An integrative approach to treatment may help slow down kidney disease.
by Lisa James
As far as Eileen Smith was concerned, it was simply another round of routine bloodwork ordered by her physician. But when the results came in, it was found that “creatinine, the kidney test that tells you something is out of whack, was quite elevated. She told me to see a kidney specialist,” says Smith, a retired retail worker living in Bushkill, Pennsylvania.
During her visit with the nephrologist, Smith asked about possible dietary changes to slow the progression of her kidney disease. “He said I would need a special diet when I got to dialysis, which would be in three to six months. I said in my mind, ‘I’m not going there.’”
That was more than two years ago and Smith, now 68, isn’t on dialysis yet. She credits a blend of conventional and alternative treatments for allowing her to avoid the procedure.
Up to 400,000 Americans with end stage renal disease (ESRD, also known as kidney failure) undergo dialysis every year, hooked up to machines that remove toxins in the blood that their failing kidneys can no longer capture. ESRD is the last stage of chronic kidney disease (CKD), in which the kidneys progressively lose function. That goes beyond cleaning the blood; kidneys also help to maintain mineral balance and to regulate blood pressure.
The kidneys can rebound after acute problems, such as infections. However, “once tissue becomes scarred it’s not functional anymore,” says Jenna Henderson, ND, of Holistic Kidney in Danbury, Connecticut (www.holistic-kidney.com). By stage 4, the one before kidney failure, symptoms may appear including fatigue and swelling (edema). Progression brings signs of toxin buildup, or uremia, such as nausea, vomiting and severe itching. In many cases, CKD causes few symptoms until the kidneys have suffered significant damage.
While CKD can be caused by disorders such as IgA nephropathy and polycystic kidney disease, most people wind up in a nephrologist’s office for two reasons: diabetes and high blood pressure. Not everyone realizes the danger. “I’ve had diabetes for 20 years,” Smith says. “Nobody ever told me I needed to have tests for my kidneys.” (Kidney stones usually don’t cause kidney disease unless they recur and are not treated.) Obesity and aging are other risk factors. And imaging studies, especially those that use contrast dyes, can also damage the kidneys.
Just as diabetes and high blood pressure rates have increased, so has the rate of CKD. According to the National Institutes of Health, more than 20 million Americans have kidney disease; the incidence of diagnosed cases in people age 65 and older more than doubled between 2000 and 2008.
The Total Picture
CKD’s stealthy nature means that patients can be taken aback by the diagnosis. Henderson understands; she became interested in naturopathic medicine 20 years ago after being diagnosed with the rare kidney disorder FSGS. She tells patients “they’re going to be all right. I’ve had some patients who have been on the verge of needing dialysis and they still don’t need it.”
The stage of CKD someone has is one determining factor when formulating a treatment plan. “The needs of someone who is approaching stage 5 are different than those of someone who is in dialysis or is having a transplant,” says Henderson.
Most CKD patients have other conditions that need to be addressed. “It’s all linked together. For example, kidney disease is a risk factor for heart disease; if a person has liver problems that can make kidney disease worse,” says Rich Snyder, DO, who practices nephrology in Easton, Pennsylvania, and has written What You Must Know About Kidney Disease and What You Must Know About Dialysis (both Square One).
That’s why Snyder, who now treats Smith, takes a whole-body approach to CKD. “We do what we can to maximize liver function, heart function, to decrease diabetes,” he says.
It’s also crucial to counteract proteinuria, or protein in the urine, marked by a foamy appearance. “If urine looks like it came from a shaken soda can, that’s not normal,” says Henderson. Snyder compares the kidney to a fishing net; in proteinuria, “it’s like someone taking a scissors and cutting that fishing net—you’re leaking a nutrient your body needs. That also sets off inflammation; it makes the kidney have to work harder.”
One of Snyder’s biggest recommendations is eating more plant foods. “I believe animal protein is a toxin,” he says. “Switching to a plant-based diet is alkalinizing.” Henderson says if animal products are eaten they should be of the grassfed variety because they provide a better ratio of healthful omega-3 fats to the inflammatory omega-6s. “Fast foods are loaded with phosphate-based preservatives that are bad for the kidneys,” she notes.
Snyder believes “everyone should be on a probiotic because there is a lot of scientific literature linking the intestine with increasing inflammation, which affects the kidney. Everyone should be on a daily antioxidant. I use omega-3 fish oils to minimize systemic inflammation.” He adds, “Low vitamin D levels play a role in kidney disease and low vitamin D is epidemic in our society.”
Snyder uses a variety of herbs, supplements and homeopathic remedies based on each patient’s needs, some more frequently than others. For example, “Most everyone I see has bone problem; I like vitamin K2 because it helps prevent the body from leaching calcium out of the bones and putting it in the blood vessels. I also like a high-quality multivitamin.” In addition, Snyder favors CoQ10, alpha lipoic acid and a combination of olive leaf and hawthorn, as well as milk thistle for liver dysfunction and D-ribose for heart failure. (He stresses that people with CKD should consult a healthcare practitioner before devising a supplementation plan.)
“I try to use an integrative approach. A treatment program has to be personalized,” Snyder says.
Smith believes in Snyder’s combination philosophy. She keeps her kidney disease under control with diet and supplements as well as prescription medication.
She has especially taken a book suggested to her by Snyder, The Vegetarian Diet for Kidney Disease by Joan Brookhyser Hogan (Basic Health), to heart. “I eat lots more vegetables than I used to. I don’t eat meat; chicken is the worst thing you can eat because of all the hormones they feed them,” Smith says. “I try to do organic as much as possible. And I’m pretty much wheat- and gluten-free. That has made a tremendous difference.” What’s more, her treatment plan has lowered her insulin needs.
As a result, Smith has the energy to ride horses and keep up with her eight-year-old grandson. “I feel wonderful and my numbers are down,” she says. “It has been such a learning experience.” Her husband, Martin, credits Snyder for “simplifying the approach.
The other doctor took an attitude of ‘Take this drug, take that drug, don’t worry about the diet.’”
Based on her own experience and those of her patients, Henderson maintains a positive outlook when it comes to kidney disease. “Even if the worst-case scenario happens you can live very well,” she says. “It doesn’t have to be the end of your life.”