Kidney Disease and Kidney Stones
The kidneys are vital organs that function for many reasons in the body. They are responsible for the elimination of the breakdown of by-products of protein (ammonia, urea, and ketones.) They also remove toxins from the blood, are critical in electrolyte and fluid balance, aid in the regulation of blood pH (acidity versus alkalinity), and adjust the volume of water in our body during filtration and elimination. The kidneys are our biological filters.
Kidney function plays a critical role in maintaining blood pressure. Sometimes hypertension can be due to improper kidney function. The term kidney disease can describe many conditions, but primarily it is referred to as renal failure. This occurs when the kidneys are unable to properly clean normal biological chemicals from the bloodstream. Failure may be complete or partial, temporary or permanent. There are two forms of renal (kidney) failure:
Acute Renal Failure. This refers to the sudden onset of kidney malfunction sufficient enough to permit the accumulation of nitrogenous wastes in the blood. Mild attacks are not uncommon.
Chronic Renal Failure. This refers to the slow development of kidney malfunction. This is a more permanent condition and may preclude kidney failure—a life-threatening disorder. This is referred to as end-stage renal failure, which may be treated with kidney transplants or hemodialysis. Herbal treatment in serious kidney conditions is controversial.
Kidney stones are solid, rock-like materials that are formed by the mineral substances contained in the urine. Also called nephrolithiasis, the development of kidney stones—which can range in size from a grain of sand to a golf ball—is one of the most common disorders associated with the urinary tract. Kidney stones affect 10 percent of the U.S. population. The cause of kidney stones can almost always be associated with poor diet choices and lifestyle.
Kidney stones are generally caused by an accumulation of calcium oxalate (oxalic acid), uric acid, struvite, cholesterol, magnesium ammonium phosphate, and cystine stones. Calcium-oxalate or calcium phosphate stones are the most common, and they occur when too much oxalate is present with not enough water to keep it in solution. Kidney stones can cause extreme sudden pain in the back, side or groin; blood in the urine; fever and chills; and vomiting. They can grow to a size that can be life threatening and may require surgery to be removed. Lithotripsy is a non-invasive procedure that uses shock waves to break up stones into smaller pieces, enabling the urine to excrete them. Kidney stones affect mostly middle-aged and older men.
It is important to remember that these stones are not formed because one has too much calcium IN the body; they are formed because they are leaching too much calcium OUT of the body. The problem is not calcium intake; it is lack of calcium absorption. Thus, these patients need to take calcium (citrate, not carbonate) because studies have concluded that the intake of dietary calcium is inversely associated with the risk of kidney stones. Magnesium in the urine inhibits stone formation by increasing the solubility of calcium oxalate.
A low protein diet (approximately 30-40 grams per day) is always the first consideration in treating kidney disease, and a low protein diet can defer renal replacement therapy to patients with chronic renal failure. High protein (mostly from red meat) will stress the kidneys and over time can be a contributing factor to a decline in kidney function (see RISKS below). Increasing dietary fiber is also important; fiber decreases the formation of gallstones and kidney stones.
It is important to recognize that a diet with a high intake of animal protein and fat increases the risk of stone formation. Meat protein generates more acid and has a higher sulfur content than vegetable protein. A study from Italy concluded that eating less animal protein and salt, while eating more vegetables, led to a reduction in the recurrence of kidney stones. Affluent societies with dietary patterns that include fat, refined carbohydrates, alcohol, coffee, refined sugar, chocolate, aspirin, soft drinks, tobacco, high salt, high vitamin-D enriched food, and animal protein have a high rate of calcium-containing stones.
The habit of drinking black tea daily and the use of iron supplements to counter anemia contribute to the development of kidney stones and calculi. The tannic acid in black tea can cause the calcium in the body to solidify and to accumulate in the kidneys, causing excruciating pain. Some stones are not of a calcium nature, but rather are primarily precipitations of uric acid crystals, and therefore an indication of gout.
One should eat a more plant-based diet and rely on beans, seafood, and lentils as the major source of protein. If possible, try to maintain a diet that is more alkaline and less acidic.
There is evidence to suggest that once a patient is on dialysis due to kidney failure, he or she should consume more protein compared to someone suffering from recurrent kidney stones.
Creatinine remains a simple single test that measures nephron function. Serum creatinine is commonly measured as an index of glomerular function. In general, serum creatinine varies inversely with the glomerular filtration rate (GFR).
A number of factors may affect creatinine levels, including heavy dietary meat (protein) ingestion, medications such as cimetidine (Tagamet) and glucocorticoids (steroids), and muscle mass decrease in chronic illness.
Most doctors tell their patients to avoid calcium supplements, but this recommendation appears to be extremely unwise. Calcium restriction actually enhances oxalate absorption, and calcium oxalate stone formation is increased. High intakes of calcium, potassium, and fluids have been shown to be associated with lowered risk of kidney stones.
Patients on hemodialysis have a danger of losing too much selenium through their pores. The mechanics of modifying selenium status may particularly be important for hemodialysis patients, considering their cancer mortality rates.
A study examining the dietary intake of 10,000 nurses over a 10-year period showed that women who ingested the highest percentage of protein had significantly more kidney stone problems. High protein diets (be careful of the Atkins Diet) cause abnormalities in the urine that make stone formation more likely.
Increased protein intake will negatively affect kidney-function markers in a blood test. High protein will increase the glomerular filtration rate (GFR) of the kidney, which causes the organs to work harder. The negative response from a higher GFR is an elevated blood-urea-nitrogen (BUN) level and a lowered pH in the urinary tract from an added uric acid load. The resulting acidic environment promotes calcium excretion, and thus high stone formation. Despite the effects of high protein and fad diets in the increased formation of kidney stones, experts note that underlying disorders can put one at risk for forming kidney stones. Individuals with gout, high blood pressure, urinary tract infections, leukemia, kidney disease, lymphoma, hyperparathyroidism, lead toxicity, multiple myeloma, obesity, and an increased family history of stones have an increased risk of developing kidney stones.
Physicians usually do not treat kidney stones—they routinely medicate the pain until the stones pass on their own. If a stone does not pass in a prescribed period of time, surgery used to be necessary. In recent years a noninvasive procedure called lithotripsy usually breaks up the stones so they can be passed. In lithotripsy, which is done under anesthesia, shock waves are directed at the stone to pulverize it.
SUPPLEMENT PROTOCOL for KIDNEY STONES
- CALCIUM CITRATE and MAGNESIUM CITRATE
Several studies have addressed the efficacy of magnesium and calcium citrate in the prevention of recurrent calcium oxalate stones. Citrate forms insoluble complexes, inhibiting the formation of calcium phosphate and oxalate stones. When citrate is given as a salt, urinary pH is increased, which inhibits uric acid stone formation. Recommended doses of 500 mg of supplemental calcium citrate should be taken with each meal. Doses of magnesium should be between 300-600 mg daily. These doses can decrease the risk of stone formation by as much as 90%.
- CRANBERRY JUICE
Drink cranberry juice in large volumes (100% natural, not sweetened) to prevent urinary tract infection and to try to “flush” out stones. The excretion of oxalic acid in the body is significantly increased after taking cranberry juice. Ordinarily, it is best to avoid oxalic acid, but in this case it helps to dissolve the calcium deposits in the kidneys.
- VITAMIN B6 (Pyridoxine)
Vitamin B6 is shown to have positive results in people with calcium oxalate stones. A study of more than 85,000 women determined that high doses of vitamin B6 may decrease oxalate production. Dosage: 50-200 mg daily. It is advisable to complement vitamin B6 supplementation with VITAMIN B COMPLEX.
- CHANCA PIEDRA
This South-American herb is known by indigenous healers as the “stone-breaker” in Spanish. It is well known as a natural remedy for kidney stones and gallstones, liver protection, high cholesterol, and cancer prevention. It also has an analgesic effect. Dosage: 500 mg (in extract) used 2-3 times a day. See a qualified practitioner.
- STINGING NETTLES
The German Commission E approved supplementation of stinging nettles internally for supportive therapy as a diuretic in patients with lower urinary-tract inflammation to prevent kidney stone formation. Dosage: One dose 3 times a day as directed on package.
This mineral has a therapeutic benefit in the prevention and treatment of kidney stones by decreasing urinary calcium excretion and increasing urinary citrate. Urinary potassium excretion correlates with a decreased risk of stone formation in post-lithotripsy patients. Either potassium bicarbonate or potassium citrate can be used. High doses of calcium and potassium and fluids have been shown to be associated with a lowered risk of kidney stones. Dosage: As directed by a qualified practitioner.
MILK THISTLE (Silymarin), DANDELION, BARBERRY, HORSE CHESTNUT, and SAW PALMETTO are herbs that combat stone formation and exhibit a diuretic action. They also have moderate anti-inflammatory and anti-spasmolytic activity. Dosage: As directed on label.
- ANTIOXIDANTS (VITAMIN C w/bioflavonoids, SELENIUM, VITAMIN E)
Antioxidants have a positive affect on blood cholesterol, which can directly or indirectly have a negative affect on oxalate stone formation. As reported by many physicians, routine restriction of vitamin C to prevent stone formation appears unwarranted. Dosage: As directed on labels.
Goldenrod contains the compound leiocarposide, which is a potent diuretic that helps the body flush out excess water. Famed ethnobotanist Dr. Jim Duke has good evidence that goldenrod is effective in treating chronic kidney inflammation (nephritis). Dosage: As directed (in a tea form).
- INOSITOL HEXAPHOSPHATE (IP6)
Research has shown that IP6 significantly inhibits the precipitation of urinary calcium oxalate crystals. An inadequate intake of IP6 may pose an increased risk for the development of calcium oxalate kidney stones. Dosage: As directed on package.
Decreased total urinary oxalate has been reported following boron supplementation. Some leading researchers suggest a potential role in controlling kidney stones formation. Dosage: 2 mg daily.
- SOY ISOFLAVONES
Soy isoflavones have a positive effect on renal failure and stone formation. Dosage: Supplement freely with organic soy food choices.
SUPPLEMENT PROTOCOL for KIDNEY DISEASE
- LOW PROTEIN DIET
- B-COMPLEX VITAMINS
B-complex vitamins, especially FOLIC ACID (800 mcg), VITAMIN B6 (100-200 mg), and VITAMIN B12 (300-500 mcg), effectively lower homocysteine levels, which can be very damaging to the kidneys.
- MILK THISTLE MIXTURE
A Milk thistle mixture of silymarin and silibinin has an ability to stimulate new cell growth in the liver and kidneys pertains only to normal cells; silymarin and silibinin have no such stimulatory effect on cancer cells. This is of enormous importance: Silibinin can apparently selectively stimulate the growth of certain types of normal cells while inhibiting the growth of malignant cells. Likewise, the very fact that silibinin raises glutathione levels in the liver serves as a safeguard against cancer since higher glutathione levels produce a shift in the immune function toward better anti-cancer and anti-viral defenses. Dosage: 150-600 mg daily, or as directed.
- VITAMIN E
Vitamin E has been shown to protect the kidneys from free-radical damage and may help restore tubular flow in severe disease. Dosage: 400-800 IU daily.
Pre- and post-dialysis patients can be deficient in L-Carnitine, which leads to general muscle weakness. L-Carnitine has been extensively studied in patients with renal failure. Supplementation, either oral or IV, mitigates some of the disorders associated with dialysis, including renal anemia, cardiac dysfunction, and insulin resistance. Dosage: 500-1,000 mg daily for 8 months. [NOTE: The National Kidney Foundation recommends the use of L-Carnitine for the treatment of anemia associated with chronic renal failure.]
- STINGING NETTLES
Stinging nettles is an herb with a long history in folklore as a “blood cleanser.” The use of stinging nettles extract for the treatment of renal dysfunction represents a novel indication. In recent studies from Britain, stinging nettles extract showed a beneficial effect on compromised glomerular function as measured by serum creatinine levels. Dosage: As per label.
Deficiency of this important antioxidant mineral may be a risk factor in kidney disease and result in higher cancer mortality rates. Dosage: 100-200 mcg daily.
- Dialysis patients should be taking antioxidants like LYCOPENE, VITAMIN C, and N-ACETYLCYSTEINE to protect against dialysis-induced free radicals.
Supplementation may help postpone the need for dialysis among kidney disease patients. Dosage: 500-2,000 mg daily, or as directed.
- GINKGO BILOBA, PANAX GINSENG
These herbal preparations work together as a renal protection formula. Dosage: As directed by a qualified healthcare practitioner.
Alternative Medicine Review- Monographs-Volume One, 2002. Thorne Research, Inc. Dover, ID.
Arvigo, R, Cranberry Juice Can Heal/Prevent Kidney Stones. Tree of Life, July 2004, 4(1); 4.
Bogye, G, Tompos, G, Alfthan, G. Selenium Depletion in Hemodialysis Patients. Alternative Medicine Review, Aug 2000. 5(4): 390.
Boron-Monograph. Alternative Medicine Review, December 2004. 9(4): 434-436.
Chanca Piedra Extract. Raintree Nutrition Tropical Plant Database. www.rain-tree.com
Curham, GC, et al: Comparison of Dietary Calcium with Supplemental calcium and Other Nutrients as Factors Affecting the risk of Kidney Stones. Ann Intern Med, 1997 (126):497-504.
Curham, GC, Willett WC, Speizer, FE, Intake of vitamins B6 and C and the Risk of Kidney Stones in Women. Alternative Medicine Review, August 1999, 4(4); 287.
Disease Prevention and Treatment- Third edition. Life Extension Media. Hollywood, FL. Pp. 388-390.
Duke, JA. The Green Pharmacy, Rodale Press, Emmaus, PA. 1997.
Healthplus. Kidney Disease. The Jag Group, 1997.
Heron, S., Yarnell, M. Recurrent Kidney Stones: a Naturopathic Approach. Alternative and Complementary Therapies, Feb. 1998. Pp. 60-67.
L-Carnitine- Monograph. Alternative Medicine Review, March 2005. 10(1): 42-47.
LaValle, J. Kidney function. Natural Medicine, Level 1. Lecture, 1997.
Lukaczer, D. Decalcifying the Stone. Nutrition Science News, Dec. 1999, 4(12); 566.
Marion, JB. Anti Aging Manual. Information Pioneers. S. Woodstock, CT., 1996
Milk Thistle Extract. www.health-n-energy.com/silibin.htm
Treasure, J. Urtica Semen reduces Serum Creatinine Levels. Journal of the American Herbal Guild, Fall/Winter 2003. 4(2): 22-25.