kidney disease and disability

Illustration by Mark Weber

I was born with spina bifida — basically an in utero spinal cord injury — in the early ’70s. Like many others with mobility limitations, I have had to deal with what I call the “side dishes of disability.” In those days, we found ourselves in many learn-as-we-go situations. One of the recurring side dishes that popped up consistently for me was renal health. At one point in my childhood, it seemed I had a different type of UTI on a monthly basis.

Back then, everyone was preoccupied with creating a germ-free environment, so my doctors prescribed a different antibiotic each round. Eventually they decided that my system was being compromised by the constant rotation of antibiotics. Since I would always carry low-grade bacteria by nature at all times, unless it “bloomed,” the best thing for my body was to allow it to create its own antibodies.

Time passed. Then, in the spring of 2012, I tangled with acute renal failure after being prescribed the wrong blood pressure medication. The error shut down my entire system. I was born with only one kidney, so the risks were exponentially higher. It was an extremely frightening experience.

With a new diagnosis — chronic kidney disease — and the fact that I am constantly seated, I knew I would now be facing serious, ongoing renal issues. I decided in that moment that the outcomes predicted for me weren’t acceptable, and if there were anything I could do to improve my circumstances or regain my health, I would do it.

I immersed myself in research, statistics, methodologies, case studies, and the world of medical diet restrictions concerning CKD. I turned to those wiser and more experienced than myself and found the most often-repeated directive specific to kidney health, reduction of UTIs and avoidance/delay of dialysis was renal-friendly dieting. What I’ve learned over seven years through researching and practicing renal-friendly dieting has been my saving grace. This is what I want to share with you. To date, I have avoided kidney dialysis and stayed off the path to a transplant list.

A Kidney-Friendly Diet

Our kidneys, those two bean-shaped vital organs no larger than your fist, filter approximately 200 quarts of blood each day — almost enough to fill a bathtub. This all-natural filtration system removes waste and toxins from your blood, creates urine and sends the purified blood throughout the entire body. However, if you are a wheelchair user, being seated most of the day and unable to
walk is not the greatest gift to your urinary tract.

According to the National Kidney Foundation, one out of three American adults is at risk for kidney disease, a reality exacerbated by our typical diet, where the bulk of the food intake is over-processed, highly salted, high in sugar, high in protein and depleted of quality nutrition. Also, the balance of potassium, sodium and protein dramatically impacts renal health because they’re difficult to filter when the kidney is weakened or compromised. A solution is renal-friendly dieting.

I am not a urologist, nephrologist or home health worker, so I have no following of people who have taken my advice. But I have found what works for me, and it seems that many people follow the kind of diet that I use and have encountered beneficial results. A renal-friendly diet is one that is low-to-no sodium, low potassium and relatively low in protein. Because of the diet, I have sacrificed tastes I adore and been counted out when it came to some traditional foods I valued and grew up with. I had to relearn how to cook with alternatives that resembled my Scandinavian heritage.

Your kidney function, blood pressure and overall health will improve almost immediately if you dramatically cut added salt or high-salt food intake from your diet. Your blood pressure will begin to lower, hypertension will begin to ease up, which in turn assists your heart health. It isn’t easy to dramatically reduce or eliminate salt intake. But after about two weeks, the next time you inadvertently chow down on salty processed food, your taste buds will “burn” because you’ve re-assimilated to food’s true taste — foodies unite!

Potassium is crucial to our body’s chemical balance and helps regulate fluids and muscle contractions (fatigue, muscle weakness, spasms and cramps are signs that you may be low on potassium). However, too much potassium (hyperkalemia) can also cause fatigue, heart palpitations and muscle weakness due to an imbalance between cell-blood-sodium combinations, which taxes the kidneys.

Americans are the world’s number one meat consumers, so protein plays a disproportionately large role in our diets. Your kidneys are responsible for filtering the waste products generated when your body processes proteins. The more protein you eat, the more work for your kidneys — leading to potential overworking when compromised.

If your kidneys could choose whether they were carnivorous or vegetarian, they would choose to be veggie. Our bodies, however, need certain things in proper amounts that vegetarian or vegan diets might not be able to deliver on their own without supplements.

If you look at the soft part of your palm and visualize that as the amount of meat you should eat every day, you’re on track. The average American eats nearly three times that amount. Blood tests that screen for or monitor kidney disease measure the amount of protein found in the blood, called creatinine. When you have chronic UTIs or CKD, protein levels must be cut by more than half, and it’s recommended you eliminate red meat. If you’re close to dialysis, consider vegetarianism.

According to Dr. Robert Galarowicz, author of All Natural Kidney Health & Kidney Function Restoration Program: Everything You Need to Know to Improve Your Kidney Health, Avoid Dialysis and Live a Better Quality Life, we should opt for plant-based proteins such as beans and tofu as much as possible. Dr. Galarowicz is my virtual go-to renal health guru. Through his books and website, he has provided me the most comprehensive research, the most applicable strategies and the easiest menu guidelines in all my years of research.

The Importance of Water

Like many solutions to the issues that disabilities present us with, taking care of one problem potentially creates or overlooks others. I had to seriously consider my unique dietary and disability needs before going into this lifestyle change. Please consult with your physician, nutritionist or specialists who are experts in handling specific complications before embarking on any dietary change. For example, limiting protein — a crucial element in fighting CKD — is in opposition to the recommendation of eating large amounts of protein to combat pressure sores, and a nutritionist or specialist will know best how to navigate these complexities.

It is easy to see the cycle that can lead to problems. An overload of protein, added salt, and high levels of potassium equals renal stress, which results in crystallizations that can attract sticky bacteria, which become bladder sediment, and that often morphs into infections. Infections leave scars and compromise your kidney health, potentially leading to CKD. CKD impacts hormone regulation, blood pressure, heart health, sugar regulation, metabolism and the body’s ability to fight off other illnesses.

In addition to eating a renal friendly diet, I found staying well hydrated optimizes health. Dehydration expedites the process of developing chronic urinary tract infections and thus speeds up this cycle. This is especially true for those of us who are constantly seated and unable to get any “walking motion.” Urine held in the bladder can collect sediment due to inactivity, which can lead to crystallization and a friendly environment for UTI-causing bacteria. Drinking lots of fluids can help keep your bladder flushed and minimize crystallization.

Living Healthy

Proper diet and water intake are keys to good kidney health. If you decide to make a significant lifestyle change, work with your doctor and know that with any dietary change, your body will take a couple of weeks to acclimate.

The fact is our greatest wealth is our health. It took years for me to understand that disability can be greatly mitigated by true wellness. Limitations can become less bothersome when you create and maintain your health with self-care, proper diet, and exercise at whatever level possible, from the inside out. This includes spirituality and mental health in addition to how you regenerate your physical being with great food and fresh water every day.

That may sound a little like motivational hype at first, but research and science and my own personal experiences have proven otherwise.