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The Epidemic of Kidney Disease: A Call for Alkalinity

The Epidemic of Kidney Disease: A Call for Alkalinity

Rich Snyder, DO

Kidney disease is an epidemic that affects approximately thirty one million people in the United States, with approximately six hundred thousand currently on dialysis. This number is a significant underestimate as kidney disease often remains unrecognized and undiagnosed until it is too late. In North America, the most common causes of kidney disease are diabetes and hypertension. With the current obesity and inflammation crisis, our younger generation is being diagnosed with kidney disease.

If you view kidney disease from a holistic viewpoint, it is in fact a consequence of malnutrition, inflammation, and acidosis (aka the MIA Complex) as are many chronic illnesses. Acidosis especially can not only have a devastating effect on kidney function, but can impact the function of other organs as well. It can worsen intestinal health (i.e. affect its ability to absorb nutrients or cause malabsorption), as well as bone health (it can dramatically increase the risk of bone disease and the development of osteoporosis which increases the fracture risk).

If we look at a typical western American diet, it is high in Omega 6, very pro-inflammatory and very acidic. Animal protein, in particular can be very inflammatory; the animal protein is processed by the body and is broken down into hydrogen ions. The higher the hydrogen ion load (the lower the pH) the greater the total body acidity. There is increased workload of the body to not only buffer this acid load but also on the kidneys to excrete this acid load.  

If one realizes that the average American eats more than 4-5 grams of protein a day, can you imagine the degree of acidity that is being generated on a daily basis? The kidneys have to work over time to deal with not only the higher protein load, but the kidneys and the body also have to deal with the increased acidity which increases oxidative stress on the kidney and increases inflammation.

Diabetes, which again is the most common reason for kidney disease in North America, causes acidosis, malnutrition and inflammation, all of which directly affect kidney function. Diabetes can affect intestinal health: the nerves of the intestine can be affected by diabetes which can slow digestion and affect absorption (a term called diabetic gastroparesis). The high blood glucose levels cause an overgrowth of Candida in the intestine which can worsen inflammation through the effect of mycotoxins (and further affect nutrient absorption). Recent studies have demonstrated that a leaky gut, intestinal dysbiosis, and the inflammation that is caused by this is a direct risk factor for worsening kidney disease.

Uncontrolled diabetes causes acidosis in the body; in the kidney specifically diabetes can cause a specific type of acidosis, rendering it difficult for the kidney to eliminate the acid that the body has built up. Diabetes also causes oxidative stress and inflammation through the generation of advanced glycosylation end products or AGEs for short.  Uncontrolled high blood sugars and the leaking of protein into the urine (proteinuria) are also potent causes of oxidative stress, inflammation and worsening kidney disease referred to as diabetic nephropathy (ne-fra-pa-thee).

Acidosis also affects bone health. The bone is a buffer for the continued acid load, in addition to the buffers in the blood and in the cells. Alkaline mineral salts, such as magnesium and calcium actually are “leeched” from the bone into the bloodstream to buffer the excess acid that is built up on a daily basis. This weakens the bone over time and increases the risk of developing osteoporosis and fractures. Acidosis can stimulate the secretion of parathyroid hormone, which increases calcium “leeching” from bone; the secretion of parathyroid hormone is already increased from kidney disease (secondary hyperparathyroidism).

Last but not least, acidosis can worsen kidney function. Studies have demonstrated that acidosis, especially in someone with kidney disease, can not only worsen the kidney function, but also can be a source of weakness and fatigue, severely affecting the functional status of the person.

What is the solution? The solution to countering the acidity, inflammation and malnutrition that is the source of all chronic illness, not just kidney disease, lies in alkalinity. An alkaline-based diet is rich in fruits and especially vegetables. There is a lot of information concerning the value of a plant based diet not only improving kidney health but in improving total body health. An alkaline based diet consists of foods high in antioxidant value that not only counter inflammation, oxidative stress, and acidosis but also provide significant nutrients that most of us are lacking.

Alkaline water is beneficial for many reasons. There are studies that mineralized, alkaline water can help improve GI tract function and health, which improves nutrient absorption and decreases total body inflammation. In fact, a study done in 2002 demonstrated that the use of an alkaline mineralized solution improved the overall movement of the GI tract (ie improve gastric peristalsis), food digestion and nutrient absorption.

Alkaline, mineralized water can also improve bone health. Studies have demonstrated that the use of alkaline water can improve markers of bone health and decrease the calcium “leeching” from the bones. There are many studies that demonstrate the effect of bicarbonate supplementation in maintaining and/or improving kidney function as well as improving overall endurance, sense of well-being, and overall functioning. We recently sent an abstract to the National Kidney Foundation touting the benefits of alkaline water in improving serum bicarbonate levels.

It is only through a holistic perspective that we are going to be able to fight the epidemic that is kidney disease. Adhering to a plant-based alkaline diet as well as using mineralized, alkaline water such as Santevia Water Systems should be part of any arsenal to combat inflammation, reduce acidity, and improve kidney health.  

References
Abol-Enien H, Ghieth OA et al. “Ionized alkaline water: new strategy for management of metabolic acidosis in experimental animals.” Therapeutic Apheresis and Dialysis. 2009 Jun;13(3):220-4.
Anders HJ, Andersen K et al. “The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease.” Kidney International. 2013 Jan 16. [Epub ahead of print]
Bertoni M, Olivieri F et al. “Effects of a bicarbonate –alkaline mineral water on gastric functions and functional dyspepsia: a preclinical and clinical study.” Pharmacological research. 2002. 46(6): 525-531.
deBrito-Ashhurst I, Varagunam M et al. “Bicarbonate supplementation slows progression of CKD and improves nutritional status.” Journal of the American Society of Nephrology. 2009 Sep;20(9):2075-84.
Goraya N, Simoni J et al. “A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate.” Clinical Journal of the American Society of Nephrology. 2013 Mar;8(3):371-81.
Kalantar-Zadeh K, Mehrotra R et al. “Metabolic acidosis and malnutrition-inflammation complex syndrome in chronic renal failure.” Seminars in Dialysis. 2004 Nov-Dec;17(6):455-65.
Trivedi H, Dylewksi J et al. “Alkaline Water: An Alternative to Oral Sodium Bicarbonate in CKD?” Abstract National Kidney Foundation: Spring 2013 Meetings.
Wynn E, Krieg MA et al. “Alkaline mineral water lowers bone resorption even in calcium sufficiency: alkaline mineral water and bone metabolism.” Bone. 2009 Jan;44(1):120-4.
Wynn E, Krieg MA et al. “Postgraduate Symposium: Positive influence of nutritional alkalinity on bone health.” Proceedings of the Nutrition Society. 2010 Feb;69(1):166-73.


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