Author's Perspective: When I worked as a volunteer for the American Diabetes Association, I met a lot of diabetics with kidney problems. As you are probably aware, the combination of having diabetes and taking diabetic medication takes a tremendous toll on your kidneys.
If you have protein leaking in your urine or if you have high blood pressure, you need to take action now! Your kidneys perform many vital functions that your body requires on a 24/7 basis. But, your kidneys are very delicate, especially the small capillaries that feed into your kidneys. The high blood glucose levels cause major damage to your kidneys (along with your eyes and feet).
You will not notice any major problems for 10 to 15 years -- that's one of the reasons why kidney failure is such a big problem. There are no major noticeable symptoms associated with kidney problems until your frequency to urinate increases and eventually protein starts to leak into your urine.
It is imperative that you change the way you're eating right now before the kidney damage progresses too far. Start with our Death to Diabetes nutritional program to stop the progression of the damage to your kidneys. You do not want to end up on kidney dialysis and have to go on a kidney transplant list!
Author's Sidebar: Some diabetics underestimate what they know when it comes to diabetes. They ask me all the time how could I know so much about diabetes -- even more than their doctors. :-) First of all, when you come out of a diabetic coma like I did, you're really motivated to learn everything you can about diabetes. :-)
Also, I have to thank other diabetics like yourself for my knowledge about diabetes. Over the years I have learned a lot from many of you. So many of you were so open with sharing your stories with me. Talking to many of you was like going to medical school!
When I tell other diabetics that I learned a lot from them, they laugh it off. Believe it or not, you know a lot more than you realize. It's because of you that I learned so much about protein leaking, kidney disease, and kidney dialysis.
During diabetes training classes, some of you will not respond to my questions because you don't believe they know the answer. Then, I take you through an exercise where I ask leading questions that leads you to respond with the right answer. It's a great exercise because I can see the look of pride and accomplishment in your face -- there's a glow when you realize that you know a lot more than you realize. You just need someone to bring it out of you. :-) So, stop underestimating what you know and take advantage of this information to save your life or the life of a loved one.
FYI: I learned this teaching technique when I was a volunteer math tutor (algebra, geometry, trigonometry and calculus) for the Urban League and several local high schools. There was nothing more rewarding than seeing the look on a teenager's face when he/she realized that they understood more than they realized about algebra or trigonometry. I even had some of them helping me tutor some of the younger kids. This empowered them and gave them even more confidence in themselves. Their parents loved it.
Now, I try to do the same thing with some of you who are learning how to deal with your diabetes. There is nothing more empowering than figuring out how to improve your own health!
Well, actually there is ... Some of you who have become health advocates are taking what you learned from our classes and educating and empowering diabetics in your church and community. That is very rewarding and so important to show others the way to better health.
Every day, your kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid.
Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called the glomerulus, and a tubule.
The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it; however, it prevents blood cells and large molecules, mostly proteins, from passing.
The filtered fluid then passes through the tubule, which sends needed minerals back to the bloodstream and removes wastes. The final product becomes urine, which drains down into collecting ducts to the ureter.
Diabetic nephropathy occurs when proper blood glucose levels are not maintained, leading to excess inflammation and glucose in the bloodstream, clogging the small capillaries that feed into the kidneys.
In addition, there is an excess amount of acid waste in the blood that further clogs these small capillaries. The accumulation of calcium (due to the extra insulin) and acid waste in the kidneys causes the formation of kidney stones and ultimately causes kidney cells to die.
Because kidney cells cannot be regenerated or repaired, the remaining cells have to work that much harder to filter substances from the blood.
To help with the filtering process, the heart increases the flow of blood plasma to the kidneys, which in turn elevates blood pressure. As the kidney cells continue to die, the risk of kidney failure increases dramatically.
This eventually leads to one or both of the kidneys losing their ability to function properly, characterized by high protein levels in the urine (proteinuria). Alcohol, tobacco, conventional animal meat, and many of the other “dead” processed foods accelerate the deterioration of the kidneys.
The earliest detectable change in the course of diabetic nephropathy is a thickening in the glomerulus. At this stage, the kidney may start allowing more albumin (protein) than normal in the urine, and this can be detected by blood tests for albumin. This stage is called “microalbuminuria” (micro refers to the small amounts of albumin).
As diabetic nephropathy progresses, increasing numbers of glomeruli are destroyed. This increases the amounts of albumin being excreted in the urine, and may be detected by ordinary urinalysis techniques. At this stage, a kidney biopsy clearly shows diabetic nephropathy.
Protein may appear in the urine for five to ten years before other symptoms develop. High blood pressure often accompanies diabetic nephropathy. Over time, the kidney’s ability to function starts to decline.
Diabetic nephropathy may eventually lead to chronic kidney failure, which consists of 5 stages -- see below for details. The disorder continues to progress toward end-stage kidney disease, usually within two to six years after the appearance of high protein in the urine (proteinuria).
Diabetic nephropathy is the most common cause of chronic kidney failure and end-stage kidney disease in the United States. People with both Type 1 and Type 2 diabetes are at risk. The risk is higher if blood glucose levels are poorly controlled. However, once nephropathy develops, the greatest rate of progression is seen in patients with high blood pressure.
Diabetic nephropathy is generally accompanied by other diabetic complications including high blood pressure, retinopathy, and vascular (blood vessel) changes, although these may not be obvious during the early stages of nephropathy. Nephropathy may be present for many years before high protein in the urine or chronic kidney failure develops.
Don't let this happen to you! Take action -- be proactive and start following a plant-based diet such as the Death to Diabetes nutritional program to protect and nourish your kidneys. Otherwise, you will face kidney dialysis and/or you'll have to wait for a kidney transplant.
Early stage diabetic nephropathy has no symptoms. But, over time, the kidney's ability to function starts to decline. Symptoms develop late in the disease and may include:
- Foamy appearance or excessive frothing of the urine
- Frequent hiccups
- General ill feeling
- Generalized itching
- Nausea and vomiting
- Poor appetite
- Swelling of the legs (edema)
- Swelling, usually around the eyes in the mornings; general body swelling may occur with late-stage disease
- Unintentional weight gain (from fluid buildup)
The first laboratory abnormality is a positive microalbuminuria test, which implies that you are very likely to develop diabetic nephropathy. Most often, the diagnosis is suspected when a routine urinalysis of a person with diabetes shows too much protein in the urine (proteinuria). The urinalysis may also show glucose in the urine, especially if blood glucose is poorly controlled.
The microalbumin test checks urine for the presence of a protein called albumin. Albumin is normally found in the blood and filtered by the kidneys. When the kidneys camera are working properly, albumin is not present in the urine. But when the kidneys are damaged, small amounts of albumin leak into the urine. This condition is called microalbuminuria (or proteinuria).
Without treatment to slow the leakage of protein, the kidneys may continue to be damaged and eventually fail.
If the microalbuminuria test is positive, it indicates that the blood vessels to your kidneys are damaged. It also reflects more widespread blood vessel disease that can increase your risk of heart problems.
Warning! Don't Wait Until It's Too Late!
If you have been diagnosed with protein leaking in your urine, it is imperative that you take action! You need to change to a plant-based diet immediately to protect your kidneys from further damage and possible kidney disease (nephropathy)!
Otherwise, you will eventually end up on kidney dialysis or have to get a kidney transplant! It's not fun to be put on a transplant list and wait for a viable transplant. In addition, the number of foods and the specific foods that you can't eat will increase as your kidneys get worse. In most cases, you will have to go on a very restrictive diet, such as a low sodium-low potassium diet.
Consequently, start with the Death to Diabetes diet, and add raw juicing, wholefood nutritional supplements and herbal tinctures to nourish and protect the kidneys from further damage.
There may or may not be signs of other diabetic complications. High blood pressure may be present or develop rapidly and may be difficult to control. Serum creatinine and BUN (blood urea nitrogen) may increase as kidney damage progresses.
If there is any doubt in the diagnosis, a kidney biopsy may be performed to confirm the diagnosis and to study the extent of the disease.
Medical Exams and Tests
The main sign of diabetic nephropathy is persistent protein in the urine (proteinuria). Protein may appear in the urine for 5 to 10 years before other symptoms develop.
If your doctor thinks you might have this condition, a microalbuminuria test will be done. A positive test often means you have at least some damage to the kidney from diabetes.
Damage at this stage may be reversible with a plant-based diet such as the Death to Diabetes diet. The test results can be high for other reasons, so it needs to be repeated for confirmation.
High blood pressure often goes along with diabetic nephropathy. You may have high blood pressure that develops rapidly or is difficult to control.
Laboratory tests that may be done include:
- Serum creatinine
The levels of these tests will increase as kidney damage gets worse. Other laboratory tests that may be done include:
- 24-hour urine protein
- Blood levels of phosphorus, calcium, bicarbonate, PTH, and potassium
- Protein electrophoresis - urine
A kidney biopsy confirms the diagnosis. However, your doctor can diagnose the condition without a biopsy if you meet the following three conditions:
- Persistent protein in the urine
- Diabetic retinopathy
- No other kidney or renal tract disease
A biopsy may be done, however, if there is any doubt in the diagnosis.
Medical Treatment for Kidney Disease
The goals of treatment are to keep the kidney disease from getting worse and prevent complications. This involves keeping your blood pressure under control (under 130/80). Controlling high blood pressure and blood sugar are the most effective ways of slowing kidney damage from diabetic nephropathy.
Your doctor may prescribe the following medicines to lower your blood pressure and protect your kidneys from damage:
-- Angiotensin-converting enzyme (ACE) inhibitors
-- Angiotensin receptor blockers (ARBs)
Unfortunately, these drugs do not work over the long term. Instead, eat more vegetables, avoid animal meat, and follow a superior wellness program like the Death to Diabetes program.
It is also very important to control lipid levels, maintain a healthy weight, and engage in regular physical activity.
You should closely monitor and control your blood sugar levels with a superior diet, including raw vegetable juicing. Doing so may help slow down kidney damage, especially in the very early stages of the disease.
Urinary tract and other infections are common and can be treated with appropriate antibiotics.
Dialysis may be necessary once end-stage kidney disease develops. At this stage, a kidney transplant may be considered. Another option for patients with type 1 diabetes is a combined kidney-pancreas transplant.
Nephropathy is a major cause of sickness and death in persons with diabetes. It is the leading cause of long-term kidney failure and end-stage kidney disease in the United States, and often leads to the need for dialysis or kidney transplantation.
The condition slowly continues to get worse once large amounts of protein begin to appear in the urine or levels of creatinine in the blood begin to rise.
Complications due to chronic kidney failure are more likely to occur earlier, and get worse more rapidly, when it is caused by diabetes than other causes. Even after dialysis or transplantation, persons with diabetes tend to do worse than those without diabetes.
Note: For more information about kidney dialysis, read the Death to Diabetes blog post about kidney dialysis.
Possible complications due to kidney failure include:
- Chronic kidney failure (rapidly gets worse)
- Dialysis complications
- End-stage kidney disease
- Severe hypertension
- Kidney transplant complications
- Peritonitis (if peritoneal dialysis used)
When to Contact a Medical Professional
Call your health care provider if you have diabetes and a routine urinalysis shows protein.
Call your health care provider if you develop symptoms of diabetic nephropathy, or if new symptoms develop, including little or no urine output.
But, don't wait for this to occur!! Take action -- be proactive!
With chronic kidney disease, the kidneys don’t usually fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, dietary and lifestyle changes may help slow its progress and keep you feeling your best for as long as possible.
To help improve the quality of care for people with kidney disease, the National Kidney Foundation (NKF) created a guideline to help doctors identify each level of kidney disease. The NKF divided kidney disease into five stages. When the doctor knows what stage of kidney disease a person has they can provide the best care, as each stage calls for different tests and treatments.
Glomerular filtration rate (GFR) is the best measure of kidney function. The GFR is the number used to figure out a person’s stage of kidney disease. A math formula using the person’s age, race, gender and their serum creatinine is used to calculate a GFR.
A doctor will order a blood test to measure the serum creatinine level. Creatinine is a waste product that comes from muscle activity. When kidneys are working well they remove creatinine from the blood. As kidney function slows, blood levels of creatinine rise.
The five stages of CKD and GFR for each stage:
- Stage 1 with normal or high GFR (GFR > 90 mL/min)
- Stage 2 Mild CKD (GFR = 60-89 mL/min)
- Stage 3A Moderate CKD (GFR = 45-59 mL/min)
- Stage 3B Moderate CKD (GFR = 30-44 mL/min
- Stage 4 Severe CKD (GFR = 15-29 mL/min)
- Stage 5 End Stage CKD (GFR <15 mL/min)
- (Dialysis or a kidney transplant needed in order to maintain health).
Once you know the GFR you can determine the stage of kidney disease and read about that particular stage to determine what to do.
Stage 1 of CKD
Stage 1 kidney function is mild kidney disease with a normal glomerular filtration rate, or GFR. The GFR is a number determined by diagnostic tests and a mathematical formula that relates to the percentage of kidney function. A GFR of 90 therefore means that you have 90 percent kidney function.
Many patients in stage 1 will not exhibit any signs or symptoms. The presence of blood or protein in the urine may alert a doctor that there is kidney damage causing mild kidney disease.
In addition, a patient with high blood pressure may trigger further investigation since high blood pressure is the second most common cause of kidney disease.
Good blood pressure and blood sugar control are very important at this stage to help prevent any more changes. Unfortunately, a lot of people fail to make the necessary dietary and lifestyle changes.
The best way to prevent kidney damage is to control blood sugar and blood pressure levels by following a plant-based diet such as the Death to Diabetes Nutritional Program.
If possible, try to avoid taking diabetic and blood pressure drugs as these drugs may help to cause damage to your kidneys -- especially if you are taking large doses, multiple drugs, and/or over an extended period of years.
If you're diabetic or have high blood pressure, have your doctor perform a microalbumin urine test on a regular basis. This test can find small amounts of protein in the urine.
And watch the amount of salt, sodium, and protein you eat. Eaten in large amounts, these elements put extra stress on the kidneys. If you're already showing signs of kidney damage, talk to a diabetes health coach or renal dietitian. He or she can help you plan a diet that will help protect your kidneys from further damage.
Stage 2 of CKD
A GFR in the range of 60 to 89 percent is indicative of a patient with stage 2 kidney function.
This stage is still considered to be mild kidney disease and patients might still not exhibit any symptoms. Stage 1 and 2 together are known as chronic renal insufficiency and can be detected through abnormal results of blood tests or urinalysis.
Other ways a person may discover they are in stage 2 CKD include:
- Higher than normal levels of creatinine or urea in the blood
- Blood or protein in the urine
- Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
- A family history of polycystic kidney disease (PKD)
When detected in stage 1 or stage 2, the progression of the disease can be slowed, stopped or even reversed with changes in diet and lifestyle and treating any underlying conditions such as high blood pressure or diabetes.
At this stage, treatment includes quitting all tobacco products, controlling high blood pressure, and keeping blood sugar levels as close to normal as possible. Doing these things can protect the kidneys against any further damage.
Stage 3 of CKD
Stage 3 kidney function, known as moderate chronic renal insufficiency is characterized by a GFR of 30 to 59 percent.
Most (but not all) patients in stage 3 will exhibit one or more of the following symptoms:
- Puffiness or swelling (edema) of extremities caused by excess fluids remaining in the body
- Shortness of breath
- Urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal)
- Kidney pain felt in back
- Changes in appetite
- Sleep problems due to muscle cramps or restless legs
Treatment will still focus on controlling high blood pressure and keeping blood sugar levels as close to normal as possible, e.g. eat foods with less sodium and phosphorous.
However, your doctor may prescribe an ACE inhibitor or similar drug to help.
Anemia, a condition caused by a decrease in red blood cells, can also be present in stage 3.
Stage 4 of CKD
Severe chronic renal insufficiency, stage 4 kidney function, is a serious condition that may require dialysis. With a GFR of 15 to 29 percent the kidneys are not able to filter the blood efficiently.
Symptoms that are experienced in stage 4 include:
- Fluid retention, swelling (edema) of extremities
- Shortness of breath
- Urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal)
- Kidney pain felt in their back
- Sleep problems due to muscle cramps or restless legs
- Nausea and/or vomiting
- Taste changes: a metallic taste in the mouth
- Bad breath due to urea buildup in the blood
- Loss of appetite: People may not feel like eating, and some people report having a metallic taste in their mouth or bad breath.
- Difficulty in concentrating: Having trouble doing everyday things such as balancing a checkbook or focusing on reading the newspaper can occur.
- Nerve problems: Numbness or tingling in the toes or fingers is a symptom of CKD.
Treatment will include adopting a restrictive plant-based diet to support remaining kidney function, controlling blood pressure, and keeping blood sugar levels as stable as possible.
At stage 4, it’s necessary to see a nephrologist (a doctor who specializes in treating kidney disease). The nephrologist examines the patient and orders lab tests to gather information to recommend treatment.
Unfortunately, by this stage, dialysis is usually required. Dialysis is the use of an external machine to do what the kidneys can no longer do --remove excess waste, salt and water from the body.
People in stage 4 CKD will usually visit their doctor at least every three months. Blood tests for creatinine, hemoglobin, calcium and phosphorus levels will be done to see how well the kidneys are working.
The doctor will also monitor other conditions such as high blood pressure and diabetes. In addition to helping the patient keep their kidneys working as long as possible, the nephrologist will also help prepare the patient for dialysis or a kidney transplant.
Medical Treatment Options for Stage 4 CKD
Patients with stage 4 CKD will need to consider the following treatment options, including:
Hemodialysis: This is a treatment that can be done in a center or in a patient’s home with assistance from a care partner. A dialysis machine removes a small amount of a patient’s blood through a man-made membrane called a dialyzer, or artificial kidney, to clean out toxins that the kidneys can no longer remove. The filtered blood is then returned to the body.
Peritoneal dialysis (PD): Unlike hemodialysis, PD is a needle-free treatment and a care partner is not required to to help assist during treatment. PD can be performed at home or at work.
Kidney transplant: This is a preferred treatment and does not require as many diet restrictions as those who are on hemodialysis or PD.
Renal dietitian: A person in stage 4 may also be referred to a renal dietitian. Because diet is such an important part of treatment, the dietitian will review a person’s lab work results and recommend a meal plan individualized for their needs. Eating a proper diet can help preserve kidney function and overall health.
Stage 5 of CKD
In stage 5, also known as end stage renal failure, patients will have less than 15 percent of their kidney function remaining.
Anemia will definitely be present causing fatigue and weakness. The accumulation of waste in this stage can cause symptoms such as bruising or bleeding easily, headache, lower mental alertness, thirst, muscle cramps, itchy skin, numbness or tingling in the extremities, difficulty breathing and decreased urine output.
Symptoms that are experienced in stage 5 CKD include:
- Fatigue and weakness
- Loss of appetite
- Nausea or vomiting
- Being unable to concentrate
- Making little or no urine
- Swelling, especially around the eyes and ankles
- Muscle cramps
- Tingling in hands or feet
- Changes in skin color
- Increased skin pigmentation
Because the kidneys are no longer able to remove waste and fluids from the body, toxins build up in the blood, causing an overall ill feeling.
Kidneys also have other functions they are no longer able to perform such as regulating blood pressure, producing the hormone that helps make red blood cells and activating vitamin D for healthy bones.
If you are diagnosed with stage 5 CKD, you will need to see a nephrologist immediately. This is a doctor who is trained in kidney disease, kidney dialysis and transplant.
The doctor will help you decide which treatment is best for you—hemodialysis, peritoneal dialysis (PD) or kidney transplant—and will recommend an access for dialysis. Your nephrologist will develop your overall care plan and manage your healthcare team.
Dialysis treatments for people with stage 5 CKD:
Most people report feeling much better once they begin dialysis. As the toxins are removed from the blood medicines replace the functions the kidneys can no longer perform, they find they can enjoy a good quality of life.
There are two types of dialysis treatments for people with stage 5 kidney disease:
Hemodialysis: This treatment that can be done in a center or in a patient’s home with assistance from a care partner. A dialysis machine removes a small amount of a patient’s blood through a man-made membrane called a dialyzer, or artificial kidney, to clean out toxins that the kidneys can no longer remove. The filtered blood is then returned to the body.
Peritoneal dialysis (PD): Unlike hemodialysis, PD is a needle-free treatment and a care partner is not required to to help assist during treatment. PD can be performed at home or at work.
Kidney transplant is another treatment option
If you wish to have a kidney transplant, tell your nephrologist. Your nephrologist will explain the process of how to get on a waiting list for a cadaverous kidney or how to find a living donor.
When at stage 5 CKD, either dialysis or a kidney transplant is necessary to continue living.
Patients in this stage will be on dialysis waiting for a kidney transplant.
For more details about these stages, refer to the following website: https://www.kidney.org/nutrition/Kidney-Disease-Stages-1-4
Note: Refer to the Death to Diabetes Blog for more information about each stage of kidney disease and how to treat each stage.
Because heart disease, cancer and diabetes continue to rise, so does kidney disease, kidney failure and dialysis.
Unfortunately, most doctors are unaware of how to protect your kidneys before they fail! Oh, by the way, most drugs, especially those for heart disease, cancer and diabetes cause damage to the kidneys!
Please Note: There are a lot more restrictions on the foods that you can eat as your kidneys get worse. That's why it's so important to not wait too long to get your diabetes and blood sugar under control.
Key nutritional and lifestyle remedies include the consumption of a plant-based diet, raw juicing, and plant oils; the avoidance of sweets, processed and canned foods; periodic detox; regular exercise; quality sleep; stress reduction; and, keeping a journal.
Because everyone responds differently to various foods, it is imperative that you work with a renal dietitian and diabetes educator to customize a meal plan for you and offer assistance in food choices and meal planning.
Nutritional Strategy for Kidney Health
In order to prevent or treat kidney disease, you should follow a plant-based diet with raw salads and green vegetables such as spinach, kale, bell peppers, onions, and broccoli.
Drink raw vegetable juices, but, be careful with vegetables that may contain too much potassium. Use the author's Power of Juicing book as a guide.
Also, eat wild salmon and sardines for the Omega-3s. Foods and nutrients such as filtered water, celery, cucumbers, lemons, limes, organic apple cider vinegar, and cranberries nourish, protect and cleanse the kidneys and the bladder.
Use plant oils such as extra virgin olive oil and coconut oil.
Top 10 Foods for Kidney Health
It is imperative that you avoid the processed foods and beverages, including soda, diet soda, coffee, milk, wheat, gluten, flour, bread, animal meat and trans fats.
Please Note: There are a lot more restrictions on the foods that you can eat as your kidneys get worse. That's why it's so important not wait too long to get your diabetes and blood sugar under control.
Unfortunately, some of the foods that can help you with your diabetes may be a problem if your kidneys have become severely damaged.
Foods such as spinach and other green, leafy vegetables tend to contain potassium and phosphorus, two minerals that may be harmful to your (damaged) kidneys.
However, there are still enough healthy foods that you can eat to maintain good blood sugar control -- so that you can safely wean off the diabetic drugs.
Weaning off the diabetic drugs and the high blood pressure drugs is important because these drugs can cause further damage to your kidneys. Consequently, it is imperative that you work with a nephrologist and a naturopathic doctor to ensure that you're receiving optimum treatment that will prevent you from having to face kidney failure, dialysis, and/or a kidney transplant.
Also, take wholefood nutritional supplements and/or organic herbal tinctures to help nourish, detox, and protect the kidneys from further damage.
All persons with diabetes should have a yearly checkup with their doctor to have their blood and urine tested for signs of possible kidney problems.
Persons with kidney disease should avoid contrast dyes that contain iodine, if possible. These dyes are removed through the kidneys and can worsen kidney function. Certain imaging tests use these types of dyes. If they must be used, fluids should be given through a vein for several hours before the test. This allows for rapid removal of the dyes from the body.
Commonly used nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen, and prescription COX-2 inhibitors such as celecoxib (Celebrex), may injure the weakened kidney. You should always talk to your health care provider before using any drugs.
Refer to the wellness protocol section in Chapter 15 of the Death to Diabetes book and the Power of Juicing ebook for more details about kidney health.
Proteinuria and How to Treat It
Proteinuria - also called albuminuria or urine albumin - is a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body.
As blood passes through healthy kidneys, they filter out the waste products and leave in the things the body needs, like albumin and other proteins. Most proteins are too big to pass through the kidneys’ filters into the urine. However, proteins from the blood can leak into the urine when the filters of the kidney, called glomeruli, are damaged.
When the blood vessels of the kidneys are damaged, protein can leak from your blood into your urine. Normally, kidneys filter out waste products and proteins, most of which are too big to pass through the kidney's filters. If they are damaged and your kidneys cannot properly filter waste, some of the protein may be found in your urine.
Abnormal amounts of protein in your urine is called proteinuria. Depending on the types and amounts of protein leaking from your kidneys, you may be at risk for kidney failure.
If you have proteinuria, chances are you show no symptoms. When protein loss gets excessive, your urine might look foamy and you may notice swelling in your hands, feet, abdomen, or face. The only way to determine how much protein is in your urine is to have it tested regularly.
Proteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure, and diseases that cause inflammation in the kidneys. For this reason, testing for albumin in the urine is part of a routine medical assessment for everyone. Kidney disease is sometimes called renal disease.
If CKD progresses, it can lead to end-stage renal disease (ESRD), when the kidneys fail completely. A person with ESRD must receive a kidney transplant or regular blood-cleansing treatments called dialysis.
Note: Microalbuminuria is referred to as excretion of 30-300 mg of albumin daily or 20-200 µg of albumin per minute; by routine dipstick screening methods, these amounts are too small to be detected.
Note: Ensure that you visit a nephrologist if you develop proteinuria, or any adverse prognostic markers (e.g. rise in albumin excretion of >1 g/day), or any worsening in renal function.
A natural treatment strategy for proteinuria should be customized to address your specific health needs. Some of those strategies may include the following:
Eat anti-inflammatory foods and take wholefood supplements. Since inflammation is a key problem, eat more anti-inflammatory foods; and, avoid the "dead" foods that cause inflammation. Key foods and supplements that can protect and nourish your kidneys include filtered water, lemons, limes, organic apple cider vinegar, parsley, cabbage ginger, cranberry, chlorella, CoQ10, and raw juices.
Note: You will have to limit your intake of various foods if your kidney disease gets worse. See below for foods to avoid.
Lessen salt intake. Remember that when you have proteinuria, your problem is not just the blood that comes with your urine. You will experience swelling as well. Cure this swelling by making sure that your body is kept hydrated. Lessening your salt intake can help your body maintain the right hydration because salt actually lessens your body's water.
Stay hydrated. Staying hydrated is necessary for prevention and treatment of kidney disease. Keeping your urine diluted is important for keeping your kidneys healthy.
Filtered (or distilled) water is the best choice, but you can also drink raw juices or herbal tea. If your urine is light colored after you go to the bathroom, you are getting enough fluid. Also try to avoid or limit caffeinated beverages to one cup a day because it can actually make you dehydrated.
Use organic herbal tinctures. These herbal tinctures (designed specifically for kidney health) are absorbed a lot easier and can protect your kidneys from further damage. Look for tinctures from reputable companies that contain Uva Ursi Leaf, Juniper Berry, Horsetail Herb, Burdock Root, Corn Silk, Parsley Root. If you didn't wait too long long, these herbal tinctures can help your kidneys before you lose a larger percentage of kidney function. So, don't wait until you have to face kidney dialysis or a kidney transplant! -- Take action now!
Note: Get the Nutritional Supplements Brand Names ebook for a list of reputable companies and quality supplements.
Perform cleansing/detox. A cleansing/detox can help to remove the buildup and accumulation of toxins and other chemicals in the kidneys.
Treat your blood sugar problems. If you are suffering from diabetes, be sure to address sugar problems effectively. Keep your sugar levels under control with a plant-based diet. Through this, you would also be able to control your proteinuria.
Maintain a low blood pressure. Treating your high blood pressure would be a good starting point in treating your proteinuria because this illness is, most of the time, accompanied by high blood pressure. This is because high blood pressure greatly affects the capacity of the kidney to filter the protein in the blood. In other words, treating high blood pressure is one way to treat proteinuria. Read our web page for treating high blood pressure or read Chapter 15 of Death to Diabetes.
Avoid prescription drugs and OTC drugs such as NSAIDs. These drugs take a toll on your kidneys, so be careful with taking too many drugs. Talk to your doctor about non-drug alternatives.
Lessen your (animal) protein intake. Your kidneys are already having trouble filtering proteins from your blood. Do not worsen this problem by taking more protein. Be more sensitive on the kinds of foods you eat, particularly on the protein level of such foods. You can check the National Kidney Foundation's site to see menus that could help you lessen your protein intake.
Address urinary tract infection (UTI) issues. UTI actually prolongs your proteinuria. This is because a person who has UTI is more prone to the possibility of the spread of bacteria. Treating your UTI would be another way of treating proteinuria.
As a last resort, consult a doctor about the possibility of using Angiotensin-Converting Enzyme (ACE) drugs to treat your proteinuria. These are inhibitors used to relatively decrease the protein in the urine. But remember that drugs won't fix the problem -- they will work temporarily until your kidneys fail and you have to go on dialysis.
People with reduced kidney function must adhere to a renal or kidney diet to cut down on the amount of waste in their blood.
Wastes in the blood come from the food and the liquids that are consumed. When kidney function is compromised it does not filter or remove wastes properly.
If wastes are left in the blood they can negatively effect a person's electrolytes. Following a renal (kidney) diet may also help promote kidney function and slow the progression of complete kidney failure.
A renal diet is one that is low in sodium, phosphorous and protein. A renal diet also promotes the importance of consuming high-quality protein and less fluids. Some people may also need to limit potassium and even calcium.
Every person's body is different, and therefore, it is crucial that a renal dietitian work with each patient to come up with a diet that is tailored to his or her needs.
General Dietary Guidelines for Kidney Disease include the following:
Raw foods, apples, asparagus, bananas, cauliflower, celery, cranberries, cucumbers, garlic, legumes, onions, papaya, parsley, potatoes, pumpkin, red bell peppers, sprouts, seeds, spirulina, strawberries, acidophilus, watercress, watermelon
Drink clean water (6-8 glass’s per day), eat smaller portions of meat, do small mild cleanses
Potassium, phosphates, beet greens, meat, spinach, rhubarb, swiss chard
Do Not Eat:
Processed foods, chocolate, cocoa, eggs, dairy, salt, ham, lunch meats
Food Restrictions Increase as Kidney Disease Worsens
Reducing potassium intake is only necessary if your kidney function drops to below 20 percent, according to the Association of Kidney Patients.
Cut back on the amount of fruits and vegetables you consume to reduce potassium. Eat no more than a total of five servings of fruits and vegetables per day. This includes limiting the amounts of textured vegetable protein (TVP) and legumes (beans) for vegetarians.
Low Potassium and Low Sodium Foods: If you ignore your diabetes, you will eventually lose kidney function and will probably have to go on a low sodium and low potassium diet. Foods that are low in sodium and potassium include spinach, kale, lettuce, cucumbers, bell peppers, carrots, bean sprouts, garlic, and onions.
Since most foods contain potassium, the key is to select those lowest in potassium including vegetables such as asparagus, cooked cabbage and carrots, cauliflower, peas, green peppers and spinach; fruits such as apples, blackberries, blueberries, cherries, peaches, pears and plums. Protein foods that are permitted include a serving of chicken or turkey, tuna, eggs, shrimp, nuts and seeds.
To further help your diabetes and protect your kidneys, we recommend that, after you have read and used the Death to Diabetes book, you need to go beyond that book. Specifically, it may be necessary for you to go on a vegan plant-based diet with lots of raw foods and raw juicing.
In addition, if you want more information about following a vegan diet (plus lots of vegan recipes), we recommend the 3-in-1 Death to Diabetes Cookbook.
For more details about dietary changes, refer to the following website: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/eating-nutrition
Why should kidney patients monitor sodium intake?
Too much sodium can be harmful for people with kidney disease because their kidneys cannot eliminate excess sodium and fluid from the body. As sodium and fluid build up in the tissues and bloodstream it may cause:
- Increased thirst
- Edema: swelling in your legs, hands and face
- High Blood Pressure
- Heart failure: excess fluid in the bloodstream can overwork your heart making it enlarged and weak
- Shortness of breath: fluid can build up in the lungs, making it difficult to breathe
How can a person monitor their sodium intake?
- Always read food labels, sodium is always listed.
- Pay close attention to serving size.
- Use fresh, rather than packaged meats.
- Choose fresh fruits and vegetables or no salt added canned and frozen produce.
- Avoid processed foods.
- Compare brands and use items lowest in sodium.
- Use spices that do not list “salt” in their title (choose garlic powder, instead of garlic salt).
- Cook at home and do not add salt
- Limit total sodium content to 400 mg per meal and 150 mg per snack
FYI: According to the new Dietary Guidelines for Americans, adults and children are advised to eat less than 2,300 mg of sodium per day. People who are 51 and older, African Americans, and people with diabetes, hypertension or CKD should reduce their sodium intake to 1,500 mg each day.
Why should kidney patients monitor potassium intake?
When kidneys fail they can no longer remove excess potassium, so the level builds up in the body. High potassium in the blood is called hyperkalemia which can cause:
- Muscle weakness
- Irregular heart beat
- Slow pulse
- Heart Attack
How can patients monitor their potassium intake?
When the kidney’s no longer regulate potassium a patient must do so by monitoring the amount of potassium that enters the body.
Tips to help keep potassium at safe levels:
- Talk with a renal dietitian about creating an eating plan.
- Limit foods that are high in potassium.
- Limit milk and dairy products to 8 oz per day.
- Choose fresh fruits and vegetables.
- Avoid salt substitutes & seasonings with potassium.
- Read labels on packaged foods & avoid potassium chloride.
- Pay close attention to serving size.
- Keep a food journal.
Some examples of low-potassium foods include apples, asparagus, beans, blueberries,cabbage, cauliflower, celery, corn, cucumber, eggplant, green beans, kale, noodles, onions, okra, pasta, peas, pears, peas, peppers, rice and zucchini.
High-potassium foods include artichokes, beets, broccoli, Brussels sprouts, carrots, Chinese cabbage, greens, mushrooms, parsnips, potatoes, spinach, tomatoes, winter squash, bamboo shoots, kohlrabi, and, rutabagas.
If you are worried about getting too much potassium from vegetables, you can also leach some of the potassium out of them by soaking them for at least two hours in a ratio of 10 times the amount of water to vegetables and then cooking them in a ratio of five times the amount of water to vegetables.
FYI: A normal amount of potassium in a typical diet of a healthy American is about 3500 to 4500 milligrams per day. A potassium restricted diet is typically about 2000 milligrams per day.
Your physician or renal dietitian will advise you as to the specific level of restriction you need based on your individual health. A renal dietitian is trained to help you make modifications to your diet in order to prevent complications for kidney disease.
Why should kidney patients monitor phosphorous intake?
Normal working kidneys can remove extra phosphorus in your blood. When kidney function is compromised they no longer remove excess phosphorus. High phosphorus levels can pull calcium out of your bones, making them weak. This also leads to dangerous calcium deposits in blood vessels, lungs, eyes, and heart.
How can patients monitor their phosphorus intake?
Phosphorus can be found in many foods. Therefore, patients with compromised kidney function should work with a renal dietitian to help manage phosphorus levels.
Tips to help keep phosphorus at safe levels:Phosphorus-Foods
- Know what foods are lower in phosphorus.
- Pay close attention to serving size
- Eat smaller portions of foods high in protein at meals and for snacks.
- Eat fresh fruits and vegetables.
- Ask your physician about using phosphate binders at meal time.
- Avoid packaged foods that contain added phosphorus. Look for phosphorus, or for words with PHOS, on ingredient labels.
- Keep a food journal
The following is a list of the key nutrients that your kidneys require to maintain good health. However, you should get most of these nutrients via your food -- not from nutritional supplements.
If you decide to take any supplements, make certain that they are whole food supplements, not synthetic, as synthetic supplements are not good for the kidneys. If necessary, get the Nutritional Supplements & Super Foods ebook to help you.
Vitamins for Kidney Disease:
-- Vitamin A – helps healing process of urinary tract lining
-- Vitamin B complex – helps fluid metabolism
-- Vitamin C – boosts immunity and elevates urine acidity
-- Vitamin E – elevates immune system
-- Zinc – immunostimulant
Minerals for Kidney Disease:
-- Calcium – helps body use all minerals in synergy
-- Magnesium – see calcium
-- L–Arginine – aids kidneys
-- L-Methionine – helps circulation within kidneys
-- Multi-enzyme complex – aids digestion
-- Potassium – stimulates kidney function, but may need to be avoided
Herbs for Kidney Disease:
-- Buchu Tea -- treats inflammation and infections in urinary tract
-- Dandelion Root – aids kidney excretion function of waste
-- Cranberry – acidifies urine and kills bacteria
-- Celery and Parsley – diuretic (decreases uric acid)
-- Hydrangea – natural diuretic – cleanses urinary tract
-- Uva Ursi – natural diuretic – cleanses urinary tract – germicidal
-- Marshmallow Tea – cleanses kidneys
-- Goldenrod tea, juniper berries, stinging nettle, parsley, red clover, watermelon seed tea are all good for kidney disease.
These vitamins and minerals (from food) and herbs help with kidney health. But, if your kidney function has deteriorated significantly, then, supplements may not help -- in fact, they may irritate the kidneys and cause more harm than good.
Please Note 1: If your kidney function has deteriorated significantly, you should contact your healthcare provider for a renal diet specialist who understands kidney health and diabetes.
Please Note 2: Dr. Schulze (at HerbDoc) has powerful organic herbal tinctures for the kidneys, liver and other organs. Work with a licensed herbalist and naturopath doctor in using the kidney detox herbal tinctures and kidney detox tea to fight your kidney disease.
Note: For more details about kidney disease and its stages, refer to our Death to Diabetes Blog.
If you want to protect your kidneys and/or reverse your diabetes, then, get the ex-diabetic engineer's Death to Diabetes book.
If you need more nutritional help with your kidneys and diabetes, then, consider getting the Raw Food Diet book.
If you need a lot of diabetic-friendly meals and some vegan meals, then, get the Death to Diabetes cookbook.
However, if your kidney function has deteriorated significantly below 60% functionality, you should get a renal dietitian to help you with your meal planning.
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- American Diabetes Association. Standards of medical care in diabetes--2010. Diabetes Care. 2010 Jan;33 Suppl 1:S11-61.
- Inzucchi SE, Sherwin RS. Diabetes Mellitus. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 248.
- American Diabetes Association (2004). Nephropathy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care. 27(Suppl 1): S79–S83.
- ^ Berkman, James; Rifkin, Harold (1973). "Unilateral nodular diabetic glomerulosclerosis (Kimmelstiel-Wilson): Report of a case". Metabolism (Elsevier Inc.) 22 (5): 715–722. doi:10.1016/0026-0495(73)90243-6. PMID 4704716.
- ^ Kimmelstiel P, Wilson C. Benign and malignant hypertension and nephrosclerosis. A clinical and pathological study. Am J Pathol 1936;12:45-48.
- ^ Diabetes Mellitus and Angiotensin Converting Enzyme Inhibitors
- ^ a b The ONTARGET Investigators; Yusuf, S; Teo, KK; Pogue, J; Dyal, L; Copland, I; Schumacher, H; Dagenais, G et al. (2008). "Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events". New England Journal of Medicine 358 (15): 1547–59. doi:10.1056/NEJMoa0801317. PMID 18378520.
- ^ Wahren J, Ekberg K, Jörnvall H (2007). "C-peptide is a bioactive peptide". Diabetologia 50 (3): 503–9. doi:10.1007/s00125-006-0559-y. PMID 17235526.
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