Kidney hemorrhages

Because of stress, medications, and high urinary losses, a vitamin-C deficiency can be readily produced during any kidney disease; hence the danger of hemorrhaging is tremendously increased. Even a mild lack causes blood to appear in the urine.

The passing of bloody urine or hemorrhaging have sometimes been quickly stopped when huge amounts of vitamin C and/or "bioflavonoids" have been given to persons with severe nephritis.

Since a cholin or vitamin-E deficiency can also cause hemorrhages, large amounts of lecithin, cholin, and vitamin E should be given with vitamin C the minute kidney disease is diagnosed, and all increased immediately if blood appears in the urine. Kidney hemorrhages have sometimes been stopped by giving vitamin E alone.

Uremia Poisoning

A nitrogen-containing substance known as urea is formed from the breakdown of body cells and from food proteins used as calories. so Since concentrated urea is toxic, if the amount of this substance in the blood becomes excessive, uremia poisoning can result.

A low-protein, high-calorie diet or even a protein-free diet is customarily given to patients threatened with uremia poisoning. The stress of an extremely low protein intake, however, can cause so much body protein to be broken down that more urea is formed than if a high-protein diet is eaten. Because the blood urea usually increases if fewer than 40 grams of protein are given daily; at least this amount should be obtained. Though extremely low-protein diets have proved to be dangerous;they are still being used.

Urea in the blood rises rapidly during a vitamin-B6 deficiency. Giving the amino acid alanine or an excessively high-protein diet, either of which increases the need for vitamin B6, makes uremia poisoning markedly worse. W hen 200 milligrams of vitamin B6 were taken daily by deficient volunteers, the urea level quickly fell to normal; and the blood urea, which is particularly excessive during the toxemia of pregnancy, also dropped to normal after vitamin B6 was given. Such findings indicate that this vitamin should be increased immediately if uremia poisoning threatens.

Low-Salt Diets

Because sodium is usually held in the body during dropsy, ordinary table salt and foods containing baking soda are customarily restricted. Though low-salt diets are relatively unappetizing, foods may be well seasoned with herbs, condiments, and salt substitutes. If the diet can meet all the needs of stress and generous amounts of potassium are obtained from foods and/or supplements, salt restriction may be only temporary.

Deficiencies of salt, or of sodium and chlorine, have been produced in patients by too severe salt restriction; and weakness, muscle cramps, vomiting, and an elevated blood urea has resulted. Such symptoms should be watched for, especially during hot weather. Because a salt deficiency can be dangerous, no fewer than 500 milligrams of sodium should be obtained daily, and a low-salt diet should not be adhered to after dropsy has been corrected. Taking generous amounts of potassium--physicians sometimes give12 grams or more daily--causes salt to be excreted and often makes salt restriction unnecessary.

The Present State of Chaos

The famous urologist Dr. Thomas Addis described the dietary management of kidney diseases as being in an "extraordinary state of disorganization" and "chaos"; and many investigators have pointed out that diets used today for kidney diseases are 40 years behind research findings.

All experimentally produced kidney disease is corrected provided the nutrients needed for repair are amply supplied. The problem is that irreparable damage can be quickly done unless the diet is promptly improved. When the disease is allowed to become serious, so many nutrients are continuously lost through the damaged kidneys that dietary help becomes an uphill task.

Diet for Kidney Diseases

Because each case of Bright's disease varies during the course of the illness, a doctor must determine the amount of protein, salt, and fluid to be allowed daily. As with a diabetic diet, all nutritional improvements must be made within the framework of these allowances. He will emphasize that calories must be kept high at all times to prevent either food proteins or body proteins from being used for energy and the urea formation increased; and that six meals or more must be taken daily.

Despite years of controversy, authorities now agree that protein must be unusually high except when uremia poisoning threatens. It must be sufficient to replace all albumin lost in the urine and feces, and to rebuild tissues, meet the general body needs, and fulfill the demands of stress. Patients able to take 150 to 200 grams of protein daily recover much more rapidly, and kidney biopsies show greater healing than in others obtaining less protein. Persons in charge of feeding nephrotic patients should use the tables of food composition to count both the grams of protein and the calories obtained daily.

If sodium is restricted, ocean fish and proteins from animals which eat salt--meats, eggs, cheese, milk--may be limited. Low-sodium milk and cheeses are available. Tearily yeast is particularly low in sodium, and wheat germ, soybeans, soy flour, nuts, and salt-free nut butters are all excellent and contain far less sodium than animal products. If eggs are limited, use 2 yolks instead of 1 whole egg. When protein is drastically restricted, only egg yolks, liver, yeast. yogurt, milk, and cheese should be used, and incomplete vegetable proteins should be avoided. Pep-up can be prepared with low-salt milk or any fruit juice. Oils should be used for cooking and seasoning instead of solid fats. As long as meat is allowed, fresh and/or desiccated liver may be taken several times daily, especially when anemia is severe.

Supplements should be heavily relied upon to furnish all nutrients not obtained from food. The following amounts! have been given: daily to persons with kidney disease in the studies cited earlier: 3 to 6 tablespoons of lecithin and 1,000 milligrams of cholin, usually as 250 milligrams at each meal and before bed; 30 milligrams of vitamin B6 or more; 50,000 to 75,000 units of vitamin A; 300 to 600 units of vitamin E; and 5 to10 grams of potassium chloride. If little or no milk is allowed, 250 milligrams of calcium should be taken four to six times daily, preferably with magnesium and 10 milligrams of vitamin B2. I feel that the anti-stress formula should be taken around the clock; that the blood cholesterol be known and supplements given accordingly; and because digestion is usually below par, that hydrochloric acid, digestive enzymes, and yogurt or acidophilus milk or culture be taken each time food is eaten. The more liquid the patient is asked to drink, the more carefully the diet must be planned and the larger the amounts of supplements used. When diuretics are given, the situation becomes one of hoping that enough nutrients can be retained in the body to rebuild kidney tissue.

The success of a nutrition program depends largely on how promptly dietary improvement is initiated. If an adequate diet is given from the moment the diagnosis is made, the usual attitude that kidney diseases are "not amenable to cure" appears to be unjustified. If given a chance, our bodies have an amazing ability to heal themselves.