Lupus - Nutrition and Kidney Disease in Lupus

Nutrition and Kidney Disease in Lupus

Dateline: 08 March 99

What do the Kidneys Do

Systemic Lupus Erythematosus (SLE) can target major organs, such as the kidneys. The kidneys are responsible for keeping the chemicals in your body in balance. It's easy to take this humble pair of bean-shaped organs at your back for granted. However, since the kidneys perform so many vital functions in our body, kidney disease can have a variety of effects. Let's look at how the kidneys do their job.

Every minute, the kidneys filter one liter of blood to remove excess fluid and waster products. The microscopic filters called nephrons actually do this work. The kidneys take these wastes from the blood and eliminate them through the urine. When the nephrons are inflamed, this disturbs the body's ability to perform important metabolic functions.

Lupus Nephritis (inflammation of the nephrons of the kidneys), is a potentially serious complication of lupus. Estimates are that from one-third to one-half of all lupus patients will need medical treatment for this condition. . Some but by no means all of the kidney problems in SLE patients are caused by Lupus Nephritis. Urinary tract infections, medication sensitivity, and advanced hypertension are culprits too.

Quotes from Some of the Experts

Most patients develop lupus nephritis early in the course of their disease. It is rare to see a new onset of renal disease in someone who has had SLE for 10 years or more.
H. Michael Belmont, M.D., Director Lupus Clinics, New York University School of Medicine

The clinical course of lupus nephritis is highly variable... In many patients, the urine abnormalities are very mild and may be present on one examination and absent the next. This form of lupus nephritis is rather common and, generally does not require any special medical evaluation or treatment. However, in some patients, the abnormal findings on urine studies persist or may even worsen over time. patients with this type of lupus nephritis are at risk for loss of kidney function. They may require additional studies. . .
John H. Klippel, M.D., Clinical Director, NIAMS, NIH

What Difference Does Nutrition Make

Medical Nutrition Therapy in kidney disease is a very complex matter. In general, the goals can be summed up this way:

  1. Control high blood pressure
  2. Minimize fluid retention (edema)
  3. Meet calorie needs, (which can be high)
  4. Balance electrolyte and mineral content of the blood, especially Sodium, potassium, and phosphorus
  5. Meet protein needs, without burdening the kidneys

Your renal specialist may refer you to a Registered Dietitian(R.D.) to help you handle these complex issues.
Here are some questions you may consider together.

  • Is Your Serum potassium is too High or Too Low potassium is a common element which is usually eliminated by the kidneys when it's not needed, except in renal disease. Many fresh fruits and vegetables contain potassium.
  • Is Your Serum phosphorus is too High If so, your intake of dairy products may need to change.
  • How Can I Control my Fluid Intake Avoid water intoxication.
  • How much protein do I Really Need This is a delicate balance. Meat, poultry, fish, dairy, cheese, and eggs, may all be limited.

Kidney disease may be fairly common in SLE, but it does not affect everyone. If affected, you can help manage your symptoms and the progression of the problem by being better informed.

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