Diabetes is a risk factor for kidney disease. In fact, over 50% of patients on dialysis have diabetes.  So if you have diabetes find out what can you do to prevent or delay kidney disease.

Results from a 4-1/2 year study of almost 1300 Chinese people with type 2 diabetes points to the American Diabetes Association targets to answer this question. (Archives of Internal Medicine, 2010:170:155-161). The study researchers reported that meeting the ADA target goals for hemoglobin A1C (HbA1C), blood pressure, cholesterol and triglycerides make a difference in keeping kidneys healthy. In fact, focusing on these targets can reduce risk of diabetic nephropathy by up to 35%.

American Diabetes Association Targets

• HbA1C less than 7%*
• Pre-meal glucose 90 to 130 mg/dL
• After meal glucose no higher than 180 mg/dL
• LDL cholesterol less than 100 mg/dL
• HDL cholesterol above 50 mg/dL for women and 40 mg/dL for men*
• Triglycerides less than 150 mg/dL
• Systolic blood pressure below 130 mm Hg* Read more…

A high salt intake is even more damaging to your health than eating too many calories, too much cholesterol or even smoking. That’s because eating too much sodium can cause high blood pressure and can interfere with the effectiveness of your blood pressure medications. Uncontrolled blood pressure is the leading cause of strokes and heart attacks. For kidney patients on dialysis, salt not only increases blood pressure, it contributes to thirst and makes removal of fluid from your body more difficult. Read more…

Thursday March 11 is World Kidney Day, a time to bring attention to kidney disease awareness, treatment and prevention. I will be participating in Building Bridges to Optimum Health World Kidney Day Los Angeles, a conference at the Holman United Methodist Church—please stop by if you happen to be in the LA area.
For those of you who cannot attend, here are a few highlights from my talk on Nutrition and Kidney Disease.
Kidney disease continues to rise with a strong link to epidemic rates of obesity, diabetes and high blood pressure. Early nutrition intervention can make a difference in preventing and treating these diseases that increase risk for kidney failure.

• If you are at risk for kidney disease but do not have it yet, follow a DASH diet (Dietary Approaches to Stop Hypertension) to help lower your blood pressure and eat healthier. For more information on DASH diet: www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
• If you already have early kidney disease (stage 1-3) focus on controlling blood pressure and diabetes. A low sodium diet, carbohydrate counting, glucose monitoring and daily exercise are recommended. Reduce protein to the Dietary Reference Intake (DRI) 0.8 grams/kg body weight/day and limit high phosphorus foods and phosphate additives to help preserve kidney function. Most Americans eat much more protein in their daily diets. Work with your doctor and dietitian to be sure you eat enough high quality protein to prevent malnutrition.
•  If you are in stage 4-5 CKD, not on dialysis, you may need to restrict potassium, phosphorus and fluids in addition to sodium. A reduction in protein to help decrease waste build-up in the blood may be prescribed, but maintaining adequate calorie and protein intake to prevent malnutrition is even more important.
• After starting dialysis there is no need to restrict protein—in fact extra protein is needed to replace losses in the dialysis treatment. Low sodium and low phosphorus are still required. Potassium and fluid restriction depend on the type and frequency of dialysis selected.
• In addition to the above, focus on consuming healthy fats (omega 3’s from fish, monounsaturated fats from olive and canola oil), high quality, low phosphorus proteins (egg white, fish, lean meats).
• Eat the rainbow–for good health include colorful fruits and vegetables high in anti-oxidants with anti-inflammatory properties as well as fiber, vitamin C and vitamin E.
• For successful dietary changes focus on education, family support, variety in meals and commitment to making changes to improve your health.
  Takeaways
• What you eat matters in your health-disease  for chronic disease prevention and treatment
• Diet goals change with stages of chronic kidney disease (CKD) and dialysis
• Start making changes now; it will make a difference tomorrow.

Learn more about kidney disease at www.kidneyawarenesstime.org, www.davita.com, www.yourkidneys.com, and www.kidneytrust.org.

I’ve never been to Michigan…until this week. Back in the spring I dusted off my bicycle and started doing weekly rides in preparation for Tour DaVita, a bike ride fund raising event sponsored by The Kidney Trust. Proceeds from the ride fund raising are spent on kidney disease screening and programs to help increase awareness of kidney disease risk factors. Read more…