Heart disease is the leading cause of death among patients with chronic kidney disease, in part because high cholesterol and high blood pressure are common among this group. The reasons for hypertension and high cholesterol are not entirely obvious at the outset, and the means to control cholesterol is not necessarily the same as for people with healthy kidneys.
Proteinuria
High levels of urine protein are one of the first symptoms of kidney disease. While healthy kidneys keep proteins in the blood, the filters of inflamed kidneys often allow proteins in the blood to spill into the urine. These proteins include antibodies and enzymes.
Mechanism
Cholesterol levels are usually high in patients with high urine protein because the enzymes that help break down cholesterol are lost into the urine. Since the cholesterol cannot be broken down, cholesterol levels start to soar, often to startling heights. Under these circumstances, minimizing dietary cholesterol will have little effect. Instead, doctors try to control urine protein through ACE inhibitors, steroids or other means. When urine protein is controlled, cholesterol levels also return to their original baseline.
Dietary Issues
Once urine protein returns to baseline, you can get a better sense of your true cholesterol levels. If cholesterol levels continue to remain elevated, even though urine protein is under control, eliminating dietary sources of cholesterol, such as meats, eggs, cheese and butter can be helpful. Nephrologists also might control this problem by prescribing drugs known as statins.
Warning
Never change your diet without consulting your nephrologist. Even seemingly healthy changes such as eating a heart-healthy, low-cholesterol diet can cause problems if potassium levels are high as well. Under these circumstances, you need to discuss exactly what you are eating to replace the high cholesterol foods you used to eat.
References
- National Kidney Foundation: Chronic Kidney Disease
- National Institute for Diabetes and Digestive and Kidney Diseases; Proteinuria; March 2009
- Healthcommunities.com; Nephrotic Syndrome Overview, Signs & Symptoms, Causes; May 2001
- National Kidney Foundation: KDOQI Clinical Practice Guidelines for Cardiovascular Disease in Dialysis Patients
