How can I slow down my kidney failure?

When renal failure reaches an advanced stage, periodic monitoring is carried out in a specific consultation for it (ACKD), in which more frequent revisions are made and all the complications of renal failure are closely controlled and treated (anemia, phosphorus, and high potassium, low bicarbonate, etc.) and all the factors that can worsen and accelerate the evolution to more advanced stages: medications and toxins, high blood pressure, obesity, and diet.

Overall, we must say that the patient with chronic renal failure should have healthy lifestyle habits and place special emphasis on the following factors:

Medications and toxics:

When there is renal failure, most medications need to reduce the usual dose to avoid side effects. But some of them can worsen kidney function and it is necessary to avoid them. This is the case of anti-inflammatories, which are so frequently used to treat pain; It is better to use non-anti-inflammatory analgesics (paracetamol, metamizole, tramadol) and some antibiotics.

It is advisable to avoid scans with iodinated contrasts, but if necessary, it is recommended to apply measures to reduce their toxicity.

Arterial Hypertension:

In these advanced phases of kidney disease, poorly controlled BP is probably the factor that will most influence the faster loss of kidney function. It is recommended figures around 130-135 / 80-85 mmHg; in elderly people, it may be adequate 140-150 / 85 mmHg. This is achieved through a diet without salt, which at this time is also necessary so that edemas do not appear, thinning if there is overweight or obesity, and with medication for its tension.

Obesity:

There are people in whom the cause of their kidney failure is obesity itself and also obesity can prevent adequate control of blood pressure and promote the appearance of the so-called metabolic syndrome or diabetes.

Arterial Hypertension:

In these advanced phases of kidney disease, poorly controlled BP is probably the factor that will most influence the faster loss of kidney function. It is recommended figures around 130-135 / 80-85 mmHg; in elderly people, it may be adequate 140-150 / 85 mmHg. This is achieved through a diet without salt, which at this time is also necessary so that edemas do not appear, thinning if there is overweight or obesity, and with medication for its tension.

The proteins of the diet:

We must make changes in the diet from the initial stages. At the beginning are less strict changes limited to moderately decreasing salt, avoid foods that contain a lot of phosphorus (cheeses, nuts) and slightly decrease the total amount of meat or fish eaten per day. Later, in more advanced phases (function below 30%), it will be more strict.

General aspects of the diet of Renal Insufficiency before dialysis:

• The diet should always be without salt to avoid fluid retention and poor control of tension.
• Basically, the diet consists in decreasing the total amount of animal proteins that are eaten daily at 0.6 gr / Kg / d, which is 40-60 g of protein per day (once the fat and other components of the food have been deducted) ) according to the weight of each individual.
• When eating less protein, you also eat less phosphorus which is what you are looking for, but you also have to limit the milk to two a day (1 glass of milk and/or yogurt) and avoid the cheese (it must be exceptional and all case fresh cheese in small quantity). In addition, you should avoid other products with high phosphorus content such as soft drinks, chocolate, and whole drinks. If with the restriction of the diet it is not possible to control the levels of phosphorus in the adequate limits (lower than 4.5 mg/dl), it will be necessary to associate chelating medicines to diminish their absorption in the intestine and for that reason, they should always be taken with the food.
• The potassium tends to be high and to control it we have to eat fewer foods rich in potassium such as fruit and vegetables. It is recommended not to take more than 2 pieces of fruit per day, preferably pear or apple; Fruits like banana or grape are not recommended because of their high potassium content. The rest of the fruits occasionally and replacing one of the 2 recommended. You can also take fruit in syrup, discarding the broth of the preserve. In case, despite all measures, potassium levels are above 5.5 meq / l, the chelating medication should be associated to reduce intestinal absorption and should be taken with meals.
• When eating less protein, you may also eat fewer calories. Eating fewer calories can make you lose weight and the proteins you eat can be used as calories, which could lead to malnutrition. You must ensure a minimum of 30 Kilo-calories per Kilo of ideal weight (the healthy one for your size). You should compensate the calories you do not eat with proteins, with foods of higher caloric power (olive oil, sugar, bread, garnish with rice, pasta, mayonnaise sauce, jelly, jam, hard candy, honey, and syrup, etc.). If it is diabetic, the caloric supplement should be based on starches and vegetable fats and not sugars.