Nutrition. Vitamins. You.
All About Detox Part 1 Dr. Claire Arcidiacono, ND Liver health is important for our overall health for so many reasons. One of the most well-known functions of the liver is to detox our bodies. Doing a detox, or cleanse is one of the topics …
Kidney Health Part 4 Dr. Claire Arcidiacono, ND Dialysis I wanted to talk about dialysis because in my experience it is one of the topics that people have the most questions about. If you can recall in part 1 of kidney health, I talked …
Kidney Health Part 3
Dr. Claire Arcidiacono, ND
In this blog on kidney health, I will be reviewing polycystic kidney disease (PKD), chronic kidney disease (CKD) and even kidney failure. The reason I have for putting these 3 disorders in one blog is that all 3 place you at an increased risk of needing dialysis. So, let’s get into it, shall we?
Polycystic kidney disease (PKD) is a genetic disorder that causes cysts to develop in the kidneys. Now how are these cysts different from the common kidney cysts I mentioned in part 2 of kidney health? Well, PKD forms cysts that usually affect kidney function whereas common kidney cysts are usually harmless. PKD is due to a specific gene mutation, which can be inherited. In contrast common kidney cysts occur when the tube of a nephron begins to swell and fill with fluid. While the exact causes of common kidney cysts are not yet known it is known that they do not form because of an inherited condition. (1, 2) Please see the picture of common kidney cysts (3) vs. PKD. (1)
There are 2 forms of PKD. The first form is autosomal dominant polycystic kidney disease (ADPKD). This often does not present symptoms until adulthood. Symptoms can include flank pain, high blood pressure, headaches, UTI, kidney stone and blood in your urine. The second form of PKD is autosomal recessive polycystic kidney disease (ARPKD). In this case symptoms start soon after birth or in early childhood. In fact, during pregnancy cysts may be detected on the fetus’s kidneys during a prenatal ultrasound. Symptoms can include low birth weight, high blood pressure at birth, breathing problems and a swollen abdomen. Other symptoms can include growth failure, frequent UTIs, pain and even high blood pressure. (1) Now what symptoms might you expect with simple kidneys cysts? While they usually don’t cause symptoms, they may cause pain, fever, frequent urination and bloody/dark urine. In some cases, they may lead to an increase in blood pressure. (2)
PKD can have severe complications. In fact, ARPD can be fatal in babies with severe diseases. Other complications can include UTIs, kidneys stones and high blood pressure that can be hard to control. PKD can increase the risk of brain aneurysms, heart valve problems, colon issues, preeclampsia, and liver/pancreatic cysts. PKD can lead to kidney failure and the need for dialysis. (1) Complications of simple cysts can include infections; urine blockage and the cyst may burst or bleed. (2)
Moving on to chronic kidney disease (CKD). What is CKD? Well CKD basically mean’s that there is damage to the kidneys, and they aren’t working as well as they should. CKD gets worse over time and gradually the kidneys will be less and less able to do all their jobs. Eventually as the kidneys begin to fail dialysis may become necessary. There are 5 stages of CKD. Please see the attached chart. (4)
| stage | GFR (mL/min) | What It Means |
| Stage 1 | 90 and higher | Your kidneys are working well but you have signs of mild kidney damage. |
| Stage 2 | 60 to 89 | Your kidneys are working well but you have more signs of mild kidney damage. |
| Stage 3a | 45 to 59 | Your kidneys aren’t working as well as they should and show mild to moderate damage. This is the most common stage. You may notice symptoms at this stage. |
| Stage 3b | 30 to 44 | Your kidneys show moderate damage and don’t work as well as they should. With the right treatment, many people can stay in this stage and never advance to stage 4. |
| Stage 4 | 15 to 29 | You have very poor kidney function; your kidneys are severely damaged and close to not working. |
| Stage 5 | Less than 15 | Your kidneys are very close to failing or have stopped working. You may need kidney dialysis or a kidney transplant at this stage. |
CKD can be inherited and run in families. There are a number of disorders that can lead to CKD. These can include autoimmune disorders such as lupus, and other disorders such as diabetes related nephropathy. Polycystic kidney disease is also a risk factor. Other conditions that can lead to CKD include glomerulonephritis, membranous nephropathy, nephrotic syndrome, vesicoureteral reflux, and any urinary tract obstructions. Certain medicine can also lead to CKD. Having a history of diabetes, high blood pressure, heart disease and abnormal kidney structure/size, and being over age 60 can all increase the risk of developing CKD. Complications include high blood pressure, heart disease, nerve damage, infections, fluid buildup and metabolic acidosis. You may become anemic, have high potassium or high phosphorus. You may develop gout and even brittle bones. Over time you may need dialysis. (4)
Finally, there is Kidney failure. Kidney failure is exactly what it sounds like. One or both of your kidneys can no longer function well on their own. This can either be temporary or chronic. (5) Just like with CKD there are 5 stages. Please see the above chart for staging. Kidney failure is more common than you might expect. It affects 750,000 people in the US every year and 2 million worldwide. What can cause our kidneys to fail? Well common causes are diabetes and high blood pressure. Other causes are lupus, PKD glomerular disease and untreated systemic diseases. Also, any urinary tract obstruction, severe dehydration, and even certain medications. Signs that your kidneys may be failing can include fatigue, nausea/vomiting, swelling, cramps, change in appetite and even confusion or trouble concentrating. There may be frequent urination and dry skin. Advanced kidney failure will require dialysis, and you may need a kidney transplant.
In our next and final blog, I will be reviewing dialysis and supplements that you can use both before and during dialysis.
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Kidneys Part 2 Dr. Claire Arcidiacono, ND In the first part of our discussion on kidney health we reviewed basic information such as what the kidneys do for us and tests that can measure our kidney health. (1) In this blog we will review the …
PRIMARY FOOD, LIFESTYLE AND OUR HEALTH~JOY by: Allie Might, FMC, INHC, ATT “The best way to choose what to keep and what to throw away is to take each item in one’s hand and ask: ‘Does this spark joy?’ If it does, keep it. …
Kidney Health Part 1
Dr. Claire Arcidiacono, ND
No conversation about the liver would be complete without talking about the kidneys since one of the functions of the kidneys is to help remove waste from our body. Now I understand that kidney health can be a confusing and complex topic. It involves basic topics such as just what do the kidneys do? What can go wrong with our kidneys? And then there is the topic of dialysis and just what it does for the body and what it means in terms of our health if we require dialysis. To keep this from becoming overwhelming I have decided to split this topic into separate parts. This part will be more of an introduction to our kidneys. Now as I just said, the kidneys play an important part in removing waste from the body. In addition to removing waste our kidneys have numerous functions that are important in keeping us healthy. (1) So, let us get into it, shall we?
The main job of the kidneys is to function as a filtration system and remove waste from the blood. What happens is that blood enters the kidneys through the renal arteries and exits the kidneys through the renal veins. (1) Inside of each kidney there are filtering units called nephrons. These are made up of 2 parts, the glomeruli and renal tubules. These 2 parts perform something called glomerular filtration and diffusion. What basically happens in this 2-step process is that waste is removed, water and other nutrients are reabsorbed, and the waste/ excess fluid is sent to collecting chambers. Eventually it makes its way to your bladder and will exit the body as urine. (2)
In addition to helping clean the blood the kidneys make some especially important hormones. For example, they make a hormone called renin that increases blood pressure. This is important because if circulation to the kidneys is compromised for any reason the kidneys will try to increase their blood flow by increasing renin to try and increase the amount of blood they receive. However, this increase in renin will raise overall blood pressure. The kidneys also produce a hormone called erythropoietin. This helps the body make red blood cells. The kidneys also produce calcitriol, which is a form of vitamin D (this helps with the absorption of calcium). If the blood sugar drops too low the kidneys can help increase it by producing glucose. The kidneys keep tight control over the acid/base balance in our blood. (2) The kidneys also control the overall chemistry of the body. For example, they regulate the concentration of salt and water moving around the body. (1)
There are certain tests that can be done to check our kidney health. First, a urinalysis test to check the urine for certain substances such as blood or protein. The doctor can also do an ureteroscopy to look at the bladder and ureters. You can also do a kidney biopsy as well as imaging testing such as an X-ray or CT scan. (2) There are blood tests that can be done to check the kidney function. For example, blood tests can include BUN, Creatinine and estimated GFR levels. (3)
In our next blog we will review some of the most common conditions that can affect our kidney health and function. I know I have not reviewed any supplements in this blog so I’ll refer you to my blog on Daily Detox since the Daily Detox powder does touch upon nutrients that can help with kidney health.
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