Being Good to your Kidneys
A little help for some unsung heroes Bruce Thomas, MD
Amidst the chaos of the pandemic, we may not pay attention to parts of our bodies that might be hurting, but just don’t seem to be screaming as loud for attention. Many holistic doctors feel that a great part of taking care of yourself is taking out the bad things and putting in the good.
The kidneys are part of taking out the bad. But, for many of us they might be hurting.
Some may think of kidney trouble as a scenario of a grandmother having to go to dialysis. That’s awful, but hard to miss. What about the preceding chronic kidney disease (CKD) that threatened to lead to that though?
The CDC1tells us that:
- 15% of US adults-37 million people-are estimated to have CKD.
- Amongst those over 65 years old, 38% have CKD.
- Most (9 in 10) adults with CKD do not know they have it.
Given that there’s no way to tell if you have it without being tested, it’s a good idea to see your doctor and if you have it, you’ll likely get good advice.
Some of the advice may be:
- Keep your blood pressure down.
- Eat healthy to avoid diabetes or manage it well if you do and
- Don’t take chronic non-steroid anti-inflammatory meds (NSAIDs) like Ibuprofen and Aleve as they can make the kidneys worse.
However, the advice usually stops there. Is there anything else to be done?
Depending on the severity of the Chronic Kidney Disease, your doctor might enlist the help of a kidney doctor to look deeper into things besides blood pressure and diabetes that could be causing the problem, like genetic conditions, mechanical problems, post infectious issues, or rheumatologic concerns.
If nothing seems obvious, your holistic doctor might look at other things that could be bothering your kidneys.
Heavy metals like Mercury2, 3Cadmium4 and Lead5 are all known to hinder your kidney function. Interestingly, there is some evidence that especially in the presence of these heavy metals, Glyphosate, the main ingredient in Roundup ®, may also be present. In Sri Lanka, where there is an epidemic of kidney disease, researchers have found that people who drank water from wells where Glyphosate and heavy metal concentrations are higher, had a fivefold increased risk of CKD6
In another article, these authors proposed that combinations of metals and Glyphosate contribute to the most debilitating disease of agriculture work there, Sri Lankan Agriculture nephropathy7
“Nature”, one of the most esteemed scientific journals in the world, reports animal studies showing Glyphosate to be bad for the kidneys and liver8 – one more reason to eat organic.
There are actually quite a lot of medicines that are toxic to the kidneys, with NSAIDS being the most famous. The other ones are worthy of a review with your doctor if you have kidney disease, but they are comparably not very common medicines. Recently, however, a very common group of medicines has been observationally strongly linked to kidney disease: Proton Pump Inhibitors, PPI’S, (Prilosec, Nexium, Aciphex, and Protonix, etc.). Researchers call this an “extremely strong association.”9 This invites the lifestyle changes and possibly the help from a holistic doctor, as PPI’s can be so hard to get off.
There are quite a lot of other associations linked to chronic kidney disease that you can review with your doctor, but instead of going over them here, I’d like to just give you a few pearls that I like that may help.
Garlic10 and its cousin, aged Garlic Extract,11 have been shown to be helpful. I may recommend 1200 mg twice a day for Aged Garlic.
A European study found that older adults with low omega 3 levels have a great decline over a three-year follow than those with good levels, suggesting that fish oil could help. 12
If someone tends to run high in blood sugar, anything that can block glycation, which is the attachment of a sugar molecules to another molecule, may help. One thing that is good at this is Benfotiamine13, a fat-soluble form of Vitamin B1.
Another favorite is N Acetyl Cysteine (NAC). This has long been known to help with the damage the IV contrast causes to kidneys, but has also been shown to be protective of kidney function generally14. I may recommend 600 mg twice a day.
Regretfully, CKD is increasing in our population. Nevertheless, there is actually a mountain of research about what makes sense and what could help, far more that I can include in this blog post. The standard advice has real value, but I think the people who have this, who in most cases don’t even know who they are, will benefit from an even deeper dive.
Before starting any of the above recommendations, I would recommend a discussion with your functional medicine provider. Thank you and please let us know if you have any questions!
Bruce Thomas, MD
1. https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html Accessed 10/30/20
2. Paolo Lentini P, Luca Zanol, L et al, Kidney and heavy metals – The role of environmental exposure (Review) Molecular Medicine Reports published online Pages: 3413-3419 https://doi.org/10.3892/mmr.2017.6389
3. Zalups RK: Molecular interactions with mercury in the kidney. Pharmacol Rev. 52:113–143. 2000
3. Navas-Acien A1, Tellez-Plaza M, Guallar E, Muntner P, Silbergeld E, Jaar B, Weaver V Blood cadmium and lead and chronic kidney disease in US adults: a joint analysis. Am J Epidemiol. 2009 Nov 1;170(9): 1156-64. doi: 10.1093/aje/kwp248. Epub 2009 Aug 21.
4. Jaar BG, Weaver WM Lead-related Nephrotoxicity: A review of the epidemiologic evidence EB Ekong, Kidney International (2006) 70, 2074–2084
5. Jayasumana, CParanagama, P, et al Drinking well water and occupational exposure to Herbicides is associated with chronic kidney disease, in Padavi-Sripura, Sri Lanka Environmental Health 2015, 14:6:1-10
6. Jayasumana, C., Gunatilake, S. & Siribaddana, S. Simultaneous exposure to multiple heavy metals and glyphosate may contribute to Sri Lankan agricultural nephropathy. BMC Nephrol 16, 103 (2015). https://doi.org/10.1186/s12882-015-0109-2
7. https://www.nature.com/articles/srep39328 Accessed 10/20/20
8. Moledina D, Perazella, M JASN October 2016, 27 (10) 2926-2928
9. Miguel E, García A et al The Beneficial Effects of Allicin in Chronic Kidney Disease Are Comparable to Losartan Int J Mol Sci. 2017 Sep; 18(9): 1980.
11. Maldonado PD, Barrera D, et al Aged garlic extract attenuates gentamicin induced renal damage and oxidative stress in rats. Life Sci. 2003 Oct 3;73(20):2543-56.
12. Lauretani, F, Maggio, M et al Omega-3 and Renal Function in Older Adults Curr Pharm Des. 2009; 15(36): 4149–4156.
13. Beltramo E, Berrone E, Tarallo S, Porta M. Effects of thiamine and benfotiamine on intracellular glucose metabolism and relevance in the prevention of diabetic complications. ActaDiabetol. 2008 Sep;45(3):131-41.
14. Shimizu MH1, Coimbra TM, de Araujo M, Menezes LF, Seguro AC. N-acetylcysteine attenuates the progression of chronic renal failure Kidney Int. 2005 Nov;68(5):2208-17.