutr Rev, 1997 Feb, 55:2, 50-3.
Sakhaee, K. et al: Calcium Citrate Without Aluminum Antacids Does Not Cause Aluminum Retention in Patients With Functioning Kidneys. Bone and Mineral, 1993;20:87-97.
Sanaka-T. et al: IGF-I as an early indicator of malnutrition in patients with end-stage renal disease. Nephron. 1994; 67(1): 73-81.
Sedman A et al., Nutritional management of the child with mild to moderate chronic renal failure. J Pediatr, 1996 Aug, 129:2, s13-8.
Seidner-DL. et al: Nutritional care of the critically ill patient with renal failure. Semin-Nephrol. 1994 Jan; 14(1): 53-63.
Shils ME & Rude RK: Deliberations and evaluations of the approaches, endpoints and paradigms for magnesium dietary recommendations. J Nutr, 1996 Sep, 126:9 Suppl, 2398S-2403S.
Soliman-G & Oreopoulos-DG.: Anabolic steroids and malnutrition in chronic renal failure.. Perit-Dial-Int. 1994; 14(4): 362-5.
Sponsel-H & Conger-JD. : Is parenteral nutrition therapy of value in acute renal failure patients?. Am-J-Kidney-Dis. 1995 Jan; 25(1): 96-102.
Subak-Sharpe, G.J. 1984. The Physician's Manual For Patients. Times Books Pub. New York. 607 pp.
Teplan-V et al: [Individualized supplemented low-protein diet in patients with chronic kidney failure]. Vnitr-Lek. 1994 Oct; 40(10): 623-7.
Thomas, C.L. 1985. Taber's Cyclopedic Medical Dictionary. F.A. Davis Co. pub., Philadelphia. 2170 pp.
Valdes-R et al: Surgical complications of renal transplantation in malnourished children. Transplant-Proc. 1994 Feb; 26(1): 50-1.
Walser, M. 1983. Nutrition in renal failure. Ann Reviews In Nutrition, 3.
Walser, M., H. Mullan, et al. 1984. Modifications in protein: Nutritional aspects of renal failure. In Nutritional Management. M. Walser, A. L. Imbembo, S. Margolis, & G.A. Elfert, eds. W.B. Saunders Co., Phila.
Wills, M. Uremic Toxins and Their Effect on Intermediary Metabolism. Clinical Chemistry, 31. 1985.
Williams, A.J. & J. Walls. Protein Restriction in Chronic Renal Failure. Lancet. January 12, 1985.
Woodrow G et al., Whole body and regional body composition in patients with chronic renal failure. Nephrol Dial Transplant, 1996 Aug, 11:8, 1613-8.
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