While diet won't prevent or cure kidney disease, it is an effective way to control some of the symptoms of renal failure and possibly slow disease progression. However, instead of grasping for a dietary approach for renal tubular acidosis, patients and doctors first need to evaluate the problem in terms of the patient's overall health status, especially if the patient is on dialysis.
Renal Tubular Acidosis
Renal tubular acidosis, or RTA, means that the kidneys are not removing acidic substances from the blood, resulting in more acidic blood. RTA is secondary to diseases that attack the tubules of the nephrons in the kidneys, such as Sjögren's syndrome and lupus. The National Institute of Diabetes and Digestive and Kidney Diseases explains that RTA can also be secondary to sickle cell anemia, hyperparathyroidism, hyperthyroidism, chronic active hepatitis, primary biliary cirrhosis, a hereditary form of deafness, analgesic nephropathy, rejection of a transplanted kidney, renal medullary cystic disease and various kidney diseases.
Treatment
Patients with RTA are treated with alkaline medications containing sodium bicarbonate and potassium citrate. These medications do not help the kidneys work better, but they work directly on the blood and increase the pH, making it more basic. In some instances, thiazide diuretics are also used, especially if the patient does not have low serum potassium levels. Calcium and vitamin D supplements may be used to prevent bone problems caused by RTA, especially in children.
Diet
Since RTA is associated with so many different diseases, there is no one particular diet to treat it. You might think that the solution to RTA would be eating more alkaline foods, but this could be dangerous for many people. For example, alternative practitioners claim that foods like tomatoes, broccoli and bananas are "alkalinizing." Regardless of their acidic or basic properties, these foods are very high in potassium. Since patients with advanced kidney disease often have high potassium levels, such foods could easily lead to irregular heartbeats or even heart attacks if they caused the patient's potassium levels to soar.
Basis for Recommendations
Nephrologists recommend dietary changes and supplements based upon the patient's lab results and blood pressure. Serum potassium, phosphorus and urine protein levels are particularly important in determining what foods should be avoided. Patients should never start taking calcium and vitamin D without consulting their nephrologists because these seemingly innocuous supplements are inappropriate for some kidney patients. Ask your doctor if dietary changes are necessary or if a consultation with a renal dietitian would be helpful.
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