It affects about 10% of the adult population in the world, 7% in Italy with 4.5 million patients, about half with renal insufficiency, i.e. with middle or advanced stage disease. It is chronic kidney disease, a set of pathologies that evolve over time and which in common have a progressive reduction in renal function, that is, the ability to filter and purify the blood: and the more renal function decreases, the more dialysis or transplantation is it approaches. “It is growing all over the world, due to the aging of the population and the increase of other chronic diseases, such as diabetes, hypertension, obesity and heart disease, which in turn cause kidney disease or its worsening. But with a correct lifestyle and a healthy diet, kidney disease can be prevented, or if it already exists, slow down “, he explains Vincenzo Bellizzinephrologist at the San Giovanni di Dio and Ruggi d’Aragona Hospital in Salerno and vice president of Ern (European Renal Nutrition Working Group of Era, the European Renal Association), and author of a study that measured the effect, in terms of survival and expenditure for the national health system, of an ad hoc diet for those who are already affected by the disease.
Kidney disease, it is severe. It is also unknown
by Simone Valesini
Prevention
But let’s start with prevention, of which nutrition is one of the essential elements to preserve and keep the kidneys healthy. “We should all consume at least 5 servings of fresh fruit and / or vegetables every day, possibly using seasonal products. If this goal were achieved, we would automatically reduce both preservatives such as phosphorus, which is a kidney killer, and proteins”, resumes the nephrologist. Consuming proteins in excess and for long periods of time can alter the blood flows in the renal glomeruli (the balls of arterial capillaries that filter the blood, ed) ending up damaging them over time. “Assuming even 280 grams of protein per day – says Bellizzi – means experiencing an impairment of renal function over time”.
We eat too much protein
The right amount of protein is between 0.8 and 1.2 grams per pound of body, and not just for kidney health but for health in general. Which means that a 75-pound person should be getting between 60 and 90 grams of protein, both animal and plant, per day. “But the vegetable ones contain less phosphorus than the animal ones and moreover the ‘vegetable’ phosphorus is less absorbable by the intestine – says Bellizzi-. So yes to fresh fruit and vegetables and all the proteins, as is then required by the Mediterranean diet, but increasing the share is those of vegetable origin, which are mainly in legumes: lentils, beans, peas, chickpeas and soy “.
Follow the sense of thirst
Drink abundantly throughout the day and always follow the sense of thirst, that is, do not limit yourself or postpone the intake of water, perhaps because we are unable to disconnect from work. Here, this is a general principle valid for everyone. “In the case of severe renal insufficiency, however, the ability to eliminate water is gradually lost. In these cases the doctor may indicate a restriction on the consumption of water, but it is clear that we are talking about renal disease in a very advanced stage”.
To prevent stroke, check (also) your kidneys
by Federico Mereta
Treating with nutrition: the study
But if there is a diet to safeguard kidney health, there is also one for those who are already ill, which can slow down the course of their disease and delay dialysis or transplantation as much as possible. “In this case – is Bellizzi’s consideration – we are not talking about diet, or correct nutrition, but about nutritional therapy, which, just like a cure, must be checked by specialists”. And in a study, of which Bellizzi is the author, the impact of a low-protein nutritional treatment, about 0.6 grams per kilo of weight or even less, on chronic kidney disease, in terms of expenditure and survival, was analyzed.
Dialysis delayed by 20 months
“We analyzed 60 patients adhering to a low-protein diet by comparing them with a control group of over 120 men and women with the same characteristics who had not been prescribed any diet. The initiation of dialysis and the survival of all were evaluated and they are The costs related to all therapies and health care were analyzed for more than 5 years “, explains Bellizzi. The result? The low protein diet in advanced kidney disease delayed the initiation of dialysis by 20 months, and improved patient survival by 20 months. “And it has produced a considerable gain of life and quality of life for those who are sick, and also savings for the health system. We have calculated – concludes the doctor – that if only 20% of new patients who enter dialysis every year in Italy followed a low-protein diet, the NHS would save over 60 million euros a year “.
Covid, the kidneys are also a target organ
by Letizia Gabaglio
