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Holistic approach to Chronic Kidney Disease (CKD) - My Recent Seminar

CKD patients comprise a big part of my practice. They have other co-morbidities like Diabetes or Hypertension or heart disease which have led them to kidney failure in most cases. Conventional diet instructions involve restricting protein, potassium, phosphorus, Sodium and fluids to reduce the load on the kidneys. Whereas these may help for some time, there are other factors at play. Lifestyle, including stress management, sleep patterns, physical activity, digestive and elimination health and age play a major role in aggravating the underlying conditions. My approach to counseling addresses all these issues.

There is no one size fits all plan and integrating some Ayurvedic (sister science to Yoga) principles in my practice has yielded great results. I have seen their Glomerular filteration rates (GFR a marker of kidney function) improving when they follow suggestions given. This helps slowing down the progress of kidney disease so they don't end up on dialysis very soon.

Ayurveda is an intuitive and mindful way of making food choices, using food as medicine and lifestyle choices that enhance quality of life. So its not about just improving numbers but also the well being of the patient.

Recently I did a seminar for Nurse Practitioners who work with kidney patients pre-dialysis outlining the value of Medical Nutrition Therapy or MNT which is diet counseling done by Registered Dietitian Nutritionists. One of the nurses in that group pointed out that a patient who I had counseled came back looking so upbeat although they had already put in a fistula in preparation for dialysis. Clinically she was looking great so they didn't feel the need to start her on that direction yet.

There are several advantages to early intervention as outlined in the slide above. Many times doctors do not think of referring patients because their time is so limited with the patient and the paper work they have do with our current health care system and insurance demands is so extensive that the thought of diet and lifestyle doesn't even enter their minds. So it is important that patients take charge of their health and ask for help with diet counseling to help them maneuver a complex renal diet.

Recently studies on CKD patients have shown that reducing the percentage of animal products consumed, by even 30% in their diet can go a long way in decreasing the mortality rates of CKD patients. The typical American diet of the elderly population who are the major candidates with kidney disease have no clue as to how to make proper choices for a plant based diet, even partially. The following slide outlines some of the benefits of Vegetarian diets. As you can see from the figure below that taken from a study in pubmed, animal products increase the acid load versus the plant based foods do the opposite. This is just the tip of the iceberg when it comes to kidney disease and a healthy diet and lifestyle can go a long way in controlling the progression of kidney disease.

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