June 3, 2013
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Dr. Amy’s Wellness Tip for June

By Dr. Amy Whittington, Trilogy’s Naturopathic Physician

When we think of our long term health and prevention of illness, we tend to think of the heart, brain, or even liver as the primary organs of concern. However, the kidneys, which function to filter and remove toxins and extra fluid from our bloodstream, are also vital to our health. A decrease in this filtering system can lead to fluid retention, electrolyte imbalance, and dire long-term consequences.

Fortunately, there are easy steps you can take to prevent damage to your kidneys so that they can continue functioning optimally throughout your life. A decrease in kidney function is typically known as chronic kidney disease, and it is often a complication of long-standing hypertension, diabetes, autoimmune or genetic diseases, or the result of a medication side effect. Unchecked, chronic kidney disease can result in kidney failure, a diagnosis that can culminate in the need for either dialysis or a kidney transplant, both of which are unpleasant options that make prevention of this disease that much more important.

At the onset of dysfunction in the kidneys, there are typically no symptoms. However, simple, yearly lab-work that includes a chemistry panel (as most do) should show any decrease in filtration, as evidenced by a decrease in GFR (glomerular filtration rate), and/or elevated BUN (blood-urea nitrogen). As kidney disease progresses, it can cause nausea, vomiting, swelling, and decreased urinary production.

As ominous as chronic kidney disease might seem, the good news is that it can be slowed, or made less likely, through lifestyle and other preventive measures. The primary way to avoid decline is to treat and prevent the illnesses that might lead to it. You should consult with your physician to control diabetes and hypertension, as the two most prominent risk factors. Obvious lifestyle adjustments are to limit high amounts of sugar and salt in the diet, exercise several times per week, and to limit alcohol to prevent both hypertension and blood-sugar disturbance. Another way to provide protection for your kidneys is to avoid tobacco, which has been associated with hypertension and chronic kidney disease. An overuse of NSAIDs (non-steroidal antiinflammatories), such as ibuprofen, can be detrimental to the kidneys. Clinically, I have seen many cases of an elevated BUN that corrected with decreased use of NSAIDS.

Aside from lifestyle and nutritional changes, there is also supplementation, which has shown benefit in decreasing chronic kidney disease. Perhaps the primary player is an amino acid called L-carnitine. Our bodies produce L-carnitine, but it can also be found nutritionally in meat, although protein intake often must be decreased in kidney disease. Higher supplemental levels have proven to increase function of the kidneys, as well as to decrease blood pressure. Technically speaking, L-carnitine functions to transfer long-chain fatty acids into cells so that they can be used for energy. In lay terms, the more l-carnitine, the easier it is to produce energy. In an organ that is constantly functioning, such as the kidney, an increased availability of energy allows for improved continued function (as an aside, the same is true for the heart and brain). The kidneys are thought to get an extra advantage as the kidneys themselves produce l-carnitine, and those with damaged kidneys likely produce less, compounding the issue of a lack of available energy.

In April 2013, a negative report regarding L-carnitine and heart health was picked up and reported by popular media. Avoidance of supplementation based on this report should not occur, as it was based on of a study of only 10 people, when in fact studies and metaanalyses with groups of thousands have shown a positive correlation with its use in decreasing heart and kidney disease. Deciding to supplement should, of course, only occur at the recommendation of your treating physician, especially when kidney function is involved. Coenzyme Q10 (CoQ10) is another nutrient touted to improve kidney health. In 2003, a study published found that CoQ10 treatment decreased progression and reversed renal dysfunction in most patients with end stage disease. Due to the smaller size of the study (less than 100 people), results are considered preliminary. However, for a nutrient with no side effects, and with the added potential benefits of decreasing blood pressure and improving heart and brain health, it is certainly worth a consideration. CoQ10 is a coenzyme, which is also integral in the production of energy, helping to shuttle oxygen into the Kreb’s cycle so that we can more efficiently produce energy from our food.

N-acetyl cysteine is another nutrient that in study has been shown to protect against damage that can occur to the kidneys by contrast dyes. When given by IV, N-acetyl cysteine likely works as an anti-oxidant, scavenging free radicals caused by the dye. It is unknown whether oral administration or use for general preventive measures is effective for kidney health, but n-acetyl cysteine remains a powerful nutrient in general immune support, and we will likely see more studies in the future.

Last but not least, a supplement that you have surely heard of is fish oil. Taking high doses of EPA/DHA (nearly 2 grams of these active ingredients, or higher) has been shown to result in improved glomerular filtration rates and lower blood pressure. This one is probably already in your cabinet, just add up the daily EPA and DHA to get the proper dosage.

The kidneys play a vital role in our health and longevity and if your kidneys continue to serve you well, you likely only need to mind your lifestyle and nutrition choices, limit your use of NSAIDs, and consider some general supplementation such as CoQ10 and fish oil for daily preventive measures.

If you have chronic kidney disease, you should consider further support with your doctor. It is especially important as a kidney patient that your treating physician has knowledge of everything that you are taking. Your kidneys, although less often considered, are vital organs, which function constantly to support the removal of toxins and maintain water balance.  It’s time to return the favor with a little mindful prevention.