Friday, July 3, 2009

Nutritional Considerations in Kidney Diseases

Kidney diseases kill 60,000 Americans a year and afflict at least 8 million more. Dialysis and transplants are expensive, costing taxpayers over 2 billion dollars annually. To that, add the emotional and physical costs in pain.

How Do Your Kidneys Work?
The answer is, constantly! 24 hours a day, your two kidneys filter your blood somewhat like an aquarium filter filters the water in a fish tank. The functional unit of the kidney is the nephron, a tissue unit that not only filters, but also recycles and excretes. The nephron filters blood (except red blood cells and protein); maintains the body's acid-base ion balance; recycles needed substances (water, minerals); and excretes wastes in a concentrated urine. In a manner of speaking, urine is filtered blood, or more exactly, blood is filtered urine.

Kidney Diseases and Problems:
Inflammation and Infection
The role of massive doses of vitamin C is profound in this case, providing prevention and treatment at saturation levels. Since vitamin C is filtered and "wasted" through the kidneys, it is a virtually custom-made therapy.

Degeneration (resulting from inflammation, etc.)
A chronic excess of dietary protein almost certainly taxes the kidneys and leads to gradual degeneration. (Williams, SR Nutrition and Diet Therapy, page 856, "The Aging Western Kidney"). Vegetarianism is a virtually automatic solution to our nation-wide pattern of protein abuse. Protein restriction is generally considered to be an important treatment for progressed glomerulonephritis. Reducing protein intake is obviously an ideal way to prevent a protein-breakdown induced nitrogenous overload in the first place.

Increasing carbohydrates is recommended. “Carbohydrates should be given liberally. This will also reduce the catabolism of proteins and prevent ... ketosis." (Williams) Again, a regular vegetarian diet, which is high in complex carbohydrates, will assure just this.

Nephrotic Syndrome (swelling and protein in the urine)
This condition results from tissue damage and impaired nephron function. Its association with collagen diseases (rheumatoid arthritis, lupus, etc.) is hardly accidental, for chronic deficiencies of vitamin C (and vitamin C’s helpers, the bioflavinoids) cause the very event described by Williams on page 851: "The primary degenerative lesion is in the capillary basement membrane of the glomerulus which permits the escape of large amounts of protein into the filtrate." This is because capillaries, those tiniest and most numerous of all the blood vessels, get leaky in the absence of ample vitamin C. Easily-bleeding gums are a visible example of this, but easily-leaking glomeruli (part of the nephron) are a greater, hidden, but similar problem.

Acute Renal (Kidney) Failure
Early successful management of infectious disease greatly reduces the likelihood of renal failure. Saturation with vitamin C is very effective, broad-spectrum treatment for infectious diseases (Klenner, Stone, Pauling. Cathcart). Vitamin C does not cause kidney problems; it prevents them. For example, vitamin C stops the formation or oxalate stones, and actually dissolves phosphate and struvite kidney stones (see below). If kidney failure is suspected, see your doctor early in the game, and insist that vitamin C therapy is employed. Even conventional food-groups nutrition texts (correctly) mention the need for supplemental vitamin C and the B-complex for kidney tissue healing. Just up the doses if you want best results.

In early renal failure, no protein should be given. Vegetable juice fasting may work well here. If liquids are restricted, put the vegetables through a blender and eat as a salad puree. It tastes better than it sounds.

HOW TO MAKE A BLENDED SALAD according to Dr. Christopher Gian-Cursio, who was a New York City-based, circut-riding naturopath for over 50 years. I met Dr. Gian-Cursio some twenty years ago. Here’s his recipe:

1 each small tomato, red or green pepper
1/2 small cucumber
juice of 1/2 lemon or lime
5-6 leaves romaine lettuce
3-4 stalks fresh fennel or celery

Place cut up pieces of tomato, pepper and cucumber along with lemon juice into blender. Blend until smooth and liquid. Add romaine leaves one at a time. Add celery or fennel; blend additional 2-3 minutes. (The consistency depends upon personal taste; some like it smooth and watery, others thick and crunchy.)

I will add that you should eat your blended immediately. Fresh, wholesome food does not “keep,” and crushed raw food does not keep at all.

Chronic Renal Failure
Continued deterioration means loss of vital kidney participation in the activation of vitamin D-1. The result can be osteodystrophy (loss of calcium from bone or poor bone formation in childhood). Supplementation with vitamin D and calcium are therefore required.

Amino acid supplements have shown promise in treating chronic renal failure, when coupled with a greatly curtailed amount of dietary protein of only 20 to 25 grams/day. As an advocate of vegetable juice fasting, I personally think the protein restriction may have done as much as the amino acid supplementation. Why? Because typical hospital “protein restricted diets” provide 40g/day of protein!

Consider this: the typical American eats over 100g, and frequently exceeds 120g of protein daily, which is WAY too much. So a so-called “restriction” to 40 g/day is simply a correction. Most of the world’s peoples would be pleased as punch to be able to eat 40g/day of protein. But we happily chow down three times that, call it normal . . . and then line up for dialysis.

The cost of too much meat may ultimately be over $10,000 per year for dialysis at home... or more than $35,000 per year at a dialysis center. And these are 1990 prices.

During dialysis, the water soluble vitamins (B-complex and C) are lost from the blood. Supplementation is essential, and must be both high-potency and FREQUENT.

Obstruction: Renal Calculi (stones)
There are five types of kidney stones:

1. Calcium phosphate stones are common and easily dissolve in urine acidified by vitamin C.

2. Calcium oxalate stones are also common but they do not dissolve in acid urine.

3. Magnesium ammonium phosphate (struvite stones) are much less common, often appearing after an infection. They dissolve in vitamin C acidified urine.

4. Uric acid stones result from a problem metabolizing purines (the chemical base of adenine, xanthine, theobromine [in chocolate] and uric acid). They may form in a condition such as gout.

5. Cystine stones result from a hereditary inability to reabsorb cystine. Most children's stones are this type, and these are rare.

The Role of Vitamin C in Preventing and Dissolving Kidney Stones:
The very common calcium phosphate stone can only exist in a urinary tract that is not acidic. Ascorbic acid (vitamin C's most common form) acidifies the urine, thereby dissolving phosphate stones and preventing their formation.

Acidic urine will also dissolve magnesium ammonium phosphate stones, which would otherwise require surgical removal. These are the same struvite stones associated with urinary tract infections. Both the infection and the stone are easily cured with vitamin C in large doses. BOTH are virtually 100% preventable with daily consumption of much-greater-than-RDA amounts of ascorbic acid. Think grams, not milligrams! A gorilla gets about 4,000 mg of vitamin C a day in its natural diet. The US RDA for humans is only 60 mg. Someone is wrong, and I don't think it's the gorillas.

The common calcium oxalate stone can form in an acidic urine whether one takes vitamin C or not. However, if a person gets adequate quantities of B-complex vitamins and magnesium, this type of stone does not form. Any common B-complex supplement twice daily, plus about 400 milligrams of magnesium, is usually adequate.

Ascorbate (the active ion in vitamin C) does increase the body's production of oxalate. Yet, in practice, vitamin C does not increase oxalate stone formation. Drs. Emanuel Cheraskin, Marshall Ringsdorf, Jr. and Emily Sisley explain in The Vitamin C Connection (1983) that acidic urine or slightly acidic urine reduces the UNION of calcium and oxalate, reducing the possibility of stones. "Vitamin C in the urine tends to bind calcium and decrease its free form. This means less chance of calcium's separating out as calcium oxalate (stones)." (page 213) Also, the diuretic effect of vitamin C reduces the static conditions necessary for stone formation in general. Fast moving rivers deposit little silt.

Furthermore, you can avoid excessive oxalates by not eating (much) rhubarb, spinach, or chocolate. If a doctor thinks that a person is especially prone to forming oxalate stones, that person should read the suggestions below before abandoning the benefits of vitamin C.

Ways for ANYONE to reduce the risk of kidney stones:
1. Maximize fluid intake. Especially drink fruit and vegetable juices. Orange, grape and carrot juices are high in citrates which inhibit both a build up of uric acid and also stop calcium salts from forming. (Carper, J. "Orange Juice May Prevent Kidney Stones," Lancaster Intelligencer-Journal, Jan 5, 1994)

2. Control urine pH: acidic urine helps prevent urinary tract infections, dissolves both phosphate and struvite stones, and will not cause oxalate stones.

3. Eat your veggies: studies have shown that dietary oxalate is generally not a significant factor in stone formation. I would go easy on rhubarb and spinach, however.

4. Most kidney stones are compounds of calcium and most Americans are calcium deficient. Instead of lowering calcium intake, reduce excess dietary phosphorous by avoiding carbonated soft drinks, especially colas. Soft drinks contain excessive quantities of phosphorous as phosphoric acid. This is the same acid that has been used by dentists to etch tooth enamel before applying sealant.

Remember that Americans get only about 500 mg of dietary calcium daily, and the RDA is 800 to 1200 mg/day. Any nutritionist, doctor or text suggesting calcium reduction is in serious error.

5. Take a magnesium supplement of at least the US RDA of 300-400 mg/day (more may be desirable in order to maintain an ideal 1:2 balance of magnesium to calcium)

6. Be certain to take a good B-complex vitamin supplement daily, which contains pyridoxine (Vitamin B-6). B-6 deficiency produces kidney stones in experimental animals. Remember:

* B-6 deficiency is very common in humans

* B-1 (thiamine) deficiency also is associated with stones (Hagler and Herman, "Oxalate Metabolism, II" American Journal of Clinical Nutrition, 26:8, 882-889, August, 1973)

7. Additionally, low calcium may itself CAUSE calcium stones (L. H. Smith, et al, "Medical Evaluation of Urolithiasis" Urological Clinics of North America 1:2, 241-260, June 1974)

8. For uric acid/purine stones (gout), STOP EATING MEAT! Nutrition tables and textbooks indicate meats as the major dietary purine source. Naturopathic treatment adds juice fasts and eating sour cherries. Increased vitamin C consumption helps by improving the urinary excretion of uric acid. (Cheraskin, et al, 1983). Use buffered ascorbate "C".

9. Persons with cystine stones (only 1% of all kidney stones) should follow a low methionine diet and use buffered C.

10. Kidney stones are associated with high sugar intake, so eat less (or no) added sugar (J. A. Thom, et al "The Influence of Refined Carbohydrate on Urinary Calcium Excretion," British Journal of Urology, 50:7, 459-464, December, 1978)

11. Infections can cause conditions that favor stone formation, such as overly concentrated urine (from fever sweating, vomiting or diarrhea). Practice good preventive health care, and it will pay you back with interest.

Cheraskin, Ringsdorf Jr., and Sisley: The Vitamin C Connection, Harper and Row, 1983.

Pauling, Linus "Are Kidney Stones Associated with Vitamin C Intake?" Today's Living, September, 1981.

Pauling, Linus "Crystals in the Kidney," Linus Pauling Institute Newsletter, 1:11, Spring, 1981.

Pauling, Linus How to Live Longer and Feel Better, Freeman, 1986.

Williams, S. R. Nutrition and Diet Therapy, 6th ed. Chapter 28.
* Courtesy - Andrew W Saul.

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