Eating to Control Chronic Kidney Disease
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Eating to Control Chronic Kidney Disease

Dr. Michael Greger — Nutritionfacts.org
Oct 26, 2018

The key to halting the progression of chronic kidney disease might be in the produce market or the farmer’s market, not in the pharmacy.

“In the United States, approximately one in three adults aged 65 years and older has chronic kidney disease (CKD),” as I note in my video Treating Chronic Kidney Disease with Food, but the “majority of patients with CKD do not progress to advanced stages of CKD because death precedes the progression to end-stage renal disease…” Following about a thousand folks 65 years or older with chronic kidney disease for about a decade, only a few had to go on dialysis because most died. The scariest thing for many kidney patients is the fear of dialysis, but they may be 13 times more likely to die than go on dialysis. With heart disease killing more than nearly all other causes combined, decreasing kidney function can set one up for heart attacks, strokes, and death.

That’s why it’s critical that any diet chosen to help the kidneys must also help the heart. A plant-based diet fits the bill, providing protection against kidney stones, kidney inflammation, and acidosis, as well as heart disease. (See below for links to my videos covering these very topics.) That is, “blood pressure control may be favored by the reduction of sodium intake and by the vegetarian nature of the diet, which is very important also for lowering serum cholesterol,” which may not only help the heart but also the kidneys themselves.

In 1858, Rudolf Virchow, the father of modern pathology, was the first to describe the fatty degeneration of the kidney. In 1982, this idea of lipid nephrotoxicity—the possibility that fat and cholesterol in the bloodstream could be toxic to the kidneys directly, based on data showing plugs of fat literally clogging up the works in autopsied kidneys—was formalized.

Since the notion was put forth, it has gained momentum. It appears high cholesterol and fat in the bloodstream may accelerate the progression of chronic kidney disease through direct toxic effects on the kidney cells themselves. Given the connection between cholesterol and kidney decline, the use of cholesterol-lowering statin drugs has been recommended to slow the progression of kidney disease. Of course, “[s]erious adverse effects on muscle and liver must be kept in mind.” This is why plant-based diets could offer the best of both worlds, protecting the heart and the kidneys without drug side effects.

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