Vitamin D is a hot topic.  Articles appear almost weekly in newspapers, magazines, journals and online.  I’ve heard several television reports just over the past week.  In a posting back in April, I covered some basics on vitamin D and why it’s important for chronic kidney disease and dialysis patients. Today I’m focusing on the best way to get vitamin D and how it works in the body.

Roll up your sleeves, omit the sunscreen and sit in the sun for 15 to 20 minutes between 10 am and 1 pm.  That’s the best and easiest way to get the vitamin D.  Amazingly, you can get as much as 10,000 IU of vitamin D if you are fair-skinned.  If you have dark pigmented skin additional time is required for the same effect.

How does this work?  When ultraviolet B rays from the sun hit your skin, vitamin D precursors stored in skin are activated and released into the blood. This form of vitamin D, 25-hydroxy vitamin D,  then goes to the liver for another activation step and finally to the kidneys for a final activation. The liver can store vitamin D until it is needed by the body.

If you have kidney disease, less vitamin D is activated, especially in advances stages of CKD and end stage renal disease (ESRD). You may want to ask you doctor to check your vitamin D level to determine if you have a deficiency.  The biologically active form of vitamin D is 25-hydroxy Vitamin D.  Normal blood levels are 40-60 ng/dl. U.S. studies show as many as 70% of the population has levels lower than this amount.  The lowest levels were found in the elderly, females, overweight and obese persons, and those with kidney disease or diabetes.

If low levels are discovered your doctor may prescribe high dose supplements for 6 to 12 weeks, followed by a daily maintenance dose of 400 to 1000 IU.  In addition to or instead of this supplement, dialysis patients and CKC patients in later stages may be prescribed a special activated vitamin D supplement.  This form of vitamin D is equivalent to the vitamin D activated by kidneys, and acts as a replacement if you have kidney disease.  Doctors monitor the effects of this special prescription activated vitamin D by checking blood calcium, phosphorus and parathyroid hormone (PTH) levels.

For more information on vitamin D and kidneys, read Vitamin D and chronic kidney disease on DaVita.com.

Kidney diet resources from DaVita.com

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Many chronic kidney disease patients I’ve worked with have questions about what’s important with potassium control. Not all people with CKD need to restrict potassium.  In early stages of CKD, potassium usually is not a problem because the kidneys still remove enough to keep blood levels normal.  In some cases, elevated potassium may return to normal with adjustments in medication, especially if a person is on potassium sparing diuretics.  If medications are adjusted and levels continue above normal, a lower potassium diet is needed.

Kalium-Latin for Potassium

What’s the link between potassium and kidneys?  90% of the excess potassium consumed through diet is removed by your kidneys. Read more…

(This post is part of a series looking at foods to include in a kidney diet)

Mustard is  an excellent kidney friendly diet condiment.  So many seasonings and condiments are loaded with fat and sodium.  One teaspoon of yellow mustard contains only 25 to 65 mg sodium.  (Do check labels because some brands are higher.)  Potassium and phosphorus are low at less than 7 mg a teaspoon.  Mustard paste and mustard sauce, oriental versions of prepared mustard, are similarly low in sodium, potassium and phosphorus. Read more…

Recently my mother sent me a copy of her lab report because she was concerned about her Hgb A1-C, cholesterol and triglyceride results. I was surprised to see her glomerular filtration rate (GFR) indicates she has stage 3 Chronic Kidney Disease (CKD). The biggest surprise is that her doctor didn’t discuss the fact that her kidneys are losing function or that she could make some changes to help slow the progression. This probably is not uncommon considering the numbers. There are over 26 million people in the US with chronic kidney disease, many who are unaware.  Nearly one in ten Americans has a relative with CKD. Read more…

I love frozen blueberries.  I usually fill a small bowl and eat them as they thaw while working at my computer.  My friend loves dried wild blueberries because they’re packed full of flavor—and because there’s over 6 grams of fiber per serving.  That’s great news for anyone following a low potassium kidney diet—so many high fiber foods end up on the limit list due to higher potassium or phosphorus content.  An added plus is there’s only 112 mg of potassium in a cup of fresh or frozen blueberries; phosphorus and sodium are low too. Read more…

I’ve been running across lots of information on vitamin D lately. It turns out that many people are deficient in vitamin D. Doctors are starting to check vitamin D levels and prescribe vitamin D3 supplements. Have you had your level checked yet? If you are indoors most of the time or use sunscreen when you go outside, or live in the north you may be at risk for vitamin D deficiency. Low levels have been linked to cancer, diabetes, heart disease and kidney disease. You have a 26 percent greater risk of dying if you are deficient in vitamin D.
There are several sources of vitamin D. Read more…

When you were first diagnosed with chronic kidney disease one of your first questions may have been ‘What can I do to save my kidneys so I don’t need dialysis?’ Blood pressure control, managing glucose for diabetics and adjustment in dietary protein intake can make a difference in kidney disease progression according to the research.

High Protein Foods

If you eat lots of protein and have CKD, you may want to make a few changes because a high protein diet is hard on your kidneys. On the other hand, a diet too low in protein is even worse for you. When you don’t eat enough protein, your muscles begin to break down. A blood protein called albumin begins to fall. People starting dialysis with low albumin levels are more likely to be hospitalized or die within the first 3 months compared to those with normal levels (4.0 mg/dL or greater). Following a low protein diet may buy some time before Read more…

Last week I wrote about making a PLAN for stretching your food dollars when following a kidney friendly diet. I hope you tried some of those suggestions. This week I want to zero-in on produce to help you find ways to save on your fruit and veggie budget. Read more…

Most of us are trying to find ways to save money and stretch our food dollars these days. With chronic kidney disease or dialysis there’s the added challenge of staying within your diet goals for protein, sodium, potassium and phosphorus. I’ve often heard patients complain about how expensive it it to follow their special renal diet.

Over the next few weeks I’ll focus on some ways to stretch your food dollars. The best advice I can give you starting off is to PLAN as much as possible. Read more…

No doubt you don’t need me to tell you that fast foods are bad for your health. Remember the 2004 movie—Super Size Me ? Proof that too much fat and sodium from fast food kills!  People with kidney disease have another reason to avoid the corner drive-thru though. Fast foods contain extra hidden phosphorus from all the phosphate additives used to process the food.

Research on phosphorus levels in dialysis patients shows there’s a danger with even slight increases above normal. A single milligram increase in phosphorus increases risk of being hospitalized or even dying by 20% or more. Even in CKD-nondialysis patients high-normal phosphorus causes Read more…