How to slow down the progression of kidney disease

Editor’s note:  A new study about the relationship between Chronic Kidney Disease (CKD) and musculoskeletal pain. Advice about controlling the levels of uric acid, phosphorus and calcium is provided. 

Did you know you can drastically slow down your progression of kidney disease by lowering your uric acid level?

What exactly is Uric Acid? Uric acid is a chemical created when the body breaks down substances called purines, which are found in some of the foods and drinks we consume.

Most uric acid dissolves in the blood and travels to the kidneys, where it is filtered out in urine. If your body produces too much uric acid or doesn’t remove enough if it, you can get sick. High levels of uric acid in the blood is a condition called hyperuricemia. In kidney disease uric acid may build up to toxic levels, causing more injury to the kidneys.

In a large retrospective study that was presented at the November 2013 annual meeting of the American College of Rheumatology and reported in the November 2013 issue of Family Practice Newsletter, patients, who were able to reduce their serum (blood) uric acid level below 6 mg/dL, slowed down the progression of their disease by 37%.

Dr. Gerald D. Levy, a lead investigator of the study, said the following during a press briefing: “There are numerous studies showing that people with kidney disease can develop hyperuricemia. Some of them will also develop gout. There are a few small studies showing that in humans you can reverse hyperuricemia with urate-lowering therapy and make an impact in renal disease. We wanted to see if this is true.”

The study included 111,992 Kaiser Permanente Southern California patients with a serum uric acid (SUA) level of 7 mg/dL or greater from Jan. 1, 2002, to Dec. 31, 2010. Kidney disease patients with a minimum of 12 months of health plan membership, including drug benefit prior to the index date, were studied. The primary outcome of the study showed at least a 30% worsening of renal function, starting of dialysis, having a GFR of less than 15 mL/min,
and undergoing surgery for a kidney transplant.

How To Lower Uric Acid Levels

Lowering uric acid levels can be accomplished in at least two different ways. The first is by taking medicine such as Allopurinol, which lowers the levels of uric acid in the blood.

The second way to lower uric acid levels and to slow down kidney disease is by consuming foods that are low in purines: 

  • Vegetables – According to the University of Pittsburgh Medical Center, you can eat three servings of nearly any vegetable while on
    a lowered purine diet, with 1 cup of raw vegetables or 1/2 cup cooked vegetables being equal to one serving. While this is excellent advice, you
    will need to consume lower potassium vegetables, since high potassium levels are common in kidney disease.
  • Grains – On a low-purine diet, you can have 6 to 11 servings of grains each day, including rice, pasta, or bread. Choose mainly enriched
    products, limiting your intake of whole grain or whole wheat bread, oatmeal or bran to only three servings per week. A grain serving is considered
    a slice of bread, 1/2 cup of cooked pasta, rice or cereal or 1 cup of ready-to-eat breakfast cereal.

Foods High in Purines Should Be Avoided in Kidney Disease

  • Animal Proteins – Limit poultry, meat, and fish, because animal proteins are high in purines. Avoid or drastically
    limit such high-purine foods as organ meats, anchovies, herring, and mackerel. Red meat (beef, lamb, and pork), fatty fish and seafood (shrimp, tuna,
    lobster, and scallops) are associated with kidney disease progression. All meat, poultry, and fish contain purines, so limit your intake to 4-6 ounces
  • Alcohol – Avoid or limit alcohol. Alcohol interferes with the body’s elimination of uric acid. Drinking beer, in particular, has been
    linked to high levels of uric acid. Spirits and wine also contain high amounts of purines and therefore should be limited.
  • High-Fructose Corn Syrup – Limit or avoid foods sweetened with high-fructose corn syrup. Fructose is the only carbohydrate known to
    increase uric acid. It is best to avoid beverages sweetened with high-fructose corn syrup, such as soft drinks or juice drinks. Juices that are
    100 percent fruit juice does not seem to stimulate uric acid production as much.