Tag Archives: kidney

Mineral balance is critical for healthy body functions – Role of the kidneys and increasing kidney disease


Importance of healthy kidney function is to maintain a balance of Potassium, Phosphorous and calcium and Vitamin D. Chronic kidney disease (CKD) affects every body function, including or through mineral imbalance in body.
Read below an extract from “Chronic Kidney Care” by Sharon Broscious and Judith Castognola, critical care nurses or you may want to click here to read it in detail in the original journal article. Why are more people presenting with sickened kidneys?

Electrolyte Balance
Multiple electrolyte levels are altered in patients with CKD. Potassium levels may be normal until late in ESRD, and elevated potassium levels are often associated with CKD because of the inability of the kidney to excrete potassium as a result of decreased GFR. In addition, when metabolic acidosis is present, potassium ions shift from the intracellular compartment to the extracellular space in exchange for H+, in an effort to maintain extra-cellular acid-base balance. The kidneys normally excrete 40 to 60 mmol of potassium daily.11 J.M.’s potassium level was 5.8 mmol/L, increasing his risk for fatal dysrhythmias.

Serum phosphorus and calcium levels are also altered in CKD. When GFR is less than 30 to 50 mL/min per 1.73 m2, phosphorus excretion is impaired.10 Because of the reciprocal relationship between phosphorus and calcium, this increased retention of phosphorus results in a decrease in the serum level of calcium. Three additional mechanisms can affect calcium level. Calcium is found in 3 forms in the blood: attached to protein, attached to other complexes, and free or ionized. Because some calcium is bound to protein, total serum calcium level can decrease when albumin level decreases. J.M. had proteinuria. This loss of albumin can contribute to a decreased serum level of calcium. CKD also has an effect on vitamin D synthesis. The kidneys normally convert inactive vitamin D to its active form: 1,25-dihydroxycholecalciferol.11 Impaired vitamin D synthesis results in decreased absorption of calcium in the gastrointestinal tract. The third mechanism that affects serum levels of calcium is the endocrine system. When the serum level of calcium decreases, the parathyroid gland increases its secretion of parathyroid hormone, causing calcium to be released from the bone and compensating for the decreased serum level of calcium.12 Results of J.M.’s laboratory tests showed a calcium level of 2.05 mmol/L (8.2 mg/dL) and a phosphorus level of 3.91 mmol/L (12.1 mg/dL), indicating impaired phosphorus excretion and a reciprocal decrease in calcium level.

To read more click here. You may want to continue reading to learn about:
how the healthy and diseased kidneys balance electrolytes;
the increasing public health care costs to take care of increasing number of individuals with failind kidneys;
the role of parathyroid hormone in maintaining electrolyte balance;
the alterations in excretory functions
how anemia results from chronic kidney disease
how chronic kidney disease affects every body function

Chronic Kidney Disease
Acute Manifestations and Role of Critical Care Nurses
Sharon K. Broscious, RN, DSN, CCRN and Judith Castagnola, RN, MSN
+ Author Affiliations

Sharon K. Broscious is an associate professor in the School of Nursing at Troy University, Atlantic Region, in Norfolk, Va.
Judith Castagnola is a facility administrator at DaVita Peninsula Dialysis in Newport News, Va.
Corresponding author: Sharon K. Broscious, Troy University, Atlantic Region, 5425 Robin Hood Rd, Ste B1, Norfolk, VA 23513.
Do let Sharon Broscious know that you appreciated this article by emailing the author: (e-mail: sbroscious@troy.edu)

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Can Anorexia induced deficient blood for monthly periods be reversed?


The Chinese Traditional Medicine formula Xiao Yao San, a mixture of medicinal plant roots have been used to treat symptoms of deficient blood. The three herbs include Bupleurum radix (Chai hu), Angelica sinensis (Dang gui) and Paeonia sp. (Bai shao) and may include others. I discuss the components and mode of action of Chai hu below and have previous articles on Dang gui and Bai shao.

Anorexia is a problem among young teens who are extremely image conscious and have a desire to look very thin. In their zeal they eat too little and over exercise. This is a ‘disease’ of the wealthier girls because poor girls value food and are hungry. The rich girls have plenty of food but they are bombarded with images of thin celebrities and aim to reach that ideal, unrealistic goal. Some girls die before they can be hospitalized. In most girls their periods stop because of many internal reasons. Modern medicine is unable to quickly ‘cure’ this symptom of anorexia. Doctors try to make the girls aware that they are losing bone mass due to lower calcium stores in their body, which will develop into early osteoporosis. The girls refuse to understand and continue to starve themselves. Many need to be hospitalized.

Traditional medicinal treatment of anorexia involves a team of doctors – the family pediatrician, a nutritionist, and a pshychiatrist. They can meet for seven years and not get a cure, which is getting the periods back and a normal BMI or Body Mass Index. There are several published articles on curing anorexia. Traditional Chinese Medicine in combination with a protein, carbohydrate and fat rich diet should be strongly encouraged because anorexia is an ancient disease and achieving normal blood flow has been achieved. Modern medicine may prescribe birth control pills which may induce periods but when stopped the periods stop too. Also, sometimes the teens are too young and it simply feels wrong to prescribe birth control pills. I would urge parents to learn about this natural option, which is far safer for the child.

Chai hu,  is a popularly used medicinal plant dried root in Chinese traditional medicine in a multicomponent mixture of herbs. Yamakage and colleagues (Am. J. Chi. Med., 2006) showed that the extracts of Bupleurum radix activated spontaneous lymphatic vasomotion and lymph flow. Heldon and Zhao (CEPP, 2000), showed that lymphatic vessel vasomotion, a rhythmic contraction is controlled by the Calcium store and it can be near synchronous over large vessel lengths and involve many cells.

Chai hu

Several published Chinese scientific articles discuss the components of Chai hu. A chromatographic analysis shows that Saikosaponins are the main components of which SSa and SSd are in largest concentrations (Xu, Huang, & Zhang, School of Pharmacy, Shanghai; 2008). Chen and colleagues (2007) have shown that Saikopanin c could prevent the development of nephritis in mice and hence could modulate renal or kidney disease. Click here for photo source.

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What are the five stages of kidney disease?


There are five stages in kidney disease and in the fifth stage dialysis may be suggested by a health care provider. The five stages are described here and are determined from a blood test which measures creatinine levels. The alternative to dialysis is to wait for a kidney transplant. Some people have a second choice – to face the rest of the life knowing that their kidneys are no longer functioning properly. Which is alright too because it is the cycle of life. If life has been generally good, then it may be time to prepare to say goodbye with dignity and with a smile. It may be fabulous to check out the movie, “The Bucket list” and enjoy the last few years (in some cases it maybe months) doing all you have always wanted to do and eat all you have always wanted to eat.

What if you choose not to have dialysis? You die naturally with a build up of toxins.

What if you choose to have dialysis? You die from a heart attack or from an infection.

Life expectancy is extended with dialysis in 1 out of 4 people in the oldest age group, with a dialysis program of 5 hours a day, every other day and restricted diet (Author: Comfort Care Choices). A much younger, healthier person may be offered a kidney transplant option and then dialysis is ended.

 

What is life? Life is about looking around you with amazement and wondering how every one of us lives, breathes and exists in the same space, with the same atmospheric elements and yet, each one is so unique. Well, that unique life has a beginning, a middle and an end. When others depend on us, it is valuable to take good care of our health. When, we begin to depend on others to continue living, then the real questions begin. When does one draw the line on extending existence with artificial living features, such as dialysis? Is it life? When does one say good bye with dignity? Would it not be more fun to choose a ‘do it all’ attitude instead of a fearful, prolonged extension of life with an artificial heart pumping, steel replacing are hinges, stem cells replacing our organs, etc. When do we say enough is enough?

I would advise to frankly ask your doctor questions that are important to you. Do you want to live forever and finances is not an issue? Then, say that. If you want to have least number of artificial factory built structures keeping you alive and sometimes, keeping you alive but bedridden, then say that. Be honest with yourself. Do you have money to spend on simply breathing, even if bedridden or do you have money to spend the last few years of your ‘walking’ life seeing new places or simply watching your neighbors children playing on the riverside (if your own live far away). Once you know how you want your own life to look like for the rest few years, then approach your doctor to ask about the dialysis program. The truth will set you free!

Anyway, I will continue to update you about kidney disease, dialysis and diet (to prolong life). Your comments are appreciated to let me know if I should continue on certain topics. Would you choose life with or without dialysis?

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Kidney care and natural nutrition


What should you do when someone you love has kidneys that are not functioning the way they should? Can further damage be prevented? What is your diet plan?

The only ancient kidney damage prevention food item that I am aware of is okra. There are several recipes on other wordpress blogs you could try.

There are five stages of kidney disease discussed here. The National Kidney Foundation has a lot of advice. There are other sites (below) with more advice. What concerns me is that nobody is showing that spinach which is high in potassium and iron is in a special category. It is the best natural help for anaemia (see below) because of it’s very high iron content and yet, probably needs to be taken in moderation because of its high potassium content (see below). Also, a few beans have been listed as high in potassium and yet are all beans to be avoided or just those few. One is advised to take a restricted protein diet, but which protein source is most safe? I will be looking for those answers and will keep you posted.

A healthy and sick kidney is described beautifully by the Royal Cornwall Hospital Renal Unit.

A healthy kidney’s function is to remove waste products from your body and to produce a substance that is needed to make red blood cells (a hormone called EPO). When a kidney is not functioning properly, waste products accumulate reducing appetite. Also, red blood cells carry oxygen in the blood. Shortage of red blood cells leaves you with less oxygen in the body. A poorly functioning kidney may initially show few symptoms, but gradually as it gets worse, you begin to feel tired because you lose your appetite and you are breathless because you are anaemic from fewer oxygen enriched, red blood cells. The doctor will point out other associated symptoms.

Kidney-EPO-bone marrow-Red blood Cells-Anaemia

The bone marrow makes red blood cells which carry oxygen. The healthy kidney makes a hormone called Erythropoietin or EPO which is essential to form red blood cells in the bone marrow. A diseased kidney cannot make enough EPO, causing the bone marrow to make fewer red blood cells, triggering anaemia and fatigue. Hemoglobin is the oxygen carrying protein in the red blood cells and foods rich in iron and folic acid help the red blood cells make hemoglobin.

It is obvious that a person with a kidney not functioning properly needs to have select list of food items to include or avoid. Any change in diet plan should be discussed with a Dietician or a Nutritionist with special knowledge about a diseased kidney.

In kidney failure, Potassium levels can rise to high in the body. So, it is important to limit potassium intake. Increased potassium can cause hyperkalemia; salt substitutes and “low salt” packaged foods often contain potassium so care is needed here when planning a diet for kidneys. Potassium regulates muscle tissue. Symptoms of hyperkalemia include slow, weak pulse, nausea and irregular heartbeat and may need emergency care. Why have a salt substitute in the diet at all?

You may need to balance other important nutrients too, such as sodium, phosphorus and calcium. When kidneys function improperly, sodium can build up and it’s intake may need to be limited. Salt has sodium and may need to be limited in your diet.

List of food that is specific for Kidney care is highlighted in detail by the Renal Unit of the Royal Cornwall Hospital. Remember that Potassium needs to be monitored in the diet. Protein restriction is an important part of the diet and appropriate. They are found in meat, poultry, fish, egg, milk, cheese. Researchers at the Department of Nutritional Sciences, University of Connecticut, Storrs (2005) state that there is no indication that a healthy individual should restrict protein intake to prevent kidney damage. Potatoes, fruits, vegetables, nuts and drinks that are high in potassium are best to avoid. Also, you may want to research a renal-healthy list of vegetarian food options for your renal menu. Remember to reduce salt amounts and salt substitutes in the recipes and double check the list of “avoid” vegetables, fruits and nuts. Listing just a few food options below, at the end (I would encourage you to visit the Cornwall Hospital and National Kidney Foundation sites) for a more detailed suggestion of menus.

The Renal section of the Utah Medical Center has done studies on 1074 patients on nutrition modification in kidney failure, age, gender, race, creatinine production and glomerular filtration rate (GFR).  Your GFR tells your doctor about the stage of kidney failure. Doctors can calculate your GFR from your blood creatinine test. The Renal unit found an excellent correlation between serum creatinine and a diet modified for renal failure. Each 5ml/min increase in a modified renal diet GFR was associated with a 21 % higher odds of malnutrition. So, a renal specific, healthy diet is important.

List of Foods to avoid:
Potassium containing foods
Jacket potato, mashed potato, potato chips
Banana, melons, all dried fruit
All varieties of nuts
Cartons of milkshake, tomato juice and fruit juice
Cider, strong Ale

Foods you can enjoy:
A delicious omlette with (part boiled) sauteed potatoes
Scrambled eggs and toast – now that’s a tradition you can continue forever
Chick peas – many Indian menus
Humus – middle eastern menus
Tofu – japanese menus
Apparently, the Asian and Eastern diet has some vegetarian protein options for a renal diet as long as you monitor your potassium, sodium, calcium and phosphorus intake.

I shall continue to post suggested renal healthy menus when I find reliable sources. If you have authentic sources, do share them with us. We are especially interested in peer-reviewed, researched, scientific article links from Departments of Nutrition. Also, if you have any suggestions on how to make the caregivers of the suffering loved ones less fearful, and happier, do share. Let’s beat renal failure together!

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Kidney care and okra


Okra (or ladysfinger) has some reputation as a kidney cleanser. I shall look for peer-reviewed journal publications on this subject and post them here. Once kidneys fail, dialysis assistance is begun. If prevention of kidney failure is a goal then it may be prudent to include in one’s diet vegetables such as okra, which have a reputation for maintaining kidney health, until proven otherwise. Kidney care may be essential for the generous donors who are left with a single kidney to ensure renal function (Click here to read a story about one such donor, written by the donor).

Some may find okra cumbersome to handle, and you too may be intimidated, if you handle okra for the first time. Please, trust me. Do not be turned – off. Continue to explore this little, green, ribbed pod, full of these magnificent protein packed seeds. Together, they deliver a major dose of a beautiful, mixture of vitamins, proteins, carbohydrates, fats, minerals, iron and iodine. On top of all this it includes crude fiber bringing with it a totally separate set of benefits. If the little okra did not deliver a serious benefit why else would ancient people on two separate continents be so devoted to the cultivation of fresh okra until current times? Click here for more than 400 photos of okra and okra recipes. A mucilaginous exudate appears when one chops the okra. Does this exudate have preventive properties? I shall look into it and post it here. Also, should I find a collection of tested recipes using okra, I shall post them here. Please, feel free to share your favorite okra recipes here too. Many kitchens have successfully conquered the art of cooking okra to include it as part of a renal – care menu, while celebrating the joy of a good meal. Please, visit by clicking on the international recipes featured here by different authors. You may be delightfully surprised by how flavorfully you can add okra to your own table through some of these following recipes:

1) Some, like their okras stuffed with masala, as in this Indian recipe.

2) Others like their okra fried, as in this Southern USA recipe.

3) While still others like it delicately spiced as in this Persian recipe.

4) The young fruit is eaten fresh in Nigeria, which perhaps is the only country that has two equally popular varieties of okra; one which is popular in the other countries and the second native to a restricted part of Nigeria. Although, there are several delicious African recipes to cook okra.

5) Chicago Tribune features this Indian style  okra with tomatillos recipe along with a weight loss cartoon!

It is evident that okra has long been revered from these ancient recipes. Some more recipes sites are mentioned in the Bon Appetit magazine.

Okras are difficult in find in stores but you may want to look out for them. Also, they are easy to grow from seed in the summer. Exploring both options may prove rewarding.

Research on the cultivation and utilization of Abelmoschus esculentus or okra has mainly focused on several aspects, including its cultivation as a vegetable, as a medicine and for health care, as a beverage, and in gardening. The vegetable it produces contains many nutritious ingredients: 100 g of dry, tender okra pods includes 2.11 g of deoxidized sugar, 1.06 g of cellulose, 2.44 g of CP, 0.682 g of carotene, 26.5 mg of vitamin C, 1.25 mg of vitamin A, 10.2 mg of vitamin B, and many minerals, having slightly more than common vegetables and fruits. In addition to being a good source of vitamins A, B, C it is also provides protein, carbohydrates, fats, minerals, iron and iodine (Diaz and Ortegon, 1997). Consuming 100g of fresh okra pods provides 20, 15 and 50% of the daily recommended requirement of calcium, iron and ascorbic acid, respectively (Hamon, 1988; Schippers, 2002). It is advisable to eat the whole seeds. The seeds and their kernels are rich in protein as well as fat. Most of the protein and fat of the seed is found in the kernel while the seed coat is composed of crude fiber. It is a good source of essential amino acids but its levels are lower than that of whole egg protein.

References:

ISBN 90 – 5782 – 147 – 8

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How to introduce Calcium in the diet of Autistics and Allergics
How to balance minerals in diet for healthy kidneys

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