CKD3a, low blood pressure, still worth reducing salt?

[Soozmooch]

Hi I was diagnosed with CKD stage 3 last year, average GFR 56 over the last few blood tests with low proteinuria. It came out of the blue as I am 44, fit, low weight and have low blood pressure and generally feel ok. Doctors don't seem concerned so I am trying not to worry about it too much, however am wondering if I should be changing my diet in any way, e.g. cutting salt, although I have a pretty healthy diet anyway. Or does cutting salt only help if you have high blood pressure? I guess I'm just wondering if there's anything I can do to stop it getting any worse. Thanks for your advice.

[Hidden]

Salt has at least a double whammy to it. Yes, it's not good for someone with Hypertension but for someone with CKD sodium is also a problem for your kidneys to maintain effectiveness. Of course, the doctors aren't concerned. It's not their health, it's yours. How many doctors are overweight and/or smoke? Apparently, they aren't concerned about their health either. It's up to you to get and stay concerned about your health. Be proactive and learn all you can. Kidney-friendly diets are beneficial.

One thing you will learn is that on a kidney-friendly diet you don't eliminate everything. For example, sodium, potassium, phosphorous, protein, and calcium are needed by your body. But the amount you take in is what you have to watch.

Two things for you to consider. Go to the davita.com website and register for a Kidney Smart class in your area. It's free and lasts 90 minutes and will give you lots of information on CKD and in a proper meal plan. At that same site, you will find many recipes for a kidney-friendly meal plan. Each of the items I mentioned is listed for each recipe along with other dietary information.

[orangecity41 in reply to Hidden]

Very well put Mr Kidney. I found the Davita class to be most helpful, not only with diet information but how to cope with CKD.

[lowraind in reply to Hidden]

I know that everybody is advising the davita recipes. I am finding that you have to check their recipes carefully, because some are higher sodium, potassium and phosphorous. Does anyone else find the same?

[orangecity41 in reply to lowraind]

I do also on some, and quantities not what is on my diet, so modify. Do you select the link for CKD Non Dialysis recipes?

[Zazzel in reply to lowraind]

They also don't take into account the weight of someone. A 198 pd male can eat more protein, etc than a 110 pd female. Also, some of them use ingredients high in foods that cause inflamation such as peanut butter, oils other than olive, coconut and macadamia nut etc. But, it's a place to start and works for many people.

[orangecity41 in reply to Zazzel]

So true about factors to consider on diet, Many factors to consider. "One size does not fit all".

[Bet117 in reply to orangecity41]

Agreed, Orange City.. One size does not fit all. Sodium, high amounts of protein consumption; phosphorus and potassium should be watched.

A doctor or dietician can best advise based on many factors such as labs and personal nutrition.

[Soozmooch]

Thanks for the link. I live in the UK so not able to access the classes but I will definitely check out the dietary advice. I agree it's important to take responsibility for your own health. And I guess following a low salt healthy diet is a good idea, whatever your kidney health - it can't do any harm.

[curleytop1 in reply to Soozmooch]

Hello Soozmooch, I too live in UK and have found it difficult to get the same sort of information as those in the USA seem to be able to access through their medical services. I have found various kidney-friendly diets on the websites of several hospital renal/kidney departments, also one or two in Canada, Australia and New Zealand. From these, I have been able to put together a basic diet which suits me. My GP was very vague as to what to eat, just said to eat a low potassium diet (diagnosed two years ago at age 74). She sent me to the Renal Department of the local hospital, for which I had to wait for eight months, and an ultrasound test found I have only one kidney, whose function is declining as I age, and the other kidney (a wizened little thing) has probably never functioned much! It seems to have a genetic cause too as my brother(3 years younger) had a similar diagnosis two years before me! I have had a number of blood and urine tests since this and they seem to be satisfactory, although I have never been given any lab test results or any figures so I could make my own deductions as to how I am doing! I do know that I have been at stage 3 CKD for at least 7 years and that many people stay stable at this level, also that it is not inevitable that one will go through to CKD stage 5 and dialysis - most people do not (it is the same for transplant).

So, try not to worry too much - stress helps no-one - find a kidney-friendly diet that you can eat long term , cut out or drastically reduce the usual culprits, smoking, alcohol, as little salt as possible (do not add it or salt substitutes (v. high in potassium) at the dinner table or in cooking), same with sugar and sugar substitutes, try and lose weight if you need to, keep well hydrated with plain water (I like it boiled and cooled) - and start to enjoy life again! Best wishes - Curleytop1.

[Bet117 in reply to curleytop1]

Well stated. A dear friend of mine lives in the UK and checks in on a kidney site there which is not accessible in the US or Ireland. Google around.

Most importantly, eliminate red meats, packaged foods and such meats as bacon, sausage and cured products.

Fish, eggs, eggwhites and chicken are good.

Eat lots of fresh or fresh frozen vegetables such as cabbage, cauliflower, onions, peppers, green beans, zucchini and eggplant. They are great steamed and seasoned with non sodium based spices.

Fruits such as blueberries, strawberries, pineapple and apples are also good. Apples can be eaten raw, baked with a dab of cinnamon or otherwise.

Light wheat breads are also good.

The National Kidney Foundation as great information..there is a link here above( dots) or Google best foods for kidney patients. They also have a section with suggestions for Eating Out.

Hope this helps!

[kithsirid]

cutting salt alone would not be sufficient , u must eat kidney friendly foods , no meat , no potasium roch vegitable, go to link "Dvita glomerular filtration formula " u will get more links for other details .

wish u good health

[Sally10255]

Hi, my advice, cut salt, start drinking more water..100 oz a day minimum for me, closely watch sodium, potassium, phosphorus in foods. Frozen fish is pretty high in several things. Limit overall protein. Salt, dairy, protein, alcohol, smoking, soda, diet or not...are things to really watch. For me also I stopped taking any excessive amounts of vitamins, in fact don’t take 1, no painkillers or anti inflammatories. Stay away from processed foods. I would also suggest pursuing if still concerned. My numbers were off, had ultrasound, then pain, kidney stone had moved way down low. Further testing and looking around, my left kidney is only about 6 %. Either the stone was in there causing major issues and thoroughly damaged the kidney, I could have been born this way, or something else caused the damage. My right kidney is fine, just met with doctor recently, so we will be looking closer. St least good thing, had a renal scan in early November and one just the other day...functions on both are the same..

[Ange17]

Hi, what is your blood pressure? I amsoon to be 46 and have a GFR 56 with one kidney. I see two nephrologists because I have a hard time trusting doctors anymore, (long story) and I also have seen a nutritionist. Every body is different. I am on a lower potassium diet as for some reason my body wants to hold onto it now that I only have one kidney. So I really have to watch the potassium rich foods. As for salt. Both of my nephrologists and nutritionist said no low salt for me. I have very low blood pressure .. was diagnosed with pots after having my kidney removed where my blood pressure plummets even more when I stand suddenly or bend down to fast. Normally I am 90/56 sometimes lower upon standing or bending down. My body needs the salt to maintain a good blood pressure for me. So I wouldn't just cut salt without asking your doctor about it first. Every body is different.

[curleytop1 in reply to Ange17]

Hello Ange17, Your post is very interesting, I think you are the first person I have seen on here who has very low blood pressure, as you are probably aware, most of us have high blood pressure. It is so true that we are all different and I am sure it is the reason why a general 'kidney-friendly' is not suitable for everyone with CKD. The problem in the UK seems to be that until one is at stage 5 one does not get the chance to see a renal dietician (who are few and far between) so everyone has to decide what is best to eat and drink for themselves - the GPs do not seem to understand the stress this situation can cause. I my case I had a great deal of help from my local pharmacy as they do a one-to-one session with a pharmacist who advises on one's medication and diet. It seems to be a fairly new NHS service to be repeated each year in my case and while not perfect, is better than nothing. Best wishes - Curleytop1.

[Zazzel]

Personally, I would push for finding out the root cause of the CKD which can affect treatment also what type of kidney disease you have. There are many types and that can affect treatment as well.

You will hear a variety of different advice from people here particularly on diet, due to their particular situation. Different stages of CKD require different amounts of protein intake etc. Potassium and phosphorus are not necessarily limited for everyone either, unless your lab result should show you need it. All of these things, even sodium, are necessary for your body to function. Each person is different and needs to look at their own needs. However, moderation should be important for everyone even those without CKD to stay at optimum health.

You mention low Proteinuria. If you have any proteinuria, thus is something I would watch. You want No proteinuria. When I first went to my neprologist, she suspected I had IGANephropathy ( a type of kidney disease which is autoimmune related). I had a very small amount of proteinuria and I had low blood pressure. I did start watching my sodium intake and watching what I ate more closely though I have many food intolerances already. After about a year, the proteinuria started rising to the point we needed to do a biopsy and it was determined I did have IGAN. From there, my blood pressure slowly rose until I needed bp meds.

If your proteinuria levels rise, there are meds you can take to lower it. This is just something to keep an eye on in the future along with watching all of the values of your lab results. Mr Kidney has suggested keeping an excel spreadsheet. Several of us do this an I personally find it very useful.

Come back with more questions. As you can see, there are lots of helpful people here.

[Soozmooch in reply to Zazzel]

Makes sense. They are holding off a biopsy with me as my GFR is reasonable and fairly stable. Strangely my blood pressure is relatively high when measured at the hospital - in the high 130s - but far lower when measured at home (90s). I'm a more nervous patient than I realised!

[lowraind in reply to Soozmooch]

High blood pressure at the dr./hospital is fairly common. I believe it is call white lab-coat syndrome. I only have a problem when I am at the kidney doctor, with whom I am not happy. Am seriously thinking of changing drs.

[Soozmooch]

That's a good point Ange17, my blood pressure is also low, usually in the low nineties, so perhaps some salt is beneficial.

Thanks for the advice everyone, it's helpful to come here as I never think to ask the right questions at the doctor's. Wishing you all good health.

[curleytop1 in reply to Soozmooch]

Hello Soozmooch, I cannot give any advice about whether to continue to use salt in view of your low blood pressure (I have to avoid it as I have high blood pressure controlled by tablets), but think you should ask your doctor's advice about it rather than just use it freely - there are so many reasons not to have excess salt in the diet apart from blood pressure. Regarding asking questions at the doctors, keep a notebook handy and write them down as they occur to you, then take them along at your next appointment - I find doctors are impressed with this method, probably because it shows you are taking things seriously! Best wishes - Curleytop1.

[juls]

hi, same here at stage 3a ..doctor has said nothing about even being at this stage? found out by being in the hospital eGFR was at 48 then 55 now at 54 ? all my rheumatologist says is that it is stable..? whatever that means and yes diet is probs a good idea no salt, drink plenty of fluids.. water give em a good flushing... does anyone else here have any problems being followed up by your GP ...? Who actually diagnosis you with CKD. ?

[orangecity41 in reply to juls]

I was diagnosed by GP 2 years ago. I am at stage 3 and see GP every 6 months now. Was every 3 initially. I am also on Medicare.

[juls in reply to orangecity41]

just been looking up some blood results seems 2015 GFR was 3a then it was 59 it's now 54 so I guess it's OK for now x maybe when it dropped to 48 when I was ill in hospital. does stable mean it's not CDK when its been below 60 for 3years who knows maybe longer?

[orangecity41 in reply to juls]

In my situation progression has been slowed down. My numbers too have bounced around, and are other factors. Imagine age is a consideration also. Different labs also can make a difference in readings. Best you and your Doctor watch the eGFR figures.

[juls]

yeah, the age factor is defo a fact, still, at my age, it's still low but I feel fine so just keep the diet right. I'm thinking of changing my GP soon so let's see.