Acute kidney injury, proteinuria, and blood sugar compromise renal function in diabetes patients: Study

Acute kidney injury, proteinuria, and blood sugar increase the risk of poor renal function in diabetes patients. The researchers looked at 3,679 type 2 diabetics from a de-identified cohort of patients.

Patients were classified into groups based on the following risk factors: acute kidney injury (AKI), proteinuria (protein in the urine), and unmanaged blood sugar. Diabetics without any of these risk factors were compared to diabetics with all three factors as well as those who only had one or two.

Researcher Charuhas Thakar expained, “There are established risk factors in the diabetes literature. One of them is the level of sugar control. If you don’t control your sugar well, your kidney disease progresses faster, or if you leak protein in the urine and you have proteinuria, it tends to be an independent predictor of kidney disease in diabetics.”

An average 50-year-old diabetic with no risk factors has a 60 percent kidney function and loses about 1.9 to two percent of kidney function annually. This means that kidney failure would occur within 25 to 30 years. If a diabetic patient has all three factors, renal function declines at the annual rate of nearly five percent, meaning, they would need dialysis 12 years earlier.

Thakar continued, “This is a big impact for a patient. You are talking about pruning 18 to 20 years off of when you will have to go on dialysis. It’s very important information for a patient and clinician to know. The study is among the first to examine the interrelationship between these traditional risk factors for its effect on kidney disease progression.”

“We have the same tools in our arsenal to help these patients in terms of their progression of kidney disease; so our research raises questions and challenges the field of physicians. We should find ways to monitor these three groups of patients differently and target our therapies. Future studies need to evaluate how we are going to change the trajectory of loss of renal function in these patients who may suffer a faster decline by either modifying existing treatment or discovering new therapies,” Thakar concluded.

Diet tips for diabetic people with kidney disease

Some people with kidney disease have trouble eating carbohydrates and may need substitutes. When a healthcare practitioner recommends going on a low-protein diet, you will need to replace the calories from protein with fruits, bread, grains, and vegetables. There are even cases where you can consume high-calorie desserts as long as you limit items that are made with dairy, chocolate, nuts, or bananas.

Let’s look at some important recommendations, including chronic kidney disease diet restrictions:

Fats – Use monounsaturated and polyunsaturated fats such as olive oil, canola oil, and safflower oil.

Protein – Just prior to starting dialysis, a low-protein diet may be helpful. Once you’ve started dialysis, you will likely need to eat more protein to replace muscle and tissue that you lose. About eight to 10 ounces of high protein foods per day is recommended.

Calcium and phosphorus – Limiting some dairy foods may be suggested, since they can contain large amounts of phosphorus. Colas and soft drinks also have a lot of phosphorus. Calcium supplements may be a good idea to help prevent bone problems.

Sodium – Do not add salt to any food. Read food labels to find hidden salt and avoid those foods that contain a lot of salt, sodium, or MSG. Be careful with salt substitutes, as many have high amounts of potassium.

Potassium – It is best to choose low potassium fruits such as apples, pears, plums, and blueberries. Vegetables, such as bean sprouts, cabbage, green beans, and lettuce are also low in potassium.

Fluids – As kidney disease gets worse, you may have to limit fluid intake, so keep track of how much you drink and find ways to reduce fluids if you need to. Remember soups, gelatin desserts, and ice cream are all considered fluids.
Common sense should rule when eating. For example, you shouldn’t skip meals. If there are times when you just don’t feel hungry, at least try to eat four or five small meals instead of one or two big ones. There may be some people with kidney problems that have difficulty keeping their weight up. These individuals need to talk to their doctors and dieticians about the best ways to add calories to their diet. Anyone with chronic kidney disease should also talk to a physician before drinking any alcohol.

Several studies have linked “super foods” to preventing and protecting against chronic diseases. Foods that contain antioxidants seem to neutralize free radicals and protect against oxidation, which is a process of energy production and chemical reactions that can lead to free radicals. It is believed that free radicals damage proteins and cell membranes.
Based on the oxidation theory, kidney-friendly foods are the same foods that can reduce inflammation and lower the risk of cardiovascular disease.

Here are some examples of foods that you might find on a chronic kidney disease diet menu:

• Red bell peppers – Low in potassium and full of vitamins C, A, B6, as well as folic acid and fiber.
• Cauliflower – High in vitamin C, a source of folate, a source of fiber, and full of compounds that could neutralize toxic substances in the body.
• Cabbage – Full of a compound that can break up free radicals.
• Garlic – Reduces inflammation and can lower cholesterol.
• Apples – High in fiber and anti-inflammatory compounds.
• Cranberries – Promote gastrointestinal health.
• Blueberries – High in antioxidants and manganese, which promotes bone health.
• Cherries – Contain anti-inflammatory compounds.
• Egg whites – Pure protein with all the essential amino acids. For the chronic kidney disease diet, egg whites provide protein with less phosphorus.
• Fish – Provides high-quality protein and contains anti-inflammatory fats called omega-3s.