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Keeping Your Labs In Check

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!

Comments

  1. Karen says:

    I have enjoyed reading the above. How do I keep my Creatinine levels in check? and what is creatinine? From what foods do we get it from? Karen

    1. Kelly Welsh says:

      Hi Karen! Creatinine is a waste product of muscle metabolism. if the kidneys are impaired, for whatever reason, the Creatinine level in the blood will rise due to poor clearance by the kidneys. Unfortunately, this is the normal progression of kidney disease. Creatinine can rise with high levels of protein intake. You may need to follow a modified-protein diet. Make sure you check with your doctor as to your specific needs. You should also make sure to drink plenty of water, as your fluid restriction allows, if on one. Those persons in a dehydrated state can exhibit falsely high creatinine levels on your lab results. So watch protein intake, do not eliminate protein, and make sure you are drinking enough fluids. Hope this helps!

      Kelly

  2. Jeannette says:

    Kelly, thank you for your question, it has been one of mine every year when I go into the kidney dr for a check up. Although he answers, I forget by next year.

    Thankyou Karen for explaining this stuff where it makes sense.

    I have a question and I don’t know if this is the right area for it, but thought would ask: I have been told that cysts are fluid filled and burst every once in awhile. Every once in awhile I get horific back/kidney pain and there is blood in my urine. The K dr says that a cyst has burst, a former primary care dr said it was probably a kidney stone. This only happened to me 3 maybe 4 times in 12 years and I’m mid range on the kidney disease scale, I think I’m a 4. I’m wondering what this is and if diet might be able to control it? Jeannette

    1. Steve says:

      Jeanette — Never mind what that former PCP said, those were clearly cyst ruptures. I don’t know of specific ways to avoid cyst ruptures, but I’d recommend making sure you’re getting enough fiber in your diet to keep things moving easily through your gut, and avoid activities or movements that could physical trauma to the kidney areas. Unfortunately, some movements that may not have caused a cyst to rupture years before might do so as the kidneys get bigger.

  3. Kelly Welsh says:

    Hi Jeannette!

    Probably best to rely on your nephrologist here. In reality, the only way to truly know what it is/was, is to have a procedure that looks at your insides. It probably could be either. Either way, unfortunately, without knowing exactly what it is makes it hard to recommend dietary advice. If kidney stones, are the culprit, in order to make proper dietary recommendations I would have to know what the kidney stone is made of. If it is a cyst bursting, I would recommend looking at what you were doing prior to the incident. I’m guessing that you were not out playing tackle football or anything. But, PKD patients with discomfort caused by growing cysts, really need to be careful as to the physical activities that they participate in. Keeping the blood pressure down to through diet is the best recommendation that I have in trying to slow down the progression of the disease.

    Hope this helps! Stay well! Kelly

  4. Suzan V says:

    My level’ of creatine were up to 4.6 then down to 2.54and up to 3.9 all becasue of my diet – I have found that eating fresh berrie’s is great – I have not even taken any pain med’s for almost 6 month’s because of the fruit – but will be checked in a month or so to how thing’s r ging and I v the Blog’s you very much!!!!oh nd no salt no red me!!! no milk or egg’s al healthy food for pkd diet

  5. Kelly says:

    Thank you Suzan for your input! The very best of health to you!

    Kelly

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