Can­di­da Khan

Kid­ney dis­ease is a grow­ing, neg­a­tive, health con­cern in Trinidad and To­ba­go. Many of us are un­aware of our kid­ney health be­cause kid­ney dis­ease of­ten pro­vides no signs and symp­toms.

Kid­neys per­form es­sen­tial func­tions, but the main one is fil­ter­ing waste prod­ucts from the blood. Oth­er func­tions in­clude bal­anc­ing flu­ids, con­trol­ling blood pres­sure and reg­u­lat­ing sodi­um, potas­si­um and phos­pho­rus lev­els in the blood.

When the kid­neys are dam­aged, waste prod­ucts and ex­cess flu­ids build up in the body and can af­fect over­all health.

The two lead­ing caus­es of kid­ney dis­ease are lifestyle is­sues such as un­con­trolled high blood pres­sure and poor­ly man­aged di­a­betes.

These are com­mon health con­cerns that do not present signs and symp­toms. They are al­so very paci­fied un­less symp­toms are felt.

High blood pres­sure can dam­age the tiny blood ves­sels in­side the kid­neys. This then re­duces the abil­i­ty to fil­ter the blood ef­fi­cient­ly. Over time, the dam­age can lead to de­clin­ing kid­ney func­tion.

High blood sug­ar is caused by poor eat­ing habits and can al­so af­fect the kid­neys’ fil­ter­ing units, al­low­ing pro­tein to leak in­to the urine and re­duc­ing the abil­i­ty of the kid­neys to re­move waste from the blood.

I would rec­om­mend test­ing your kid­ney health us­ing eGFR (es­ti­mat­ed Glomeru­lar Fil­tra­tion Rate), which is a blood test that gives an es­ti­mate of how well the kid­neys fil­ter waste from the blood.

• Stage 1 (eGFR 90) is nor­mal kid­ney func­tion, where the kid­neys are work­ing well and bal­anced eat­ing can main­tain healthy kid­neys.

• Stage 2 (eGFR 60-89) shows a slight re­duc­tion in kid­ney func­tion with­out any symp­toms. This can be be­cause of high blood pres­sure and di­a­betes. Nu­tri­tion in­ter­ven­tions are need­ed to en­sure that dam­age is stopped.

• Stage 3 (eGFR 30-59) can be di­vid­ed in­to 2a and 2b, but waste is ac­cu­mu­lat­ing in the body, caus­ing fa­tigue and swelling in the feet or an­kles. Di­etary changes are vi­tal at this stage.

• Stage 4 (eGFR 15-29) is when kid­neys have sig­nif­i­cant­ly re­duced func­tion, and there is a need for dial­y­sis if kid­ney func­tion con­tin­ues to de­cline. Bal­anced eat­ing needs to be im­ple­ment­ed to re­duce foods in­creas­ing waste in the blood.

• Stage 5 (eGFR <15) is when the kid­neys no longer re­move waste and dial­y­sis or kid­ney trans­plant is nec­es­sary for sur­vival.

The truth is that oth­er fac­tors can cause kid­ney func­tion to re­duce, such as smok­ing, ex­ces­sive use of painkillers and obe­si­ty.

As kid­ney dis­ease pro­gress­es, the body strug­gles and these nu­tri­ents need to be con­trolled:

1) Pro­tein

Pro­tein is nec­es­sary, but eat­ing ex­ces­sive amounts will cre­ate more waste in the blood and dam­age the kid­neys. Pro­tein from eggs, fish and lean pieces of chick­en have to be con­trolled us­ing an in­di­vid­u­alised ap­proach de­pend­ing on the stage of kid­ney dam­age.

2) Sodi­um

Salt can cause wa­ter re­ten­tion and can then lead to an in­crease in blood pres­sure, putting strain on the kid­neys. Lim­it­ing processed meats, avoid­ing in­stant soup pack­ages and canned prod­ucts, while fo­cus­ing on fresh herbs and green sea­son­ings in­stead of salt, should be the main fo­cus.

3) Potas­si­um

Potas­si­um is im­por­tant for mus­cles and heart func­tion, but when kid­neys are dam­aged, potas­si­um in­take needs to be con­trolled. High-potas­si­um foods such as co­conut wa­ter, av­o­ca­do and toma­to have to be con­trolled us­ing an in­di­vid­u­alised ap­proach from your health­care provider. Low­er-potas­si­um foods such as pineap­ple, ap­ple, cu­cum­ber and let­tuce can be eat­en more of­ten.

4) Phos­pho­rus

This min­er­al can cause weak­er bones when the kid­ney is fail­ing and is found in processed cheese, soft drinks and or­gan meats. La­bel read­ing is vi­tal.

Keep your kid­neys healthy by choos­ing foods that re­duce waste in the blood, but you al­so have to keep your blood pres­sure un­der con­trol, as well as your blood sug­ar lev­els.

From my ex­pe­ri­ence, kid­ney fail­ure can be pre­vent­ed and, de­pend­ing on the phase, kid­ney func­tion­al­i­ty can be im­proved.

Ear­ly de­tec­tion and healthy eat­ing re­main the best tools for pre­serv­ing kid­ney func­tion and main­tain­ing a bet­ter qual­i­ty of life.

Can­di­da Khan, MSc RD al­so known as Di­di, is a Reg­is­tered Di­etit­ian Nu­tri­tion­ist.

She is al­so the CEO of Di­di’s Nu­tri­tion Con­sul­tan­cy (didis­nu­tri­tion­con­sul­tan­cy.com)