Renal Failure

Renal failure refers to the failure of the kidney’s nephrons to maintain normal functions. With all the vital functions to perform, renal failure results in serious consequences. Renal failure can occur suddenly (acute) or over a period of time (chronic). Oftentimes acute renal failure is only temporary while chronic renal failure is irreversible.

Probable Causes

• Damage to kidneys as in:

1. Nephritis
2. Renal artery obstruction
3. Nephritic syndrome
4. Kidney stones
5. Renal tubular disorders 

• Diabetes 

• Hypertension

• Atherosclerosis

Probable Symptoms

• Reduced or no renal output

• Increased blood urea nitrogen, creatinine and uric acid

• Uremic syndrome in severe stage which include:

1. Fatigue
2. Weakness
3. Decreased mental alertness
4. Muscular twitches
5. Muscle cramps
6. Anorexia  (See Underweight)
7. Nausea
8. Vomiting
9. Stomatitis
10. Unpleasant taste in the mouth
11. Itchiness of skin (See Infection)
12. Gastrointestinal ulcers
13. Bleeding

• Common in later stages where virtually every system in the body is adversely affected.

Note: As renal failure progresses to a severe stage, the buildup of toxic waste products in the blood (uremia) results in a complex of symptoms called the uremic syndrome.

Helpful Dietary Management

• Eat a diet low in salt.

• A low protein diet may be given depending on the loss of kidney function during the acute renal failure. Protein is a major source of metabolic waste products.

• Restrict amount of water intake to the amount of water loss.

• Take calories from carbohydrates and fats. Include an abundance of fruits.

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.53-54 © 2003 Philippine Publishing House ISBN 971-581-013-6

Kidney Stone Formation

About 60% of all kidney stones contain calcium oxalate, 9 % contain calcium phosphate, while about 11% contain a combination of both. Less common stones are composed of uric acid, cystine, or magnesium ammonium phosphate.

A stone that blocks the flow of urine or causes infection must be removed either surgically or by sound or shock waves to break up the stone into pieces that can be easily eliminated from the body.

The person who has had a kidney stone may experience recurrence, but, reports suggest that with proper treatment, a recurrence may be prevented. To date, much of the information is controversial, and research continues.

Probable Causes

• Bowel diseases (causing malabsorption)

• Cystinuria

• Glucocoriticoid excess

• Gout

• Hyperparathyroidism

• Hyperthyroidism

• Immobilization

• Osteoporosis

• Paget’s disease

• Recurrent urinary tract infections

• Renal tubular acidosis

• Vitamin D intoxication (overdose)

• Some types of cancers

Note: Depending on their composition, stones may form from a variety of medical conditions that bring about either elevated blood levels of the stone-component substances (e.g., serum calcium), excessive urinary excretion of the component substances, or deficiencies of factors in the urine that normally control stone formation.

Probable Symptoms

• Mild Pain. This occurs when small pieces of the stone break off and travel down with the urine through the ureters. The pain usually starts in the back, just below the ribs, and follows the path of the stone. Once the stone reaches the bladder, pain normally subsides.

• Severe, stabbing pain. This results if a large stone enters a ureter.

Helpful Dietary Management

• Eat a diet low in sodium and low-to–moderate in protein plus high fluid intake.

• Drink enough water—about 8 ½ glasses (eight-ounce glass)—spread within the day at regular intervals to maintain a urine volume of 2 liters per day. Maintaining a large urine volume ensures that mineral concentrations in the urine will be diluted, therefore reducing the risk of stone formation. (See The Importance of Water)

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.52 © 2003 Philippine Publishing House ISBN 971-581-013-6

Glomerulonephritis

Glomerulonephritis refers to an inflammation of the glomerular capillaries of the kidneys. This condition occurs also in children.

Probable Cause

• Streptococcal infection (with an incubation period of 1 to 2 weeks, often resulting in tonsillitis or scarlet fever)

Probable Symptoms

• Decreased urine output

• Cloudy urine which contains blood, albumin (a plasma protein) and casts

• Edema

• Hypertension

• Anemia

• Nausea

• Vomiting

Helpful Dietary Management

• Eat low-protein, low-salt diet during acute stage when almost all of the symptoms are present.

• Eat a high-quality protein. Restrict the amount, though.

• Restrict water intake if edema is present.

• Supply calories in fruit juice and puree form to minimize body tissue breakdown leading to excessive weight loss.

• Give regular diet (balanced diet) as soon as edema has subsided, blood pressure has lowered, and urine output has increased.

Note: If nausea and vomiting are present, a sufficient diet is difficult to provide.

Helpful Tips for Minimizing Nausea and Vomiting

• Eat small meals.

• Avoid high-fat foods.

• Sip clear liquids or suck popsicles to prevent dehydration. (See clear liquid diet)

• Lie down after eating.

• Loosen clothing after eating.

• Get fresh air.

• Avoid smells that cause nausea.

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.50 & 246 © 2003 Philippine Publishing House ISBN 971-581-013-6