Functional Medicine for Chronic Kidney Disease

Chronic kidney disease (CKD) means lasting abnormalities of kidney structure or function. Severity varies: many people have no symptoms, and not everyone develops kidney failure. [1]

Early recognition, monitoring and appropriate treatment can reduce risk and may slow progression. They cannot guarantee that kidney function will remain stable. [1]

Causes

CKD can affect people of different ages. Its course varies, so progression to kidney failure should not be described as inevitable. [1]

The kidneys are organs beneath the rib cage towards the back. They remove waste and extra fluid, help balance salts and produce hormones involved in blood pressure and red-blood-cell production. [2]

Kidney damage can be caused by a variety of causes, such as diabetes and high blood pressure. Autoimmune diseases like lupus may also lead to kidney damage. Obstructions in your kidneys like stones or tumours may lead to chronic kidney disease.

If your family history includes kidney issues, it's essential to get regular medical exams to determine if you are at an increased risk for developing CKD. Your doctor can identify other conditions that could be placing undue stress on your kidneys and suggest a strategy for prevention.

CKD assessment uses creatinine-based estimated glomerular filtration rate (eGFR) and a urine albumin-to-creatinine ratio (ACR), alongside the clinical history. A full blood count can detect anaemia but does not diagnose CKD by itself. [1]

Other tests to diagnose CKD include urine tests, which detect protein in your pee. Excess protein may indicate that your kidneys aren't functioning optimally.

Another type of test is a glomerular filtration rate (GFR). This measurement indicates how efficiently your kidneys filter blood.

An abnormal result may need repeating and comparing with earlier results. A sudden deterioration can be acute kidney injury; it should not be labelled chronic without appropriate assessment. [1]

Symptoms

With age, kidneys can become damaged and no longer filter wastes and extra fluid from your blood stream as effectively. As a result, you may end up with dangerously high levels of salt, water and other substances in your body.

Kidney disease can be caused by a number of conditions and disorders that damage the tiny blood vessels (glomeruli) in your kidneys, leading to inflammation. They may also be damaged due to diabetes, high blood pressure or certain drugs.

A kidney biopsy is sometimes needed to establish the cause. It involves taking a small tissue sample and has risks, including bleeding; a specialist explains the reasons and alternatives. [2]

Other causes of kidney damage include toxins such as lead and drugs and chemicals. Long-term use of certain medications like NSAIDs or IV street drugs can permanently harm the kidneys, as can exposure to certain kinds of chemicals.

When your kidneys stop working properly, they cannot produce enough hormones that instruct your blood to form oxygen-carrying red blood cells. This causes extreme fatigue and makes breathing difficult; it could also make skin itchy or lead to difficulty sleeping or urinating.

Furthermore, kidney disease can wreak havoc on your muscles and nerves, leading to muscle twitching or weakness, cramping, pain, pins-and-needles sensations, restless legs syndrome and even encephalopathy - an illness which affects the brain and may cause confusion or seizures.

Early CKD often causes no symptoms. Monitoring helps assess the individual risk of progression; dialysis or transplantation is not inevitable for everyone. [1]

Other symptoms of kidney disease include fatigue, nausea, itching, loss of appetite, confusion and swelling in your hands, ankles and feet. These can occur if the kidneys fail to remove enough fluids from your body or excrete enough salt and potassium.

Diagnosis

The kidneys filter waste and extra water, balance salts and produce hormones that support blood pressure control, red-blood-cell production and bone health. Red blood cells are made in the bone marrow, not by the kidneys themselves. [2]

CKD can remain stable or progress. Treatment depends on its cause, test results, associated conditions and the person’s goals. [1]

Blood tests estimate kidney filtration, while urine ACR measures albumin leakage. Results, duration and other clinical findings are considered together; selected patients need specialist assessment. [1]

Tell your clinician about persistent fatigue, weight loss, swelling or urinary changes. Assessment considers kidney function, albumin in the urine and relevant blood chemistry; protein in the blood is not itself the diagnostic marker described here. [1]

If your family history includes kidney disease, speak to your doctor about getting tested regularly. This is especially important if you have any risk factors for the condition such as diabetes, lupus or high blood pressure.

A nephrologist can help plan treatment where specialist care is needed. Medicines are chosen for the cause and complications; supplements are used only for a specific indication and with a safety review. [2]

Many patients find these therapies to be an effective means of delaying or preventing end-stage kidney disease. Not only do they control signs and symptoms, but they may reduce your risk for serious complications like heart disease or kidney failure as well.

Earlier assessment gives more opportunity to manage risk. The response varies, so slower progression cannot be promised to an individual. [1]

Treatment

CKD can impair the removal of fluid, minerals and waste. The effect depends on the severity of the disease and any change in kidney function. [1]

Treatment for chronic kidney disease (CKD) aims to minimize complications, slow the disease's progression and enhance quality of life. Possible treatments for CKD may include medications, diet/lifestyle changes and physical activity.

Diet advice should be individualised by the renal team or a renal dietitian. Protein, potassium, phosphate and fluid needs vary; do not start a high-protein diet or broad food restriction from a generic list. [2]

Exercising is an integral part of managing CKD, as it can improve blood pressure, aid in sleeping and strengthen bones. Furthermore, exercise may reduce your risk for developing diabetes and heart disease.

Herbal and “kidney detox” supplements can harm kidneys or interact with medicines. Check every product with the renal team or pharmacist before use. “Natural” is not a guarantee of safety. [3]

Lifestyle support can complement standard renal care. It must not replace treatment for diabetes, blood pressure, kidney inflammation or other established causes of CKD. [2]

Gentle movement or relaxation may support wellbeing when suitable. Energy healing has not been established as a treatment that restores kidney function. [2]

Activity should be matched to your health and capacity. Improvements in balance or wellbeing do not prove that a movement practice reverses CKD. [2]

Functional medicine is not a substitute for dialysis, transplantation or specialist kidney care when these are needed. Delaying necessary renal treatment can be dangerous. Decisions about kidney-failure treatment belong with the renal team. [4]

For more information or if you would like to discuss treatment and management with Dr Stavy then please contact us via email:info@drstavy.com