…Chronic Kidney Disease (CKD) that is! That’s the ad we really need broadcast on prime time tv. On par with osteoporosis and other conditions that ‘seemingly appear out of nowhere’ in people’s 60s and beyond, there’s a potent combination of ignorance (patients) and denial (health professionals) at play it seems, when it comes to discussing the earliest signs of CKD that typically start decades before you’ll ever get a ‘diagnosis’. Being specialists in preventative health care – this is something we need to have firmly on our radar in terms of early identification and also in our repertoire when it comes to risk reduction. Most of us know about water intake and all the medical risks for renal impairment but are we equally onto the critical role that mild acidosis plays in driving this condition?
It’s not just me. Promise.
A lot of this was the stuff we already know – excesses of salt, animal protein, phosphates and energy in general all spell trouble when it comes to diet’s deleterious kidney effects – but this article also goes into great detail about the specific renal insult of chronic mild acidosis.
“This reduction in extracellular pH may affect the risk for kidney injury and kidney disease progression via multiple pathways. First, reduced extracellular pH alters NADPH oxidation, which then inhibits the induction of nitric oxide production in mesangial cells. Decreased nitric oxide production may accelerate interstitial sclerosis. Second, acidosis directly stimulates endothelial cell secretion of endothelin, which enhances the activity of the sodium-hydrogen exchanger 3 activity to increase luminal hydrogen ion secretion and decreases bicarbonate section. Endothelins are powerful vasoconstrictors that may promote renal fibrosis, disassembly of podocytes, and podocyte apopotosis. Third, acidosis stimulates angiotensin II production because augmentation of ammonia secretion is accomplished via heightened renin-angiotensin system activity.”
Kramer 2017 Am J Kidney Dis. 2017 Jul;70(1):111-121.
If acid base rebalancing is something you’re interested in, I’m coming to a capital city near you to talk about this in relation to women’s health in October, at the Well Woman Symposium. I’ll be talking about the impact of mild acidosis on myriad women’s health conditions from thyroid to stress & renal to ‘fat skinny’ body types. Think you’ve heard this before…you haven’t. This time I’ll be focusing on solutions and inline with this, the exciting new evidence that goes beyond identifying mild acidosis as a significant problem and introduces the hard data on alkalising being a key part of the solution. To boot, I have extra juicy clinical examples to share with you of acid base rebalancing in action.
For now we all need to work towards, not more soft flowing thick curls, but for a set of kidneys that can last the distance!
Got patients with early signs of renal impairment and a GFR not >90? Want to learn more about what you can and should offer these clients in terms of prevention & management? Check out this podcast Nutritional Interventions in Renal Impairment – place & potency for an update in this area and discover the surprising power of nutritional interventions in slowling the progression of these conditions.