An Italian research team has created a nutritional treatment that is low in protein, salt, and phosphorus. This nutritional therapy is capable of halting the progression of renal impairment and postponing dialysis or transplantation for as long as feasible.
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| [What to eat for kidney health] |
Chronic kidney disease refers to a condition in which a person's kidneys gradually lose their capacity to filter and cleanse the blood. This condition is characterized by a gradual decline in kidney function (CKD). In Italy, over 4.5 million individuals are afflicted with this condition, and almost half of those people have renal failure, which refers to a disease that is either in the middle or severe stage (stage 3b-4-5). The population as a whole is becoming older, and with that comes a rise in the prevalence of various chronic illnesses including diabetes, hypertension, obesity, and cardiovascular diseases. As a result, the incidence of this condition is continually going up. There is currently no known treatment that can reverse the effects of chronic kidney disease (CKD), but an early diagnosis and the administration of appropriate medication can help prevent or delay the onset of acute or chronic renal failure conditions as well as the cardiovascular complications that are frequently associated with CKD. Diet plays an essential part in delaying the onset of the illness and putting off the need of beginning dialysis treatment. As such, it is considered the first line of defense against the condition. In order to keep or achieve an ideal weight on the one hand and on the other hand to reduce the sodium (salt) intake, to control blood pressure, and / or other substances (minerals), without creating malnutrition or nutritional deficiencies, this needs to be prescribed by an expert nutritionist or a nephrologist.
In this regard, a recent Italian study, led by Vincenzo Bellizzi, a nephrologist at the San Giovanni di Dio and Ruggi d'Aragona Hospital in Salerno and vice president of Ern (European Renal Nutrition Working Group of Era, the European Renal Association), analyzed the impact of a low-protein nutritional treatment, which was studied ad hoc for patients with a medium or advanced CKD, in terms of expense and survival. Patients According to the findings of the study that was presented at the 2022 Wide Angle Nephrology Dialysis and Transplant Congress, this nutritional treatment has the potential to slow the progression of the illness and postpone the need for dialysis or transplantation for as long as feasible.
The functions of the kidneys
In addition to ridding the body of unnecessary and potentially harmful substances (through urination) and controlling the amount of water and salts that are present in the body, the kidneys also play a role in the regulation of blood pressure, the formation of blood (hematopoiesis), and the metabolism of bone. These are all very important functions. When they do not function as they should, waste chemicals have a tendency to build up in the blood, which may lead to a condition of intoxication and imbalance, which in turn can lead to other significant health issues. Last but not least, the loss of total renal function results in the need for either dialysis therapy (currently, over 2.0 billion euros are spent on dialysis each year in Italy, which accounts for approximately 2 percent of the national health budget) or a kidney transplant.
The researchers monitored a group of patients for a period of 5 years who were given a prescription for a low-protein diet (characterized by a reduced protein intake: approximately 0.6 grams per kilo of weight or less). They compared this group to a control group of over 120 men and women who had the same characteristics but were not given a prescription for any diet. The research aimed to achieve the following three goals: 1) to evaluate the initiation of dialysis of patients, 2) to estimate the survival of patients, and 3) to calculate the costs of dialysis (ranging from 400 to over 4,000 euros per month), including costs for assistance, therapies supported by the National Health System, and in general the social costs that weigh on the patient. Dialysis costs can range anywhere from 400 to over 4,000 euros per month.
Nutritional therapy postponed the initiation of dialysis by 20 months
According to the findings of the study, following a low-protein diet, which is more accurately referred to as "nutritional therapy," made it possible to delay the beginning of dialysis treatment by 20 months, increased the amount of time a patient survived by 20 months, and allowed for savings of 8,400 euros per patient per year (- 25 percent ). Therefore, consuming meals low in protein and seeking the advice of dietitians who specialize in renal nutrition were both beneficial. "The use of this particular nutritional treatment, which was evaluated in our research, has resulted in significant improvements in both the length and quality of life for those who are ill, in addition to cost reductions for the healthcare system," Dr. Bellizzi said. We computed, and the attending physician elaborated, that if only 20 percent of new patients who join dialysis every year in Italy adopted a low-protein diet, the National Health Service would save over 60 million euros annually.
The diet that safeguards kidney health
Patients who have renal insufficiency, particularly when it has progressed to a more severe stage, should first and foremost adhere to a diet that is low in protein, salt, and phosphorus. On the other hand, proper diet is one of the most important factors in warding off renal impairment. Let's have a look at the fundamental tenets upon which the diet that protects renal health is founded:
1. At least five servings of fresh fruit and/or vegetables should be consumed on a daily basis, with an emphasis on seasonal produce. This results in a lower consumption of preservatives such as phosphorus, which is toxic to the kidneys and should be avoided;
2. Reduce your intake of proteins derived from animals. When they are ingested in excessive amounts and for extended periods of time, they have the potential to change the blood flow in the renal glomeruli, which are the balls of arterial capillaries that filter the blood, and ultimately cause damage to the glomeruli over time. "Bellizzi emphasizes that if you consume more than 150 grams of protein per day, you will see a gradual decline in your renal function. Not just for the sake of the kidneys' health but also for the health of the body as a whole, the ideal amount of protein to consume is between 0.8 and 1.2 grams per body kg. According to these calculations, a person who weighs 75 kilograms should take between 60 and 90 grams of protein, which may come from either animal or vegetable sources, each day ";
3. Raise the proportion of your diet that consists of vegetable proteins. Vegetable proteins, in contrast to animal proteins, have a lower phosphorus content, and the phosphorus that is present in vegetable proteins is also less absorbable by the colon." So, to summarize what Bellizzi said, yes to fresh fruit and vegetables and all proteins, as is then required by the Mediterranean diet; however, increasing the share of those of vegetable origin, which are present above all in legumes, such as lentils, beans, peas, chickpeas, and soy; and no to processed foods ";
4. Consume liquids in accordance with the level of thirst you experience; in other words, do not restrict or delay the amount of water you drink. In the event of Chronic Kidney Disease, fluids that have low mineral residues and, in certain instances, waters with low salt levels should be selected as a general rule. "However, if a person has significant renal insufficiency, as Bellizzi pointed out, they would progressively lose the capacity to evacuate water from their body. Therefore, in these situations, the physician could recommend cutting down on how much water you drink, but it is important to keep in mind that we are discussing a highly advanced stage of renal disease ".