I have labs drawn every 3 months. What should I be looking at nutritionally and how can I keep these labs where they should be?
Okay, it’s time for me to put on my lab coat to speak seriously to you about a very important topic: your lab results!
How many of you ask for copies of your lab results when visiting your doctors? How many of you know what your lab results mean? How many of you can adjust your diet according to your lab results? Your lab results are the key to balancing your kidney diet. By knowing what they mean, you can translate the results into what foods and vitamins and minerals your body needs.
Just when you think you’ve mastered your eating plan to produce perfect lab results, things change. It could be seasonal food items. At least ½ of my patients will experience higher potassium levels in August (when tomatoes are in season). In December, phosphorus levels are much higher due to the holiday food items consumed. These fluctuations are expected, but knowing how to recover from fluctuations is key. Another cause for a change in lab results is changing kidney function. As kidney function declines, your kidneys are unable to effectively remove potassium, phosphorus, fluid and waste products. As these levels rise, you’ll have to become more restrictive with your dietary intake. If dialysis is initiated, lab results will change again.
So what nutrition labs should you be paying attention to?
Albumin is an important indicator of nutrition status. Many kidney patients face problems with poor appetite/intake, nausea/vomiting, etc. Albumin can tell you if you are eating enough protein. When low, you leave your body susceptible to things like low energy levels, fatigue, colds, flu’s and other viruses and infections. We also know that the lower the albumin level, the higher the mortality rate. Albumin levels should be >3.8 mg/dl.
Potassium is a mineral found in many foods that you eat. It helps keep your heart beating regular and your muscles working right. Out-of-range levels are very dangerous. You may feel some weakness, numbness and/or tingling if potassium is out-of-range. Potassium levels high or low can cause an irregular heartbeat or even death. Potassium levels should be between 3.5-5.0 mg/dl.
Phosphorus combines with calcium in the body to keep your bones strong. Phosphorus is found in almost every single food that we eat. When kidneys are working normally, they remove excess phosphorus. As kidney function declines, phosphorus builds up in the body. It can cause itching in the short-term and weak bones in the long run. Your physician may ask you to take a phosphate binder with meals, such as, Tums, Phoslo, Renagel and/or Fosrenal. This medication, when eaten with food, will help to lower phosphorus levels in the body; therefore, warding off itching and weak bones. Phosphorus levels should be maintained between 3.5-5.0 mg/dl.
Calcium is the most abundant mineral found in the body. Kidney disease causes an imbalance in bone metabolism. These imbalances can cause calcium to be deposited in the blood vessels and contribute to heart disease. Do not take calcium supplements unless instructed to by your doctor. Calcium levels should be between 8.4-10.2 mg/dl.
Parathyroid Hormone (PTH) is a hormone secreted by your parathyroid. Too much PTH can cause your bones to become weak and to break easily. Your doctor may prescribe activated Vitamin D to help increase calcium absorption from the gut. Increased absorption of calcium from the gut means less calcium pulled from the bones and less PTH showing up in the bloodstream. Target levels for “intact” PTH should be between 35-300 pg/ml, with fluctuations pending the stage of CKD that you are int.
Nutrition lab results are the single most important key to monitoring your nutrition status. Be assertive! Know your labs, watch their trends and alter your diet accordingly!