According to 2010 information from the National Kidney Foundation, 26 million American adults have chronic renal failure, or CRF. Risk factors for CRF include diabetes, hypertension, a family history of kidney disease and being African American, Hispanic, Pacific Islander, Native American or elderly. When the kidneys are not functioning properly, electrolyte and hormone imbalance occurs, and toxins and fluids build up in the body. Progression of CRF may require following a specific diet, dialysis or kidney transplantation.
Anemia
Red blood cells contain hemoglobin, which carries oxygen throughout the body. The hormone erythropoietin is produced in the kidneys and triggers red blood cell production. In renal failure, the hormone is lacking, thus leading to anemia. Iron absorption is decreased in people with CRF, due to uremia, inflammation, medications, age and sex, resulting in anemia. If undergoing dialysis, iron is lost by frequent blood draws, surgical losses and dialysis tubing. Synthetic forms of erythropoietin and supplemental iron are used to decrease anemia in CRF patients.
Malnutrition
As kidney function lessens and toxins build up in the body, nausea, vomiting and anorexia may lead to decreased nutrient intake causing malnutrition. The diet commonly recommended for people with CRF is one with lower protein. The build up of nitrogenous waste is decreased when protein intake is reduced, but less dietary protein may increase the likelihood of protein-energy malnutrition. To minimize this effect, consuming more frequent meals, eating nutrient-dense foods and supplementing oral nutrition may be recommended.
Hypertension
When the pressure against artery walls is elevated, hypertension occurs. The kidneys help to maintain healthy blood pressure levels, but in people with CRF, the blood vessels within the kidneys may become damaged. Waste and fluid accumulation may occur due to poor-functioning kidneys. Hypertension may be improved by limiting sodium and alcohol intake, exercising regularly and maintaining a healthy weight.
References
- National Kidney Foundation: Chronic Kidney Disease
- National Kidney and Urologic Diseases Information Clearinghouse: High Blood Pressure and Kidney Disease
- "A Clinical Guide to Nutrition Care in Kidney Disease"; American Dietetic Association; 2004
- "Handbook of Dialysis"; John T. Daugirdas, Peter G. Blake, Todd S. Ing; 2007
