There are approximately 26 million people in the United States living with chronic kidney disease today and millions more who are at risk of developing it. This is a dangerous and serious disease that should be diagnosed and treated as soon as possible to prevent a rapid progression. It works by reducing, and eventually eliminating, the ability of the kidneys to filter waste products from the bloodstream. In time, the kidneys fail entirely, requiring dialysis or a kidney transplant. Factors that create a higher risk of chronic kidney disease include diabetes, hypertension and family history. Groups of people who have a higher incidence of kidney disease include those of African-American, Hispanic, Pacific Islander or Native American descent.
The medical community has divided chronic kidney disease into several stages to better determine its progression in a patient. The early stage does not require any drastic lifestyle changes, though there will certainly be a need for a change in diet and lifestyle, as well as visits to a physician. The latter stages require more and more restrictions, like a limit on the amount of protein that the patient can eat every day. These stages will require the help of a nutritionist to plan a suitable diet.
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Protein is a component that is necessary for life and everyone needs some in their diet. Restricting it can be dangerous if done improperly. The stages of the disease that require a lowered protein intake also create a difficulty in maintaining weight as the body starts craving food sources that will give it the protein it needs.
When protein is consumed, the body turns it into its component amino acids, which are in turn transformed into new amino acids, hormones and enzymes which regulate processes like sleep, ovulation and digestion. Whatever is left is waste that is filtered through the kidneys. These are tiny organs, about four inches long in length and one pound apiece, but they are also powerful, able to filter about 18 gallons of blood per hour. All-in-all, the kidneys filter about 60 percent of the fluid in the entire body.
Damaged or diseased kidneys cannot filter the waste produced by protein breakdown. The progress of this disease is rated in stages related to the glomerular filtration rate, which is how much blood the kidney is able to filter. At stage I, the GFR is still at an acceptable level, but a physician can tell something is wrong by the abnormal amount of protein to be found in the urine. Dialysis is not required until stage V.
Once the disease progresses to stage V, the patient will have to submit to dialysis treatments for life unless a kidney transplant is received. Even then, the patient is not always strong enough to undergo surgery. Sometimes, due to other complications or medical conditions, the patient may never be ready for a transplant. The GFR for the fifth stage of chronic kidney disease is generally less than fifteen, which means that the kidneys are functioning at ten percent of capacity or less.
The Dietary Needs of a Stage V Patient
Stages I through IV need a reduced protein intake. At first, the reduction is not a big change, especially in the first three stages. Stage IV sees a more significant restriction, down to about 10% from the usual 14-18% that most people take in from their diets. The usual diet of a vegan is only about 10-12% protein, so it's definitely possible to do it and still remain healthy. Still, it is important to consult a physician before restricting protein on your own to avoid possible complications or malnourishment.
Stage V is outright renal failure, which means that the protein restriction is gone. Dialysis will become a regular part of the patient's life and good nutrition will become even more important. Additional amounts of protein will be needed to keep the body strong. Some things, like sodium, potassium and phosphorous, may end up being restricted. The intake of fluids may also have to be reduced. The type of dialysis being used may also limit the diet of the patient as a whole.
Dialysis is a process that uses a machine to filter waste from the bloodstream, taking the place of the kidneys. It is a complicated process which usually takes several hours and has to be utilized at least three times a week.
It is important that the patient has enough calories to maintain their health and keep the muscles in shape. Protein is the lynchpin of that effort, coming from sources high in essential amino acids, like meat, eggs and certain sources of dairy. There are some high-protein foods that don't do as well because they do not contain all of the necessary amino acids. These foods include nuts, beans and nut butters. A dietician will most likely advise eating more meat and eggs, especially the latter, as eggs are considered by many to be the perfect protein. Protein supplements could very well be a part of the diet as well. You will need to get about 25% of your daily requirement of protein from each meal.
There will still be food restrictions because some high-protein foods are also high in phosphorous. These include foods like bran cereals, organ meats, sardines, chocolate, cola drinks, dried beans and brown rice. Watch for extremely itchy skin - this is an early sign of phosphorous buildup in the bloodstream.
Protein Supplements as an Extra Source of Protein
As someone suffering end stage renal failure, you will need about double the normal amount of protein, but will face exhaustion, nausea and lack of appetite, which makes it difficult to get nutrients. A protein supplement could be of great use. They come in several forms and have enough variety to appeal to everyone.
Protein Powders: These come in four kinds: rice, soy, egg and whey. The powder made from whey boosts the immune system and helps your muscles to stay in shape. Since it is derived from milk, some may not be able to take it, however.
Protein Shakes: You can find protein shakes in many varieties, including those especially made for diabetics.
Protein Supplement Shots: These have a smaller serving size than a shake but the same amount of protein and some other nutrients as well.
Protein Snacks: Protein bars and puddings are another source of protein. Avoid the ones with additional sugar, as sugar can sometimes be detrimental to your immune system.
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Dec 11, 2011 11:04:42
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