The Chronic Kidney Disease Solution - Blue Heron Health News

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The Chronic Kidney Disease Solution

By: Shelly Manning

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Introduction

Welcome dear reader!

I wrote this book because in my long years of clinical practice, the people that always celebrated the most

when they started feeling improvement in their conditions were the ones who managed to improve their

kidney functioning.

Chronic Kidney Disease (CKD) is, truly, one of the most difficult conditions to heal from - particularly if

you just stick to conventional methods. Not only is it tough to heal from, it is demanding to suffer from

too.

The good news is that if you have determination and follow the guidance in this book, then you will

naturally receive all the chances that you need to heal. With those chances comes the very real possibility

of spectacular success.

You see, what often happens to kidney patients is that they lose faith in their bodies to some degree

because with the failing of one’s kidneys arises a deep distrust of the body as being a reliable home for

your journey through life. The analogy of ‘being at home’ in your own body is perfect for CKD because

healing from CKD is like finally returning to your relaxed, healthy, and vibrant original home. The

celebration of my successful CKD patients over the years has struck me time and again as clear proof of

this fact.

So, what will you find in this book?

This book will present the best-known methods for managing or treating kidney disease. In order to

present those methods in the best way possible I have structured the book into five chapters.

In Chapter one you will find a clear discussion of just what CKD is, how it comes about, what doctors do

to diagnose it, and what they try to do about it. Most importantly, in chapter one I have described exactly

what the causes of CKD are thought to be in conventional models of CKD.

In chapter two, I show that the conventionally acknowledged causes of CKD are actually all related in

some way to chronic inflammation and tissue damage. This leads on to a discussion of the remarkable

qualities of the gut microbiome and the way it can either contribute to increasing that inflammation, or

decreasing it, depending on your day to day lifestyle choices.

In chapter three I describe the powerful effects your lifestyle choices can have on your kidney health and I

show by example the kinds of things that can really help to treat CKD via these mechanisms. Chapter 3

starts off with discussing things about diet and moves on to other interesting topics like stress, sleeping

well, and exercise – should you exercise? That’s a damn good question!

Chapter four is where I share all the latest information on the power of the natural tools you can use to

treat your CKD. By natural tools I mean supplements, vitamins, minerals, foods, fruits, nuts, herbal

INTRODUCTION

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preparations, exotic spices…you name it, if it can be used for CKD, and it’s safe, easy to get, inexpensive

and yet also super effective…then you’ll find it in Chapter Four.

In chapter Five I have taken all the info from Chapters one through four and created a practical three stage

treatment plan that tells you precisely what to do to heal. The treatment protocol includes everything from

foods to avoid, foods to eat, custom recommendations on supplements, exercise guidance, stress reduction

strategies, a dietary skeleton for a meal plan, and more.

This final chapter could be read first by those of you who don’t like to wade too deeply into information

about how CKD works, or how the natural tools actually work to help you. For those of you who want to

simply jump to the “what should I do” part of this book, then I recommend skipping to chapter five and

beginning there.

But having said that, I feel I must point out that this book has been written to be accurate and readable.

Nothing is dumbed down, but nothing is too complicated for the average educated reader either. Only the

most essential, most important points needed to have a good practical understanding of how to treat your

CKD are given – enough to understand, but not so much that you would feel like you were attending

some complex conference lecture on an obscure academic topic. I have tried in all cases to keep jargon to

the absolute minimum – just enough to give you a good command of the subject matter.

But what is the best way to make the most out of this book and really heal?

I would say the best way to read this book is in order. Each chapter introduces something new, and later

chapters build on concepts and information presented in earlier chapters. The book really shines when it is

read in order because the book as a whole is one single sustained narrative argument that presents what I

feel is the absolute best way to treat CKD according to my research and experience. So, if you read the

book in this way, then you will not only be able to take the advice I give you in the end, but you will also

understand why that advice is actually going to work to heal or manage your CKD.

My sincere wish is that those of you out there reading this may find some benefit from this work. Such

benefit that your husbands, wives, lovers, children, close precious friends, and cherished acquaintances

may one day get to celebrate your renewed health along with you.

All the best of success with your health and happiness,

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Contents

Introduction iv

Chapter One The “What”, the “Who”, & the “How” of CKD 1

What is Chronic Kidney Disease? 2

What causes it? Who gets it? 3

What puts me at risk of getting CKD? 4

The Pathogenesis of CKD 6

Diagnosis & the Stages of CKD 7

Conventional Prevention Strategies, Typical Treatment, & Advice 10

4 Kinds of Advice Given to People with, or at risk for CKD 11

Common Conventional Treatment/Management Strategies for CKD 13

A Few Questions: Deeper Causes, for the Causes? 15

What Should You Know From Chapter One? 17

The Key Points… 18

Chapter Two “…I Get by with a little help from my (little) friends…” 20

Chronic Inflammation & the Microbiome 20

Inflammation, what is it? 21

Heart Disease & Diabetes Linked Inflammation 22

The Bottom Line for Inflammation & CKD 36

What is the Microbiome? 36

Important General Features of the Microbiome 37

The Development of the Microbiome 39

CKD & The Microbiome 40

Chapter Three Lifestyle Perspectives for Healing CKD 43

Stress & Sleep 43

Methods & Tools to get Good Sleep & Live Stress-Free 46

Probiotics & the Microbiome Can Help With Stress 49

Reducing Stress and Improving Sleep with Behavioral Methods 50

Let Food be your Medicine 56

Special Prebiotics for CKD 62

Chapter Four The Tools to take us Home 65

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Natural Supplements for CKD 67

Dietary Foods/Drinks Having Potent Properties to Combat CKD 76

Other Tools 82

A Stem Cell Treatment Tool to Regenerate Kidney Tissues from Supposedly Irreversible Damage! 85

Chapter Five The Rainbow Renal Lifestyle Protocol to Reverse CKD 89

Goals to Achieve Healthy Kidneys for Life 90

The Rainbow Renal CKD Program 90

Appendix 01 The Rainbow Renal Diet Program - Phase 1 95

Phase 1 - Prevent Kidney Decline - Stabilize Your GFR 95

What to do – From Theory to Action 96

Assessment 96

Suggested Supplementation Protocol 97

Lower Blood Pressure Support Smoothie 98


Phase 2 - Restore Kidney Function - Improve Your GFR 99


Assessment 101

Suggested Supplementation Protocol 102

Nobesity Smoothie 103


Phase 3 - Repair and Renew Kidney Tissue - Normal GFR 104


Assessment 107

Suggested Golden Nugget Supplementation Protocol 108

Appendix 04 Rainbow Renal Diet - FAQ 109

Is a low-potassium diet important when you have kidney disease? 109

Appendix 05 The Best Foods for CKD 119

Appendix 06 The Big No-No’s – Avoid These 122

Appendix 07 Acid & Alkaline Foods 123

Alkaline Foods – (Good Options) 123

Acidic Foods – (Bad Options) 125

Appendix 08 - The Glycemic Index 127

LOW GLYCEMIC INDEX (< 55) 128

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MEDIUM GLYCEMIC INDEX (From 56 to 69) 132

HIGH GLYCEMIC INDEX (≥ 70) 133

Appendix 09 A Seven Day Example Meal Plan for Renal Rainbow Diet 137

Shopping List Ideas 141

Appendix 10 - Prebiotic Guidance 143

Appendix 11 A List of Sugars Added to Foods That Should Be Avoided 147

Appendix 12 Supplementation Safety Guide 148

Supplement Safety Guidelines 149

References 153

BlueHeronHealthNews.com 1

Chapter One

The “What”, the “Who”, & the “How” of CKD

Before we start on the nitty-gritty, I would just like to say a few things to help prepare the way for what is

to come and where I want to go in this chapter.

Please keep in mind that chronic kidney disease is pretty clearly defined and understood in the context of

clinical medical practice. This means that for those of you who have been given a formal medical

diagnosis of CKD, it is important to understand what that formal diagnosis means, how it was done, and

what that means about the state of your body.

In a sense, because of clear definitions of CKD, and established causes of CKD in the traditional medical

approach, we can be pretty sure about what is happening in your body should you have a diagnosis. But,

what is not addressed very well by the traditional conventional medical understanding of CKD, at least in

my opinion, is a clear explanation and description of what underlies all the so-called causes of CKD.

So, knowing the above, I feel it would be best if I start this section by describing the conventional picture

of CKD fully so that you get a clear picture of how doctors see the disease and what they say is actually

wrong. This means you will know what CKD is, what is wrong in your body if you have CKD, who gets

CKD, what the medically acknowledged causes are for CKD, how CKD progresses, what puts you at

higher risk for getting CKD, how it is conventionally treated, and what are your chances of reversing

kidney disease - All of that according to the current standard conventional biomedical practice of western

medicine.

As you will see later, in order to be successful at managing or even reversing your kidney disease it will

be necessary for you to have a more expanded understanding of the causes of CKD than what is currently

defined in modern western biomedical practice.

This does not mean that you need to have a more complicated understanding. In fact, a more expanded

understanding of CKD actually requires us to see CKD more simply – in terms of deep underlying causes.

The basic concept for healing from ANYTHING is simple, “in order to heal from a condition or disease,

simply remove the underlying causes of that condition or disease”. So you need to understand what

causes CKD in order to treat CKD.

That is why I have described some of the possible deeper causes of CKD in the latter part of this chapter

after first sharing the clearly defined bio-medical approach to CKD. When we extend our understanding

of the causes of CKD by just a tiny little bit (compared to the established descriptions of CKD) then it

becomes possible, in principle, to treat it.

So, in this vein, I will revisit earlier sections of this chapter in later sections to uncover a more useful

understanding of the causes of CKD so that you can have a chance to successfully treat it. It turns out that

the expanded understanding of the causes of CKD is actually a whole lot simpler than the conventionally

acknowledged causes of CKD –what remains is to present the evidence that supports a new understanding

and then I can show the powerful methods you can use to heal your kidneys and restore their functioning.

Chapter One - The “What”, the “Who”, & the “How” of CKD

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With that said, let’s dive into the ‘what, who, & how’ of CKD so that you can understand what you can

do about it, and why what you do about it will work.

What is Chronic Kidney Disease?

Chronic kidney disease is a term for any number of conditions that consistently and negatively affect the

way your kidneys function. In fact, the term is used whenever someone has a long term decline in the

functioning of their kidneys without any improvement. Chronic kidney disease is also sometimes called

chronic kidney failure, which is the same thing, just a slight difference in name.

The term ‘chronic’ means that the condition is long-term and may not go away, the remainder of the term,

i.e. “kidney disease” just means that the kidneys aren’t functioning properly –the dysfunction is serious

enough that doctors would classify the kidneys as seriously under-functioning.

The kidneys are two very important organs in the body that are critical for life. Their main role is to filter

waste products out of the blood by passing these waste products into urine so that they can be eliminated

from the body. Another equally important role that the kidneys play in maintaining optimal conditions in

the body is to balance our body fluids and dissolved ions (electrolytes). This means that if your kidneys

are working properly you’ll have just the right amount of water and electrolytes for optimum health. If

they’re not functioning properly, as in the case of CKD patients, then many different serious problems can

arise – one such problem related to fluid balance is water retention, which can cause swelling in the joints

and limbs (often of the feet and ankles).1 2

So, when CKD progresses to late stages then fluids and waste products can build up to dangerous levels,

leading to horrible symptoms or even death. 3 4

The amazing thing about the kidneys is that they are extremely resilient. They can adapt to just about any

day-to-day offense perfectly. To prove my point, just consider how people can actually donate a whole

kidney and still be completely fine.

This means that the kidneys are extremely good at adapting to obnoxious stressors to their functioning.

This is great news, of course, but it comes with an unfortunate price. The problem with the kidneys being

so resilient is that by the time you do start showing even only the slightest of symptoms it is likely that

your kidneys are already very far down the path of degeneration. 5 6

Basically, CKD is initially silent in onset - without any noticeable symptoms. But, after a time symptoms

will begin to show; sometimes years after degeneration began. This is why it can be beneficial to

occasionally test your kidney functioning to catch any problems before they advance too far. Catching

kidney problems early will always improve your chances of successful management or intervention.

The fact that CKD is silent in onset and can be present, yet undetected for years also makes it hard to pin

down accurate numbers for how many people suffer from the disease globally. In addition to being

difficult to detect early, it is only relatively recently, in the year 2002, that a standard definition was given

for CKD. This meant that any prevalence studies prior to 2002 might have been measuring what were

essentially different disorders under the same name, so the numbers were hard to pin down for this reason

too. In any event, at least 29 million Americans were believed to be suffering from CKD in 2009 and it



was noted then that the elderly were particularly at risk.7 More recent estimates from a large meta-review

done in 20168 have estimated that between 11-15% of the global population suffers from some form of

CKD at any one time. The majority of people suffering from CKD (90% or more) tend to be in stage 3 of

the disease (I will describe the formal stages of CKD later in this chapter).

The current conventional medical view on CKD is that it is irreversible from a certain stage onwards and

that it is tightly linked to heart conditions, obesity, and diabetes. In fact, according to research, almost all

people with CKD die due to some cardiovascular-related event – cardiovascular disease remains the

primary cause of death in CKD cases which shows that the links between CKD and heart health are

extremely strong indeed.9 Other indications of CKD and its links to cardiovascular disease include the

fact that the better your kidneys are working, the less likely you are to suffer any form of cardiovascular

disease. In other words, having happy kidneys actually protects you from heart disease.10

What causes it? Who gets it?

Any number of different diseases and conditions can cause, or lead to problems with kidney functioning.

The most common cause of kidney disease globally is diabetes, with the second most common cause

being high blood pressure. Apart from diabetes and high blood pressure, the third most common cause

amongst many others, is inflammation of the kidney, particularly when that inflammation occurs in the

functional units of the kidney.

The functional units of the kidney are called ‘nephrons’ because each nephron within the kidney is

capable, on its own, to produce urine. Some of the most important structures in each nephron are tiny

little blood vessels, or capillaries, called ‘glomeruli’ (‘glomerulus’ = singular). This is why the third most

common known cause of CKD is called “Glomerulonephritis”, a formal medical name which literally

means, ‘inflammation in the glomeruli of the nephron’ (“-itis” = inflammation; “glomerulo” = to do with

the blood vessels called the glomeruli; “nephr-“ = from “nephron” meaning “ to do with the kidneys”).

So, just to recap, the three main causes of chronic kidney disease include diabetes, high blood pressure,

and glomerulonephritis. In fact, for people who have diagnosed kidney disease, one third (over 30%) of

them got it from diabetes, one in five (over 20%) from high blood pressure. The remaining roughly 50%

of people with CKD are made up of those who got it from inflammation, some other rare cause, or from

some unknown cause. 11 Astonishingly, one study found that at least 35% of all CKD cases in young

children were due to unknown causes (i.e. idiopathic cases) which is a significant percentage albeit of a

small group of CKD as a whole since the vast majority of CKD cases happen in the elderly and not in

children. 12

In conventional western medical practice, chronic kidney disease is narrowly defined as, “any condition

in the body that results in a persistent decline in the ability of the kidneys to function properly” –

particularly with regard to the ability of the kidneys to filter the blood. So, according to this definition,

CKD isn’t a name for a single particular disease or condition on its own. Instead, you should understand

the term CKD as meaning, “Your kidneys aren’t functioning at proper levels…due to some cause”. From

the conventional western biomedical point of view, chronic kidney disease is not really a disease of the

kidney/s but more a symptom of some other cause (e.g. some other disease or condition). 13 14 15



The above might seem a little pedantic, or perhaps even obscure, but I will be revisiting the causes of

CKD a bit later in this chapter and when I do that this point will become more important. For now, it is

important to know what the most common conventional causes of CKD are acknowledged to be in terms

of standard medical practice and theory.

Later on, I will attempt to show that the causes of CKD are deeper (and simpler) than the standard

explanations and that taking a deeper view will allow people to be more successful when they treat or

prevent CKD than would otherwise be the case under the restrictions of a narrow definition of CKD.

The most common causes of CKD are usually acknowledged to be: 16 17 18 19

• Diabetes

• Hypertension (High Blood Pressure)

• Inflammation in the kidneys of two types:

o 1st type - Inflammation of the kidney’s filtration units (called collectively “glomeruli” or

“glomerulus” in the singular). The technical term for this kind of inflammation is,

“glomerulonephritis”.

o 2nd type - Inflammation of the kidney's tiny tubes (called tubules) and their surrounding

tissues. This particular inflammation is called interstitial nephritis (from the word,

“interstitial”, meaning, “related to small spaces between tissues or parts of organs”, and

“nephritis” which means inflammation (‘-itis’) related to the kidneys (‘nephr-‘; from the

word “nephron” which means “kidney, or related to the kidney”).

• Polycystic kidney disease (a disease where the kidneys develop cyst-like growths)

• Things that block the urinary tract preventing easy or regular urination. Examples include kidney

stones or an enlarged prostate such as is seen in prostate cancer.

• A condition called “Vesicoureteral reflux” where urine backs up into the kidneys.

• Infections that keep recurring in the kidney (pyelonephritis)

Ok, so that’s a lot of different conditions that can damage your kidneys and impair their functioning. The

most important causes to remember are listed first, viz. Diabetes and Hypertension. Diabetes accounts for

at least one in three cases of CKD (!), while hypertension accounts for at least one in five cases.

The other causes listed are relatively rare (very much rarer). A good percentage of cases are also

acknowledged to be “idiopathic”, which is just a fancy way of saying that the CKD occurred without a

known cause. 20

What puts me at risk of getting CKD?

In medical terminology what are called ‘risk factors’ are those factors that put people at increased risk of

getting a certain condition. This means that when people have one or more CKD ‘risk factors’ present in

their lives they will have a statistically predictable increased chance of developing CKD for each factor

present. Each factor can increase your chances of getting CKD by some percentage compared to people

who don’t have that risk factor, and each risk factor can contribute to your risks to a different degree.



We don’t really need to memorize the exact percentages that each risk factor for CKD contributes. We

only have to know what puts people at greater risk, what the main risk factors are (the greatest increased

risks), and what is common between the biggest contributing factors.

In order of importance (largest risks to smallest risks) the most common risk factors for CKD include: 21 22

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• Diabetes

• Hypertension (high blood pressure)

• Problems with the heart, veins, and arteries (i.e. cardiovascular disease [CVD], or heart disease)

• Smoking (more is worse)

• Extreme weight (more is worse, e.g. Obesity)

• Having other members of your family who developed CKD.

• Being born with, or developing an unusual kidney structure.

• Age* (The older you are the higher your risk)

o 13% of all CKD patients are in their 30’s

o 12% of all CKD patients are in their 40’s

o 15% of CKD patients are 50-59 years old

o 27% are between 60-69 years

o A staggering 33% of cases occur in people 70 years of age or older.

*Notice that a full 75% of cases occur in people 50 years or older.

Notice that diabetes and hypertension are considered to be both causes and risk factors. This is because

not everyone with diabetes gets CKD, but if you have diabetes, then you have a much higher chance of

developing kidney disease, and one third of all CKD cases happen because diabetes caused it – the same

can be said for hypertension just that one in five people with CKD got CKD as a result of their

hypertension.

Researchers have also pointed out that people in certain population groups seem to get CKD more often

than people in other population groups. For example, being of ‘African-American’ or ‘Native American’

descent will likely raise your chances of developing CKD. While this observation is true ‘by-the-

numbers’ and cannot be factually be denied, it does not really reveal why members of these groups seem

to be more vulnerable. It isn’t clear from these statements as to the reasons for these groups having higher

rates of CKD than other groups, whether because of inherited genetic factors, or because of habitual

cultural practices with regard to diet, lifestyle, or both.

The one benefit of knowing that members of certain population groups are more likely to develop CKD is

that it does help those people to be more aware and cautious with regard to CKD – perhaps leading to an

increased vigilance for the telltale signs of CKD leading to early detection; or simply to encourage

making extra efforts to preemptively prevent CKD by living a lifestyle that completely reduces one’s

chances of developing CKD.

Ok, so to recap what we have looked at so far, the main causes of CKD (conventionally speaking) are

other diseases or conditions, particularly diabetes and high blood pressure, or some unknown cause.

Furthermore, some of those same causes are also the biggest risk factors (e.g. diabetes and high blood

pressure). Other important risk factors include obesity, age, smoking, and heart or blood vessel disease.



What comes next is a description of the kinds of problems that can happen when people get CKD and it

progresses. The technical term that refers to how a disease or condition progresses, along with a

description of symptoms and complications is, “pathogenesis” - the next section deals with the

pathogenesis of CKD should you be unlucky enough to have it.

The Pathogenesis of CKD

The functions of the kidney are to balance fluids and electrolytes, as well as purifying the blood from

waste products by filtering them into the urine. When people’s kidneys go out of whack then the

symptoms or complications tend to be related to these functions. The most common symptoms can

include: 25

• Swelling because of retaining fluids (especially of the ankles, feet, arms, or legs). This happens

because the kidneys don’t balance the fluids in the body correctly. Fluid retention can also happen

around the heart and/or lungs. In these cases, people might feel pain in these areas. Fluid retention

usually raises blood pressure because of the increased fluid volume in the blood vessels.

• Disruptions in electrolyte balance can cause certain electrolyte levels to spike. A good example is

potassium. People with CKD can sometimes register huge spikes in their blood potassium levels

(a condition known as “hyperkalemia”). Hyperkalemia can be extremely dangerous, even life-

threatening because excessively high potassium levels can interfere with the way the heart and

muscles work – heart attacks would become very likely.

• Some form of disease related to the heart, arteries, and veins. (so-called ‘cardiovascular disease’

or CVD for short)

• A much higher chance of fracturing bones – i.e. weak bones.

• Low levels of red blood cells (leading to anemia).

• A Noticeable drop in desire for sex, problems getting and maintaining an erection, and even

reduced fertility.

• Certain damage to the brain and nerves, or impairment in the functioning of nerves which can

result in having difficulty concentrating, thinking clearly, personality change, seizures, and other

nasty effects.

• Poor immune system functioning can result from poor kidney functioning. This makes people

with CKD much more vulnerable to infection generally. Specifically speaking, this vulnerability

is most dangerous when infections are more likely to happen in the urinary system or urinary

tract. Urinary infections would feedback into the kidney’s functioning constituting a ‘double

whammy’ and a downward spiral of degenerating health and horrible symptoms.

• Sometimes people with CKD can get inflammation in and around the heart. This kind of

inflammation usually happens in a thin membrane that surrounds the heart (called the

pericardium) leading to a condition known as “pericarditis”.

• Women who are pregnant can have temporary changes happen in the way their kidneys function.

Most of these changes are completely normal and expected, but if the kidneys start

malfunctioning in an extreme way, or in a way that constitutes a diagnosis of CKD, then the

situation can be very dangerous for both the mother and the developing unborn child. Pregnant



women who have CKD are much more likely to die, or miscarriage, or have irregular fetal

development.

If CKD is left unchecked with all its symptoms and complications being allowed to ravage the body, then

people may develop irreversible kidney damage and enter what is called “End-Stage-Renal-Disease”

(ESRD). 26

ESRD is considered to be the final stage of CKD. I will discuss the stages of CKD later on when I discuss

how CKD is actually diagnosed, right now we are just looking at the symptoms and progression of CKD.

Suffice it to say that stage-5 CKD is so far advanced, that the only conventional medical intervention left

for these patients is dialysis or a kidney transplant. At stage 5, the primary concern for patients is simply

to survive. Even so, it may be the case that stage 5 CKD patients can do something other than a transplant

and/or dialysis because advances in modern research and new insights into CKD are coming to light all

the time.

I will give my recommendations for CKD in the latter sections of this book which definitely provide great

strategies for preventing the disaster of a stage 5 outcome. Even at stage five, there may yet be effective

strategies on the horizon, and I will look at these later. However, before we can even get to the ‘good

stuff’ I do need to round out our understanding of CKD so that the powerful strategies I present later

make total sense to you. In the very next section, I continue with how CKD risks are reduced and with

how CKD is prevented using a conventional medical paradigm.

Diagnosis & the Stages of CKD

For those of you reading this who have already been diagnosed with CKD, you will have gone through

the process of diagnosis with your clinician already. Unfortunately, in most cases, clinicians don’t often

explain what they are doing and thinking when they examine their patients. So in this little section, I will

describe what typically happens over the course of diagnosis.

Diagnosing CKD can be a bit tricky because of the fact that it has non-specific symptoms. We mentioned

this earlier, but as a quick reminder, non-specific symptoms are symptoms that could be caused by a

whole range of different things. So, your doctor will have to do some detective work to come to a final

conclusion about whether or not you have CKD. In medical terms, the process is called “differential

diagnosis”. This is just a technical term for a process of figuring out what is wrong with people given

their symptoms.

Differential diagnosis starts with taking a history, a context, and works from there by observing

symptoms and coming up with a list of possible explanations for those symptoms. The list of explanations

will be in order from the most likely explanation to the least likely – the most common to the rarest. So,

for example, if you had flu-like symptoms and your medical history indicated that you rarely got ill and

lived a generally healthy lifestyle, then the first guess for your symptoms might be seasonal flu. Way,

waaay down on in the last place on that list might be some kind of extremely rare cancer.

Once a list of ‘suspects’ has been written down and ordered from most likely to least likely then the

clinician will start to try ruling out each one in turn until only one explanation is left. This is a process of

elimination and it helps to differentiate between possible causes of your symptoms. Because the process



differentiates between explanations it is called, “differential diagnosis” and it is the main method by

which clinicians in modern western medicine approach diagnosis.

So, the tricky part of CKD is to differentiate it as an explanation from other explanations. The way this is

done is usually through a combination of using your medical history, your age, population group, your

risk factors (and so on) to see how likely CKD might be. Then specific testing can be done to check on

the kidneys and see if they are functioning properly.

One key test to check the kidneys is to use a urine dipstick to test the urine for the presence of proteins as

well as comparing that to a blood test that checks for blood levels of proteins (specifically blood levels of

creatinine). The reason they look at blood creatinine levels is to see if your kidneys are suffering an acute

kind of damage (sudden rise in creatine) versus a chronic kind of degeneration (slow and gradual rises in

creatinine).

Your medical history is important because in many cases of CKD other diseases or conditions are seen

first like diabetes, high blood pressure, obesity, etc. The presence of long-standing risk factors along with

several symptoms that imply a problem with kidneys will alert your clinician to put CKD on the list of

things to check for. Unfortunately, there are many cases of CKD that happen without any prior diseases or

conditions and seem to simply come from ‘out-the-blue’ so blood protein tests and screening of the

kidneys function are usually the most direct and reliable way to confirm a diagnosis.

Screening

Clinicians will almost never screen for CKD unless you have symptoms or risk factors present. Just

blindly screening is not a practice that is helpful for CKD because kidney function can vary quite a lot

naturally and it would be impossible to conclude that you had chronic kidney problems without some

kind of symptom. [40][41] Usually it is patients who have high blood pressure, diabetes, or obesity that are

screened – some others may also be screened to in certain situations. 27 28

So what do they do when they screen for kidney problems? Since the kidneys' main job is to filter out

waste products, clinicians will measure how much filtering is happening. They will measure your

kidneys’ filtration rate of certain substances and compare those results to a statistical data set of what is

considered to be a normal range for your age, sex, and other factors.

In particular, clinicians will do tests and then use a little math to calculate your glomerular filtration rate

(the glomerulus is the part of the kidney that functionally does the filtration from blood to urine), which is

called the GFR. The GFR is an estimate of the actual filtration rate and from that estimate, they can tell

whether it is in an expected normal range or if it is out of whack. The GFR is a measurement that is linked

to how much creatinine you have in your blood. If your kidneys are working well, then there should be

less creatinine in your blood because they are effectively removing it. If your kidneys are not functioning

well then it might mean that your kidneys are not managing to filter it out properly.29

The GFR is also interpreted in combination with the testing of what’s in your urine. In particular, they

will check to see how much albumin (a very common biological protein) is in your urine. What they will

do is then compare the levels of albumin in the urine with the levels of creatinine in your blood and come

up with a ratio. This ratio is called the “albumin-creatinine-ratio” or ACR for short.30



So, to recap a bit for clarity, the GFR (glomerular filtration rate) is calculated from how much creatinine

you have in the blood. The more creatinine the worse your kidneys are filtering, and vice versa. Normal

GFR is usually between 90 – 120 mL/min. 31

So, your clinician would have taken your total medical history in combination with your current persistent

symptoms along with checking your blood and urine for certain compounds and then decided that the best

explanation for the total picture was CKD.

Once diagnosed, your doctor may then request an ultrasound to check on how the kidneys look.

Ultrasound is an imaging technique that uses sound waves to generate images of things under the surface

layers of the body. Most people are familiar with this technology because ultrasound is the tech used to

generate images of an unborn baby in a mother’s womb during pregnancy. High-frequency sound waves

are beamed into the body and when they bounce back at different speeds we can generate an image of the

surface that it bounced off. Your doctor won’t just order an ultrasound without knowing what to look for

because it is difficult to gather useful information from the grainy images without first knowing what you

are trying to find (or not find i.e. rule out of the picture.

Ultrasound is useful for clinicians to see where your kidneys might be damaged and then determine the

kind of damage that has occurred. This helps them to get more fine-grained information about why your

kidneys are degenerating and then how to help prevent further damage from happening. [43]

Sometimes other kinds of imaging techniques can be used in cases where a clinician wants to check the

blood flow to the kidneys and see if there are differences in the way one kidney is functioning compared

to the other one.

The Formal Stages of CKD Progression

So, how does a formal diagnosis actually happen, and what are the stages of the progression of

degeneration in the kidneys.

Your kidneys’ health is linked to how much work they do, or how much filtration they are effectively

managing to carry out. So, clinicians have decided to define the progression of CKD into phases where

your kidneys are managing to filter in certain ranges. In earlier stages the kidneys are filtering quite well,

so the range values for the GFR will be high compared to later stages where the kidneys have degenerated

somewhat and the GFR value ranges are lower.

Take a look at the following table to see how CKD is divided into 5 broad stages (1 – 5) according to the

filtration rate (GFR): 32 33

STAGE DESCRIPTION GFR (Estimated)

1 Normal ≥90 ml/min/1.73m2

2 Normal to Slightly low 60-89 ml/min/1.73m2

3 Low 30-59 ml/min/1.73m2

4 Severely Impaired 15-29 ml/min/1.73m2

5 Life Threatening (Almost total kidney failure) <15 ml/min/1.73m2



Nowadays there are actually more fine-grained details that get added to the table above. For example,

clinicians also divide stage 3 into two different sub-stages (stage 3a and stage 3b). Furthermore, having a

measure of GFR is usually not enough on its own to decide how healthy the kidneys actually are, that is

why clinicians also measure the albumin content of urine and then make a ratio of the albumin content to

the creatinine content in the blood. This ratio is called the ACR (the Albumin to Creatine Ratio), and it is

used in conjunction with the GFR to place patients into a formal stage of CKD. For our purposes, we

don’t have to overcomplicate the issue. Just know that ACR is also a factor and that is why we can be

classed into stage one CKD even though our GFR is in the super healthy range of ≥90.34 35

In fact, a GFR of ≥60 ml/min/1.73m2 (milliliters, per minute, per volume = filtration of a fluid measure) is

a completely normal healthy rate for kidneys that aren’t damaged in any way. It is only when there is a

high ACR value that we need to be concerned about having problems. High ACR values tend to show

kidney damage, and low filtration with high ACR values tend to indicate chronic kidney problems

(CKD). 36 37

To confirm kidney damage, specific signs must be found in the blood and urine, as well as confirmatory

results from imaging. Working with what I have presented so far, kidney damage/disease would be

confirmed if people have an ACR of more than 30. A GFR of <60 ml/min/1.732 for three months or more

always indicates CKD. 38 39

The other factor in the progression of CKD through its stages is the amount of protein in the urine. The

amount of total protein in the urine tends to predict the chance of the kidneys getting worse over time

independently from other factors. So measuring the amount of protein is useful for doctors to determine

how critical the state of kidney health is. 40 41

The final stage of CKD, stage five, is the ‘end of the line’ from the conventional standpoint. This is a very

severe state of degeneration for the kidneys and the body. This stage often leads to what is called “End-

stage-renal (kidney)-disease” or ESRD for short. The usual conventional medical recommendation for the

treatment or management of people in ESRD is to go on dialysis or to have a total kidney transplant. 42 43

Conventional Prevention Strategies, Typical Treatment, & Advice

To prevent CKD it makes sense to eliminate or reduce the things that put you at risk of getting CKD. This

means reducing the risk factors involved. What this means is that people with high blood pressure and

diabetes should probably take sensible extra precautions with regards to their kidney health.

So from the conventional perspective, the idea is to reduce the risk factors as much as possible and

provide whatever pharmaceutical means to achieve that. As can be seen from the statistics about CKD

incidence, conventional methods aren’t really having much of an impact on the increasing numbers of

CKD patients each year. Nevertheless, many of you who are reading this who have a diagnosis of

diabetes, high blood pressure, or even CKD, will have been told to take certain medications and make

certain lifestyle changes to prevent any kind of kidney disease.

Broadly speaking, there are four kinds of conventional advice usually given to prevent CKD as far as

possible in people who are at a high risk of developing CKD.



4 Kinds of Advice Given to People with, or at risk for CKD

#1 - Over the Counter Medications – Take Care!

Non-prescription drugs, also known as over-the-counter (OTC) drugs, are all too often thought of as

completely safe and harmless. The truth is that even though OTC drugs are readily available to anyone

who asks, they are still extremely powerful chemicals with potent medical and biological effects. If

people use them at all, then they must respect the power of these drugs and make sure to follow the

instructions for their use to the letter.

The OTC drugs that are most commonly misused, intentionally or unintentionally, are pain relievers. In

fact, OTC pain-relieving drugs are responsible for a staggering amount of serious health problems every

year through misuse - be it from ignorance of the correct usage, or an underestimation of the dangers

linked to their use. Commonly misused pain relievers include aspirin, ibuprofen, and acetaminophen (e.g.

Tylenol) to name just a few. 44

The main issue for CKD patients and OTC pain medications is that almost all such medications tend to

place huge pressure on the kidneys because of how they work. Putting our kidneys under stress to process

these OTC drugs is exactly what we do NOT want to do because for CKD patients the risks are so much

more dangerous than for the average person.

It is totally understandable that people turn to OTC drugs when they are in pain, especially if their pain is

chronic. Many people in pain, particularly chronic pain, can feel desperate to find relief and would rather

kill the pain than worry too much about the effects the drug may be having on their kidneys.

It is unfortunate that many people think that OTC drugs are harmless just because they’re available over

the counter. A good example of this error in thinking is when people use analgesic drugs (the most

common non-prescription OTC drugs). Analgesics should not be taken lightly. To prove my point, here is

a little factoid to raise your alarm bells with regard to the everyday use of acetaminophen (the most

commonly used analgesic pain reliever):

• In the United States, acetaminophen (the most commonly used analgesic) accounts for at least 15

000 hospitalizations every year due to unintentional overdose since 2008. Shockingly, in 2008

roughly 25 billion doses of acetaminophen were sold in the US alone.45

Since this drug is so widely used (and unintentionally misused) perhaps it might be a good idea to list

some precautions as to its use. I do not advocate using acetaminophen (or any other OTC analgesic) at all,

however, if you are currently using it, then consider the following guidelines; they are revealing of the

dangers of acetaminophen use.46

• Exceeding a maximum dose of 4 grams/day can be very dangerous. Many prescription pain

medications contain acetaminophen without it being obvious - which makes it pretty easy to make

a mistake and exceed this dosage.

• Acetaminophen trades under many different names (like APAP, and paracetamol and some

others) – this also makes it easy to mistakenly exceed the dosage.

• When used with other anti-inflammatory pain-relieving medications it can drastically increase

one’s risk of kidney cancer.



• Drinking alcohol and taking acetaminophen is dangerous and can result in liver damage and

massive toxicity.

The bottom line is that acetaminophen is a drug that should be taken with care, if at all. The mere fact that

it is available without a prescription over the counter does not mean that it is harmless. In general, the use

of analgesics puts extreme pressure on the liver and/or kidneys so people who are taking them to relieve

pain could aggressively supplement to help the liver out with its job of detoxifying the body. Some have

suggested milk thistle extract and NAC (N-acetyl-cysteine) as good supplements for this purpose.47 48

Aside from acetaminophen, two other commonly used OTC drugs include ibuprofen and naproxen (both

are anti-inflammatory drugs called “NSAIDs” – “non-steroidal anti-inflammatory drugs”). Both of these

drugs are associated with horrible side effects like bleeding in the gut, peptic ulcer disease, high blood

pressure, increased swelling (fluid-based retention called “edema”), kidney diseases(!!), and even heart

attacks.49 50 51

Aspirin (also classed as a type of “NSAID”) is very often used to relieve our minor aches and pains.

Aspirin is also often recommended in low doses for heart protection and stroke prevention. But, long term

use of aspirin comes with severe problems like increased bleeding (and hemorrhaging) as well as a host of

other extremely dangerous effects on the heart, liver, and kidneys. Taking aspirin with alcohol, or

alongside blood pressure medication, is especially dangerous.52 The so-called ‘mild’ side effects of aspirin

include heartburn, nausea, vomiting, stomach aches, ringing in the ears (tinnitus), hearing loss (!?), and

rashes on the skin – some of these side effects are the same as the common symptoms of CKD.53

We hope that people reading this can see that over the counter drugs used for pain relief come with

serious side effects and important guidelines for safe use. It is not the case that these drugs are ‘harmless’

or ‘safe’ just because they do not require a prescription. Although they do relieve pain, this ‘pain relief’

comes at the cost of damaging or impairing other body systems.

So, the bottom line for us fellow CKD patients is to avoid using them if at all possible, otherwise to be

super careful if there seems to be no other choice. Hopefully, if you follow the recommendations in this

book, you won’t need to use OTC medications that often, if at all. The reason why this would be the case

is that having a healthy and vibrant body (maintained by great lifestyle choices) tends to result in a

drastically reduced need to use medication. Basically, you won’t need the meds that often because you

won’t have ailments as often – that is part of what “being healthy” means.

#2 Weight

Maintain your healthy weight by adopting a lifestyle that automatically takes care of it. In other words, be

active most days of the week, eat sensibly, and look after yourself. If you need to lose weight, then there

are healthy ways to do that naturally by simply easing yourself into a different kind of day to day lifestyle.

Should you believe your weight to be beyond your control, for some reason, then it may still be possible

to find out whether this is actually true – even if this is true, it may only be partially, or mostly true; there

is always something we can do.

Later on in this book, we give practical hints, tips, and instructions on diet, exercise, sleep, and other

healthy lifestyle strategies that would naturally lead to your body coming into balance on all levels,

weight included.



Most people find success in managing their weight by adopting gentle and sensible alterations to their

day-to-day activities and food choices – gradually effecting a transformation in total health; a side effect

of such a transformation is a natural return to healthy weight levels.

#3 Smoke Less or Quit Altogether

Cigarette smoking is linked to kidney damage because it can lead to damage, or make existing kidney

damage worse. The best practice in this regard is to grit your teeth and quit. These days it seems true that

most (if not all) smokers know that smoking is bad for their health, and yet they don’t because the nature

of the addiction is such that it is extremely strong.

An ironic positive side effect of suddenly being diagnosed with a serious condition like CKD is that this

can often shock people into actually, and finally, quitting smoking cigarettes/tobacco altogether.

Nevertheless, I understand that quitting smoking is very difficult to do. There are methods available that

have been devised to help people succeed at it, and any thorough research into the topic should unearth

good effective strategies that may help.

One good thing about the guidelines, tips, and practical advice for dealing with CKD in this book is that it

promotes overall health along with kidney health. Having better overall health makes it easier to quit or

reduce smoking significantly. Even if people keep smoking, but still adopt the advice in this book, the

benefits of increased general health will provide better protection from the bad effects of smoking than

would be the case if people didn’t have good health. Nevertheless, in general, quitting smoking is best for

the kidneys, especially in the long run – now you know.

#5 Focus on the Risk Factors

The final kind of advice most conventional doctors will give to help with CKD is to simply control all the

risk factors that you can – especially other diseases or conditions that could increase your chances of

getting CKD or even cause CKD to happen and get worse. Knowing your risk factors (we discussed them

in an earlier section already) will help you to realize the kinds of things you would benefit from managing

and controlling. The bottom line, reduce the things that put you at risk and increase the things that prevent

or reduce your risks.

The above advice may seem like simple common sense, but, what is not common sense is just exactly

how to manage your risk factors in the most optimal way – i.e. what should you actually do to reduce

your risks? What strategies and practices would both be effective and to your liking? In the latter parts of

this book, I do explore good strategies that should help almost everyone to combat CKD and improve

general health – strategies that are effective, natural, and varied enough to satisfy a number of possible

preferences.

Common Conventional Treatment/Management Strategies for CKD

The goal of conventional CKD treatment therapies after diagnosis is to control patients’ risk factors that

contributed to them getting CKD. Additionally, the management of CKD involves slowing down or

trying to prevent the progression of CKD through stages 1 to 5.



Unfortunately, CKD as a condition tends to contribute to its own progression because the negative

changes that happen in CKD patients can feedback into putting the kidneys under pressure. A good

example of what I mean here is blood pressure. In an earlier section, I described how high blood pressure

was one of the three most common causes of CKD. It turns out that having CKD, in other words having

kidneys that keep degenerating, tends to lead to a situation that causes high blood pressure. So this means

that not only is high blood pressure a cause of CKD, but it is also true that CKD, in turn, causes higher

blood pressure. This means that having CKD and not doing something healthy about high blood pressure

can lead to a catch-22 feedback loop; a downward spiral of degeneration and poor health. In general,

since CKD seems to be defined as being caused by other diseases/conditions (e.g. diabetes, hypertension),

part of the strategy of managing CKD is to treat the original causal condition whilst trying, so far as

possible, to prevent the negative effects of poor kidney function.

How Doctors Manage Blood pressure in Patients with CKD

There is a chemical that the body produces that causes blood vessels to constrict – raising blood pressure.

This chemical is part of the body’s ‘natural pharmacy’ which helps it to regulate its own internal

conditions to sustain and maintain optimal health and vitality.

Pharmaceutical companies have studied this chemical and felt it a good idea to manufacture special

pharmaceutical medications to artificially interfere with this chemical - resulting in a lowering of blood

pressure.

The name of this chemical is “angiotensin”. Angiotensin is also linked to the way kidneys function

because it also acts as a messenger to the adrenal glands. The adrenal glands sit just on top of the kidneys,

and when they are given messages by angiotensin they react by releasing their own messenger molecule

called “aldosterone”. Aldosterone messages the kidneys and tells them to retain sodium which can lead to

water retention and fluid build-up – a classic symptom of CKD.

Thus, controlling blood pressure in CKD patients is usually accomplished by prescribing angiotensin

inhibitors which try to reduce the effects of angiotensin. This reduces blood pressure and helps to prevent

water retention. The technical names for the two classes of drugs that are usually used for this purpose

are, “angiotensin-converting enzyme inhibitors”, and, “angiotensin antagonists”.

Research has shown that these drugs slow down the progression of CKD. Of course, these drugs could

only hope to slow the progression of CKD and not stop it altogether. This is because the drugs do nothing

to address the causes of CKD or high blood pressure. They just powerfully and artificially force blood

pressure to go down by interfering with the activity of angiotensin.54 In terms of these medications, there

is evidence that the ‘converting enzyme inhibitors’ are slightly more effective at protecting the kidneys

and delaying certain risks of death than the receptor antagonists are.55 56

Other methods used in the Conventional Management of CKD

The following list of treatments might also be given by doctors to patients with CKD depending on the

stage of progression and circumstances:

• Reducing blood fat (lipid) levels. To prevent damage to the heart and blood vessels and make the

management of weight a little easier.57



• Certain general dietary prescriptions might be recommended. For example, many doctors ask

their CKD patients to reduce sodium (salt) and eat less protein (meat, eggs, and fish). The reason

for this recommendation is to lower the proteins in the blood and lessen the chance for fluid

retention which are both core symptoms of CKD.58

• Anemia – If a patient presents with anemia either because of kidney malfunction or because of a

side effect of dialysis then their doctor may try to get the blood hemoglobin levels back within 9–

12 g/dL. Benefits have been reported in scientific studies when hemoglobin is within this range,

but not necessarily any further benefits to raising them to normal levels or higher.59 60 61

• Iron supplementation can sometimes be prescribed in advanced cases of kidney disease to prevent

anemia, although there are many potential dangers to supplementing with iron so this is usually

done under close supervision and only in severe advanced cases.62 63

• Men who have problems getting and maintaining an erection are sometimes prescribed zinc

and/or certain pharmaceutical drugs to reduce sexual problems that arise because of the typical

symptoms of CKD. [30]

• Blood levels of phosphates are often elevated in certain CKD cases. So drugs that bind with

phosphates to remove them from the blood are sometimes prescribed. 64

• Vitamin D supplementation (Calcitrol supplements), are sometimes given to patients with

metabolic problems in their bones. 65

If a CKD patient is in stage four or worse, then they will eventually be referred to a nephrologist. A

nephrologist is a specialist in kidney health. The word nephrologist literally means “a person who studies

the kidney” (from ‘nephro(n)-‘ meaning ‘kidney’, and ‘logist’, meaning ‘person who studies/knows

about’). Sometimes patients are referred to a nephrologist at an earlier stage of CKD, especially when

their ACR is more than 30, or they have high blood pressure that is resistant to control.

Finally, in conventional treatment models, stage 5 CKD is the stage where the only options left are

transplanting or dialysis.66 Unfortunately, dialysis is known to be pretty poor at removing the toxins that

build-up in ESRD patients, particularly those toxins that are bound to proteins. In other words, transplant

surgery, and artificial blood filtration (dialysis) are extreme last-resort options with health complications

of their own, and limited efficacy.67

A Few Questions: Deeper Causes, for the Causes?

I mentioned earlier in this chapter that I would revisit the causes of CKD in more depth. Now is the time

for that discussion.

The causes of a specific disease are very important when devising a way to treat that disease. A central

principle in healing is that if some set of causes and conditions gives rise to the formation and progression

of a disease, then removing that set of causes and conditions should make it impossible for that disease to

come about or sustain itself – That would lead to the successful prevention or cure of the disease.

This principle is easy enough to understand, and it is a hallmark of any healing tradition. The complexity

with this principle is not in understanding it, but in its application – that is the hard part. We need to

know, very precisely, what the causes and conditions actually are in order to remove them and so protect

you from harm.



So what are the actual causes of CKD? Well, you have already heard about the conventional medical

explanation for CKD – that it is primarily caused by diabetes, hypertension, specific inflammation inside

key parts of the kidney, other rarer causes, or no known cause (idiopathic).

However, if these were the causes of CKD then treating CKD would only be a matter of treating these

underlying diseases or conditions while also managing the damaging effects of having failing kidneys on

top of those disorders. This is pretty much the approach of western medicine to CKD. Unfortunately, they

also define CKD, when it happens, as an irreversible consequence of these conditions. The reason why

they think this is so is that the underlying conditions are difficult to treat conventionally, and kidney

damage is difficult (impossible?) to reverse.

Of course, if you actually want to be able to have any chance of treating CKD you are going to have to

look at it a little deeper because if you take a conventional view you would be stuck with an untreatable

symptom of some other disease. Fortunately, there is a way to ‘go deeper’ than the conventional view on

the causes of CKD. That way is to extend our understanding of the causes of CKD to include the causes

of hypertension and heart disease as well as diabetes and the factors in play with obesity.

There is a common link between all these disorders. That link, or core underlying factor, is chronic low-

grade inflammation. This kind of low-grade inflammation is present in diabetics, and people with

atherosclerosis or cardiovascular disorders (CVD, i.e. heart disease), and it is present in people with

obesity, it is implicated in hypertension, and it is certainly present in people with CKD. In a way, all these

disorders are related to each other, but they aren’t the same disorders, and treating people with these

disorders will differ because there will be better and worse ways of managing particular symptoms of

each different disease. But, the main underlying mechanism that eventually wears away at the body until

it presents with one of these conditions is most likely to be chronic low-grade inflammation that damages

the body over time.

All of these diseases (diabetes, CVD, CKD, etc.) are considered to be chronic degenerative lifestyle

disorders. The reason why they are considered as such is because all of these disorders are heavily

influenced by the kinds of daily foods one eats, how much one exercises, one’s habits, levels of stress,

exposure to toxic pollutants (pesticides, smoking, etc.) the state of health of our gut environment, even

how much we sleep can put us at more risk of these disorders. Also, all of these disorders are much more

likely to appear the older one is because, of course, the older one is the longer one has had to wear the

body’s natural regenerative systems down through our daily activity until something eventually fails.

Finally, all of these conditions are extremely responsive to lifestyle-based intervention, prevention, and

treatment, much more so than with standard allopathic approaches.

So, to be clear, I am not saying that diabetes, high blood pressure, or acute inflammation do not cause

CKD. They do lead to CKD. What I am saying is that the same underlying constellation of factors behind

diabetes, as well as obesity, heart, and blood vessel disease and all the rest I mentioned, happen to

underlie CKD - they can be considered as treatment targets for CKD. Putting it another way, if diabetes

caused your CKD…then what caused your diabetes?

As I will show again and again in later chapters, the core issue that keeps cropping up is chronic low-

grade inflammation that arises via different body systems and mechanisms with different negative effects,

leading to the same set of chronic and degenerative lifestyle conditions. Thus, I contend that that is what



should be targeted in any protocol for treating CKD because it is very likely to be the underlying

mechanism which, over the course of a lifespan, would definitely lead to degenerative lifestyle diseases

that progress on to kidney failure. We should treat that cause. We should also, simultaneously mitigate the

problems and damage that having failing kidneys can themselves independently cause whilst addressing

the underlying chronic inflammation. An approach that does these two things is, in my reasoned opinion,

the one that has the best chance for successfully healing CKD.

Although I have gone deeper into the underlying causes of CKD, the net result of doing this has been to

simplify the explanation of what ultimately causes CKD. This understanding allows a more optimistic

outlook on the possibility of succeeding when treating CKD and its associated problems.

In later chapters, I will describe different body systems and mechanisms where this kind of inflammation

crops up and leads to damage in cases of diabetes, cardiovascular disorders, and chronic kidneys disease.

I will also look at the kinds of lifestyle interventions like diet, food, sleep, exercise, natural supplements,

and others, that all have the most potent benefits to prevent and heal those systems. In the final sections of

the book, I will make practical recommendations as to what you can actually do on a daily basis to heal

from CKD.

What Should You Know From Chapter One?

There is no doubt that I have covered a lot of information in this chapter, and having read it you can

consider yourself pretty well informed about CKD, at least on the general points of CKD. If you’re

concerned that you won’t remember everything then I have good news for you, you don’t have to! In fact,

there are only a few key points that you should bear in mind going forward. As to the rest, it is important

to have read over it and gained a general understanding, but there is no need to remember exhaustive

details – if you need to, you can always look up the information in this section to suit your needs; this

chapter was designed to act both as a reference resource and as an introduction to the core concepts of

CKD.

In this final section of Chapter One, I will summarize only the key points – the important concepts that

you should know through and through in order to follow along in the coming chapters. If you keep only

this information in mind you will be perfectly placed to understand and implement effective strategies for

combating CKD completely by the end of the book – that is the ultimate aim.

So, what information in this chapter was the most important? The points mentioned on the following page

will serve you a hundred times over if you keep them in mind.



The Key Points…

CKD has many identified causes and risk factors. But, there are underlying factors common to each

of these that are more important in many ways. You don’t need to memorize every single cause or risk factor. To refresh your memory as to how many there were, you can flip back to those

sections if you like. There are only a few points I would like to emphasize here in this regard: 1. CKD is caused by many things

2. The three most common causes of CKD are considered to be Diabetes (most common), hypertension (high blood pressure), and

inflammation (inflammation in the kidneys that damage their capacity to function).

3. The other causes are much less common and a significant proportion of patients that have CKD have it without any known cause.

So, these points are really good to keep in mind as we move forward through the book. Consider that the above causes are the acknowledged

causes of CKD according to conventional biomedical practice. However, for us to have a more empowering opportunity to treat CKD we do need

to look deeper. In a way, we could say that diabetes, hypertension, and inflammation are related to each other, which indeed they are.

This brings me to the next important ideas you should keep in mind going forward.

4. There are deeper mechanisms that are common to diabetes, high blood pressure, and specific local inflammation in the kidneys

which could be considered as the more fundamental causes of CKD.

5. Perhaps the deepest cause of all for CKD is chronic and persistent low-grade inflammation. This kind of inflammation is common

to diabetics, obese people, people with heart disease, and of course people with specific inflammation in the kidneys.

6. Chronic low-grade inflammation is likely the real underlying factor because over time it can cause damaging changes in the body

which can contribute to diabetes or heart disease. Obese individuals are known to suffer from chronic low-grade inflammation

because of the unique characteristics of their metabolism chemistry.

7. Finally, CKD is correlated with age – the older you are, the more at risk you are – again something consistent with chronic

inflammation. Such a progression could also explain some of the cases of people who get CKD without a known cause. I argue that

for many of these cases the real cause was likely to be chronic low-grade inflammation that caused damage over time to the body,

eventually resulting in a deficiency with the kidneys.

8. Heart and blood vessel health are very strongly linked to CKD. This makes sense because of many factors e.g. by far the most

common cause of death in CKD patients is some kind of cardiovascular event like a stroke or heart attack. Another good link is

highlighted by the fact that high blood pressure is acknowledged as one of the top three causes of CKD. So CKD is seemingly caused

by cardiovascular problems and seemingly causes cardiovascular problems on its own too. This implies that the heart and blood

vessels need to be kept in good health to prevent CKD as well as to manage or cure it. The core factor in any chronic heart disease

will usually be inflammation and damage to blood vessels – something seen in diabetes too. Again, the close relationship between

diabetes, heart disease, obesity, inflammation, and CKD is abundantly clear!

So, the most important point to remember is that the constellation of factors such as inflammation, heart, and blood vessel health, keeping weight

down, and watching out for things that contribute to diabetes are the most important factors with regard to CKD onset and progression. Common

to all of these factors is an underlying chronic inflammation and the body systems that contribute to that inflammation. In the end, it makes more

sense to acknowledge a deeper common factor than high blood pressure, heart and blood vessel health and diabetes. That deeper factor is likely to

be linked to chronic daily low-grade inflammation that is linked to unbalanced mechanisms in the gut microbiome, exposure to toxins, daily

lifestyle factors like stress, sleep and exercise and so on. Even if people have diabetes, which led to CKD, the cause of their diabetes was…likely

to be heavily related to inflammation, daily lifestyle factors, microbiome factors, and so on. High blood pressure…? It’s the same story there.

If you forget every other piece of information from this chapter, then just don’t forget this last one – inflammation is the key to

understanding and treating CKD and all of its underlying and associated conditions. That is why this book will target CKD by looking to

reduce chronic daily inflammation, tone down the factors in obesity and diabetes linked to this inflammation, as well as support and

protect the heart and blood vessels. The approach is understandable and clear if you keep this in mind.

Any treatments that don’t address these underlying factors are then likely to just be supportive and protective of the kidneys, or aiming at

symptomatic management of the consequences of having CKD, or managing the negative effects of your pre-existing diabetes, obesity, high

blood pressure, etc. so that further complications and damage are not caused.

That’s it! Nothing more needs to be understood in this section. Although it is certainly important to know

about the dangers of OTC drugs or to understand the terminology, processes, and thinking your doctor

might have used to diagnose and treat you - it is definitely not necessary to memorize such information.



The extras were included to help you to understand your condition, as well as to help contextualize what

might have happened to you (or someone you know) when you were diagnosed by your doctor. This is

important because I feel that the first step to health recovery is to get informed about your body and

illness, remove ignorance, and empower yourself with the right information. Then you can heal by

implementing effective strategies – you will know why you are ill, and why what you are doing about

your illness should work to effect healing.

Inflammation is the villain, but where did it come from, and how do we deal with it? These questions and

more are explored in the chapters to come. Buckle in; the road to health lies ahead!


Chapter Two

“…I Get by with a little help from my (little) friends…”

Chronic Inflammation & the Microbiome

In this chapter, I want to begin to answer the parting question that I posed in chapter one. That is, I will

explore what inflammation is, and where it comes from in CKD. Since CKD is strongly linked to

hypertension (high blood pressure) and cardiovascular disease (CVD), as well as diabetes and obesity, I

will explore the topic of inflammation as it appears in those conditions and then show how that relates to

the kidneys and the rise of chronic degeneration of the kidneys in CKD.

I will mainly focus on cardiovascular disease (CVD) factors that involve inflammation-based damage and

include diabetes factors where they are similar. The idea here is to not go overboard on CVD or diabetes

medical theory – after all, this book is primarily about CKD and I would like to keep the discussion

focused on CKD as much as possible.

Nevertheless, first up for discussion in this chapter is to very broadly mention what inflammation is so

that I can explore how it interacts with CVD, diabetes, and CKD. This means that I will discuss the main

way that that CVD is generally caused and intersperse that discussion with important similarities found in

diabetes. The focus here is to emphasize the inflammation-based damage that both CVD and diabetes can

cause, and how this inflammation-based damage always tends to contribute to CKD onset and

progression.

If you think back to chapter one you will remember that hypertension and diabetes lead to CKD. What I

haven’t described yet is just exactly how that is the case, and in this chapter, those links should become

much clearer.

Speaking generally for the moment, consider the dense interrelationships between heart disease,

hypertension, diabetes and obesity, and CKD that have already been mentioned or implied in chapter one.

Take a look at the following points:

• Hypertension leads to CKD. CKD leads to hypertension.

• Hypertension also leads to heart disease. Heart disease can often result in kidney disease.

• The vast majority of people who die from CKD tend to die from a complication due to heart

disease of some kind. So we could say that CKD leads to heart disease since the complications of

CKD end up causing the heart, or blood vessels to fail.

• Diabetes often leads to kidney disease or damage.

• Obesity is a major risk factor for all four conditions!! Namely diabetes, heart disease,

hypertension, and CKD.

• Obesity and diabetes have characteristic mechanisms of inflammation that result in damage to the

pancreas, nerves, and blood vessels.

Chapter Two – Chronic Inflammation & The Microbiome


• Heart disease is also characterized by inflammation that can damage the blood vessels, especially

in combination with hypertension.

• CKD has characteristic inflammatory mechanisms that damage the kidney tissues and the blood

supply to the kidney; CKD leads to hypertension which is a particularly deadly combination with

chronic inflammation. The combination leads to very poor heart and blood vessel health.

So, I hope it is clear how tightly interwoven all these conditions are. These relationships are good

indications that common links must exist between them all. In this chapter, I will describe some of those

links in a bit more detail. In a way, the fact that there are so many links between these conditions is not

that surprising because CKD is more of a secondary complication of other more primary disorders. But,

those disorders are linked in terms of inflammation mechanisms, so treatment for CKD can be tailored to

reducing that inflammation, especially by using dietary and lifestyle strategies.

Finally, one of the strongest factors linking diabetes, heart disease, CKD, and chronic inflammation is

what is called the microbiome. The microbiome refers to our gut ecosystem where many little helpful

microorganisms live. It turns out that our microbiome has a major impact on our health and that some

distinctive characteristics of the microbiome are shared between CKD and each of the other conditions.

Microbiome gut ecology is tightly linked to inflammation responses in the body because the microbiome

strongly affects the immune system which is the source of all the human body’s inflammatory responses.

There can be no real discussion of the microbiome without also discussing inflammation and the immune

system. That is why I have included both of these topics together in this chapter. With that said let’s

explore inflammation next and then look at how CVD progression in atherosclerosis involves

inflammation and how that involves similar mechanisms in diabetes – all of the mechanisms I mention in

the coming sections are linked, either directly or indirectly, to causing and progressing chronic kidney

disease.

Inflammation, what is it?

Every time our immune system mobilizes itself in response to tissue damage, toxins, foreign particles, or

germs it activates what is called “the inflammatory response”. This response is actually a sign of a healthy

and functionally active immune system, and it really works well.

The immune system is one of the most complicated working systems of the body and it requires years of

effort and study to learn every little detail and nuance discovered about it so far. The detailed workings of

the immune system and the inflammatory response are thus a little beyond the scope of this book. But,

some basic concepts will be useful to us in our quest to treat CKD because inflammation, as a mechanism,

is so heavily involved in the things that cause CKD.

The immune system will begin an inflammatory response when it encounters damaged tissues, toxic

waste products from metabolism, or foreign objects in the body like harmful bacteria and viruses. When

agents of the immune system do encounter such things, special inflammation mediating chemicals are

released called (pro-inflammatory) cytokines.

The cytokines control and regulate the immune response by starting and stopping the entire cascade of

complex chemical reactions. These chemical chain reactions are all designed to protect the body from



damage, speed up the healing process of wounds, neutralize organic threats, and eliminate toxic metabolic

waste products by destroying their structure or helping to package and move them to processing organs

like the liver or kidneys where they can be specially processed for expulsion from the body.

At sites in the body where inflammation is present, people will usually experience swelling, heat,

irritation, itchiness or sensitivity. The extra heat is present at wound sites because the inflammatory

response encourages blood flow to the area; whilst swelling occurs because of complicated changes to the

structure of cells and fluids in the area. The irritation is caused by the extra heat and swelling touching on

nerves in the local area, and the extra redness at the area is due to the increased blood flow which shows

in the area as a flushed skin complexion. The increased blood flow is useful for both healing and

protection. Useful for protection because it ensures that a steady supply of immune cells and immune

active bio-molecules keep arriving and leaving the site as needed, and useful for healing because a

constant and steady stream of nutrients and raw materials keeps arriving at the wound or infection site

which makes it easier to repair and build up new tissue whilst facilitating the removal of old, dead and

damaged tissues.

The system works very well and is a triumph of nature when it occasionally defends against some threat

to the body or repairs occasional damage. Unfortunately, the system does not work so well if it is always

activated. The reasons as to why the inflammatory immune response doesn’t work so well if it is

constantly or chronically activated are, first, because it takes a lot of energy to maintain the response –

there is an energy cost. Secondly, the immune system uses very reactive chemical compounds to

neutralize other foreign organisms and compounds. If the inflammatory response is constantly turned on,

then these reactive molecules can, and often do end up damaging our healthy tissues as a side effect. This

is why chronic low-grade inflammation if present for many years can end up gradually doing serious

damage to the body which leads to degeneration and many of the effects of visible aging.

The bottom line is that inflammation is probably the key root factor underlying most chronic lifestyle

degenerative disorders today and that by addressing that inflammation there is a good chance that people

can improve their health drastically. A recent article published in the Harvard magazine made this precise

point too when they discussed the role of inflammation in chronic degenerative diseases as well as

describing the power of certain foods to help with this inflammation. It is an excellent read and I highly

recommend giving it a look if you’re interested – just follow this reference 68

So, how does inflammation and tissue damage related to CKD come about in hypertension, heart disease,

and diabetes? This is what is explored next.

Heart Disease & Diabetes Linked Inflammation

One of the primary ways that kidneys become damaged is because of damage to the fine capillaries (tiny

little blood vessels) that supply it blood for filtration. This usually happens when the blood vessels harden

and become less elastic. Gradually over time, this affects the ability of the kidneys to filter the blood

adequately and we see a gradual decline in kidney filtration rate and an increase in blood concentration of

waste products that should normally be expelled in the urine.

The hardening of blood vessels like that which is seen in the progression of CKD is a classic feature of

certain cardiovascular diseases (CVD). A good example is atherosclerosis, where the body deposits



calcium and cholesterol onto the walls of arteries which causes the arteries to become more and more

rigid and narrow, unable to function in a healthy manner.

Plaques may eventually form which then also carry the added risk of being able to rupture and break off

the walls of the blood vessels and travel around the body. Ruptured plaque debris is risky for heart attack

and strokes because the blood that surrounds the plaques in the bloodstream is much more likely to clot

and block the blood vessel completely. This could stop vital nutrients and oxygen from reaching key

organs and tissues which can lead to tissue death. This is exactly what happens to heart muscle tissue

during certain kinds of heart attack, and also what happens to brain tissue during similar kinds of stroke.

Indeed, the occurrence of heart disease, research has found, mainly depends on the health (or lack of it) of

the inner walls of blood vessels.69 70 Anatomically, blood vessels can be divided into three linked but

distinctive layers – inner, middle and outer.

The outer layer is responsible for the shape and structural integrity of the blood vessel and therefore it is

comprised of fibrous connective tissue. The middle layer is a thin section of muscle (smooth muscle)

which allows the blood vessel to constrict or dilate depending on signals from the nervous system.

Constriction and dilation of blood vessels is a way for the body to regulate its blood flow and blood

pressure. 71

The most sensitive layer is the inner layer of a blood vessel. It is a very thin layer of endothelial cells that

act as a semi-permeable membrane that serves to selectively allow particles and gasses to flow into or out

of the blood. This inner layer is called the “endothelium” and its job is to act as a barrier and protect the

middle and outer layers from damage. The endothelium also prevents highly reactive or damaging

substances from affecting the outer and middle layers.72

Unfortunately, toxins and highly reactive compounds can build up in the blood. This is what happens in

diabetics who have very high levels of glucose in the blood, or in the case of CKD, the inability of the

kidneys to properly filter out waste products means that the blood becomes more and more loaded with

potentially harmful compounds. Another way that a build-up of highly reactive ‘free radicals’ can occur is

when we constantly eat food that raises levels of reactive compounds in the blood, which protect the

blood vessels.

It has been noticed that when the inner layer of blood vessels becomes damaged, the ability of the blood

vessel to protect the middle smooth muscle layer is compromised. When toxins or free radicals (highly

reactive chemical compounds) penetrate the endothelium and come into contact with the smooth muscle

layers of blood vessels, damage to those tissues can occur. In response to the presence of these toxic

invaders, the body mobilizes an immune response to clean up the damage and remove the foreign

particles just as in the case of an infection. The mobilization of the immune system to this kind of damage

then begins the inflammatory response to help clean up.

In heart disease, it is actually the inflammation of blood vessel tissues which causes fatty plaque deposits

to appear on the inner walls of the blood vessel. Plaque formations can harden and calcify and ultimately

rupture, forming clots in the bloodstream. These clots will travel around the circulatory system where

they can lodge themselves in the fine capillaries (tiny blood vessels) of the lungs, heart or brain cause

embolism, heart attack, stroke respectively, and even kidney damage over time.73 74



So, the root factor in the causation of heart disease seems to be whatever contributes to plaque formation

in our blood vessels, in other words, inflammatory damage to the blood vessel walls. For diabetics, much

the same kind of damage is seen but because of a slightly different mechanism that has to do with

excessive blood glucose levels reacting with other compounds to make highly reactive “glycation end

products”. Glycation end products are present in heart disease because of reactions with unbalanced levels

of cholesterol and plaque deposit formation. In diabetes, damage happens in the energy production parts

of cells (the mitochondria) as well as to the inner and middle lining of blood vessels. Glycation end

products also form readily in diabetes because of chronically elevated glucose levels. Heart disease results

in the formation of plaques, while diabetes results in damage to the pancreas, blood vessels, and nerves.

This is why high blood pressure, CVD, and diabetes can all lead to kidney disease.

Plaque formation is linked to the functioning of the endothelial layer, so the factors that influence the

endothelium or contribute to plaque formation will all be relevant causal factors in the onset and

progression of heart disease. What are the main ways that such damage or impaired functioning can

occur? There are a whole host of factors that can ultimately lead to plaque formation and/or endothelial

dysfunction; the main factors can include:

Looking at CVD the factors leading to damaged blood vessels include:

• Cholesterol – higher levels of bad cholesterol (LDL) vs good cholesterol (HDL)

o A too high ratio of LDL cholesterol to HDL cholesterol makes it more likely for LDL

cholesterol to become glycated – which forms reactive species (free radicals) that cause

damage to tissues and blood vessels.

o So foods and diet and lifestyle that increase the chance of glycating LDL cholesterol will

all contribute to CVD.

Cholesterol

Cholesterol is a specific type of ‘waxy’ lipid or fat found in the body. Lipids, in general, are essential to

the functioning of a healthy human body and they play a key role in multiple different systems and

processes. Some of their main functions are listed below:

• Lipids are essential components of cell membranes, myelin sheaths (a fatty deposit surrounding

certain nerves, white matter, in the brain), and are components of other intracellular structures.

• Lipids are stored in abdominal fat cells as fuel stores. Subcutaneous fat is also used to contour

and insulate the body - thus providing insulation and sex-based body contour differences in

appearance.

• Fat storage cells can also act to secrete various biological messenger molecules.

• Lipids are an integral component of steroidal hormones.

• Lipids play a role as transporters of biologically important compounds.

Therefore maintaining good levels of lipids in the body is important in staying healthy. In other words,

fats (lipids) are not the enemy of the heart per se, they are vitally necessary to health and wellness. 75

Cholesterol specifically plays a key role in our metabolism and occurs in the body in various different

forms. Cholesterol is bound to different molecules in the body and can thus be considered to have a few



different forms in the body. The main forms of cholesterol that are related to cardiovascular health are

HDL’s (high-density lipoproteins), LDL’s (low-density lipoproteins) and VLDLs (very low-density

lipoproteins) and associated triglycerides.

Some of the major functions of cholesterol in the body are listed below:

• Cell membranes require cholesterol in their structure – up to 30% of the total mass of the

membrane is cholesterol, depending on the particular cell and its function. In cell membranes,

cholesterol performs two main functions: 76 77 78

- Cholesterol regulates the elasticity (fluidity) of the cell membrane when temperature

changes – This lets the cell membrane function properly over a wider range of

temperatures than would otherwise be possible without it.

- Cholesterol helps prevent charged particles (ions) from freely crossing the membrane

– it acts as a sort of ‘cellular insulator’. “Cellular insulation” is important in cells that

function with a charge gradient between the interior and exterior of the cell – such as

in nerve cells that require a gradient of charge to transmit electrochemical cellular

signals (fire action potentials).

• Cholesterol is required as a precursor for the manufacture of steroid hormones. Examples of

these important steroid hormones include the sex hormones (androgens and estrogens),

mineral-corticoids (used in kidney regulation of water levels), and glucocorticoids (regulation of

glucose and protein metabolism), immune suppression (calm the immune response when no

longer needed), and inflammation.

• Cholesterol is a necessary precursor molecule for the formation of vitamin D as well as providing

a framework for the synthesis of bile acids. Bile acids help to prepare dietary fats for absorption

and metabolism.

The main focus of most (conventional) clinicians will be controlling the levels of LDL cholesterol in the

blood, but all cholesterol is relatively important and research seems to suggest that it is the relative ratios

of cholesterol to each other that may be far more important than keeping the absolute amounts of a single

type of cholesterol in check.

The correlation between cholesterol levels and the risk of cardiovascular disease was initially discovered

because of observations made in medical research that discovered lipid and cholesterol deposits in

atherosclerotic lesions during the progression of atherosclerosis.79

LDL-Cholesterol

LDL is considered the most important form of cholesterol in terms of the risk of heart disease. One can

say that in general, LDL cholesterol is the specific kind of cholesterol that has given cholesterol its ‘bad’

name. The reason for this is that over the years, much research has documented how LDL cholesterol

deposits itself on the interior walls of blood vessels and as a result contributes to atherosclerosis, plaque

formation and ultimately massively increased risks for heart attack, failure, and strokes. 80

In general, the main function of lipoproteins (LDL’s, HDL’s and VLDL’s) in the body is to aid in the

transport of lipids into cells, and out of cells to the liver for use in the generation of plasma membranes

and as substrates in hormone production. LDL’s have an additional property in that they also aid the



immune system by inhibiting bacterial infection (particularly Staphylococcus aureus and some others).81

82 83

As research into LDL and heart disease became more fine-grained, the particular role of oxidized LDL

and its ability to damage the walls of arteries became better described - clearly linking this process to the

development of lesions in the blood vessel walls and arterial plaques as seen in atherosclerosis and heart

disease.84 85

LDL particles can be divided into what are called “sub-fractions” and given a number to classify them

starting from the smallest (number 1) and moving to the largest - based on the LDL diameter and density.

The lower numbered sub-fractions of LDL are larger and more buoyant (less dense by definition) other

LDL sub-fractions are small and dense. These smaller dense LDL sub-fractions are much more likely to

undergo oxidation and are therefore much more likely to lead to cardiovascular disorders and

atherosclerosis than other types of LDL.86 87 88 In addition to having a propensity to become oxidized,

these smaller dense forms of LDL being are also able to pass from the bloodstream into blood vessel

walls more easily due to their small size and composition.89

Small dense LDL penetrates the endothelial wall and contributes to the creation of plaque deposits when

oxidized. When LDL cholesterol becomes oxidized within the endothelium, inflammation arises.

Inflammation of this type is known to speed the progression of vascular disease and oxidized LDL is

associated with the progression of atherosclerosis and heart disease at all phases if present.90 91 92

Furthermore, in addition to inflammation, oxidized LDL particles have been shown to actually cause

damage to the delicate endothelial lining.93

Once the endothelial lining is damaged, it is no longer capable of adequately preventing further influx of

oxidized fatty acids into the internal structure of the deeper layers of the arteries which then causes

lesions or plaque formation. 94 95

The invasion of the blood vessel walls by reactive molecules after damage to the protective endothelial

layers causes tissue damage which in turn causes the mobilization of the immune system to the site of

damage to ‘clean up’. The immune system’s activity at damaged sites comes as a double-edged sword.

On the one hand, immune activity clears away debris, prevents infection and protects the tissue

environment; however, the activity of the immune system itself causes inflammation and the release of

powerful chemicals which can (in some cases) contribute to further complications.

Once the endothelial wall is damaged, larger LDL sub-fractions are able to penetrate into deeper layers of

the arterial walls causing damage and heightening the immune response and concomitant inflammation.

Immune macrophage cells (cells that engulf unwanted material in the body) then become overly enlarged

due to the chronic clearing of these even larger oxidized LDL particles, so large in fact that they are

unable to easily move back out of the endothelial layers.

These trapped macrophages build up in the damaged areas and continue to release inflammatory

cytokines (specialized immune active chemicals) which then further oxidizes more LDL particles and

further exacerbates inflammation – a catch-22 cycle. This catch-22 cycle drives cascading levels of

inflammation and inflammatory reactions, which ultimately speed the progress of arterial degeneration –



leading to major cardiovascular health complications like stenosis (impaired blood flow due to blood

vessel damage/malformation), stroke, heart attack, kidney disease, and even ultimately death.

Understanding that not all LDL particles are created equal and that central to the understanding of “bad

LDL” is the fact that oxidized LDL is “bad”, can help us to see that elevated levels of LDL in the blood

does not in and of itself lead to heart disease. Elevated levels of LDL do mean that there are more LDL

particles available for oxidation which could overwhelm our immune system’s ability to deal with them

and eventually cause some kind of pathological complication.96

LDL Cholesterol Glycation

How do LDL’s become prone to oxidation in the first place? One of the main mechanisms known to

cause the oxidation of LDL cholesterol is glycation. Glycation is the process whereby a molecule (in our

case a lipoprotein, LDL) reacts with glucose and then becomes oxidized, resulting in damaging changes

to the structure of the molecule and impairment of function. In addition to this, the resultant glycated

product is a highly reactive molecule that is capable of damaging the tissues it comes into contact with.

LDL particles in the presence of high levels of blood glucose are prone to glycation. Studies have found

that glycated LDL is far more likely to become oxidized than normal LDL.97 Furthermore, research

indicates that glycated LDL leads to substantially impaired endothelial functioning as well as stimulating

inflammation and oxidative stress in the smooth muscles lining blood vessel walls which can worsen

plaque buildup and formation at these sites.98 99 LDL that is both glycated and oxidized causes the

breakdown of the enzyme eNOS (endothelial nitric acid synthase) – eNOS is responsible for the

production of nitric oxide which is critically important as a signaling molecule that tells blood vessels to

dilate - promoting blood flow and lowering blood pressure.100 Finally, glycated LDL is no longer

recognized by LDL receptors in the liver which means that they will remain in circulation – this increases

the chance of oxidation and radically raises the risks for cardiovascular disease, atherosclerotic

complications, and CKD.101 102

These findings imply that diabetics and pre-diabetics need to be especially vigilant about their

cardiovascular health. The other aspects to take note of is how LDL-cholesterol, blood sugar, oxidative

damage, and inflammation are all key interrelated factors that combine to lead to the development of heart

disease. 103

Although lowering your LDL blood cholesterol levels does reduce the risk for cardiovascular disease, a

more insightful approach would be to see that it is really important to minimize the oxidation of LDL –

this is the key to managing your cholesterol-based heart disease risks. Other lipoproteins help to minimize

this oxidation thus the maintenance of healthy ratios of all the lipoprotein cholesterols is perhaps the best

approach to take given the research at present.104

Nevertheless, the research is unambiguous about high levels of LDL-cholesterol. High LDL is associated

with almost all the risk factors linked to cardiovascular disorders and heart disease. However now we

know why, and it isn’t only to do with having large amounts of cholesterol in your diet – it seems more to

do with your total existing state of health.



HDL Cholesterol

HDL is the so-called "good" form of cholesterol since research has found that increased levels of HDL in

the blood and body are correlated with decreased cardiovascular risks. This is thought to be because of the

way HDL functions in the body – removing any excess cholesterol from organs and tissues. HDL

transports this excess cholesterol to the liver where it is metabolized and prepared for excretion.

HDLs are small and dense lipoproteins that are manufactured in the liver. They transport between 20%

and 30% of the cholesterol seen in the blood.105 Typically, the cholesterol carried in HDL is considered

“good cholesterol” because studies have time and again found that this particular cholesterol functions

cardio-protectively and thus tends to decrease cardiovascular disease risk.

HDL is thought to be protective against heart disease because it functions to pick up cholesterol from

other tissues and transports it back to the liver for resorption or disposal (as bile salts). Furthermore, HDL

is an able transporter of cholesterol to the testes, ovaries and adrenal glands where that cholesterol is used

in the production of sex hormones.106

The movement of cholesterol back to the liver for processing is called “reverse cholesterol transport” and

is mediated by HDL cholesterol levels in the blood. When HDL levels are low, the reverse cholesterol

transport system doesn’t function properly and lipids will tend to build up in tissues, undergo glycation

and oxidation, or deposit on arterial walls – which as we know contributes to atherosclerosis and heart

disease. So, HDL’s and the reverse cholesterol transport system are important critical factors in the

etiology of heart disease.

Aging is a key factor that increases the risk of cardiovascular disease, diabetes, and CKD. Testosterone

levels in the body tend to decline as we age, and, studies have found that there is a link between

testosterone and reverse cholesterol transport.107 What is interesting however is that studies have shown

that testosterone decreases the blood counts of HDL in the body – so it was long thought that testosterone

supplementation would increase the risk of heart disease. While it is true that levels of HDL fall in

response to higher testosterone levels, it has now been found that testosterone actually increases the

functionality of HDL making HDL more efficient (so to speak) – the increase in efficiency happens

because testosterone increases the activity of a key receptor and a key enzyme (called scavenger receptor

B1 and hepatic lipase respectively) responsible for the successful absorption and processing of cholesterol

in the liver. 108 109 Thus it seems that declining testosterone levels (particularly in aging men) will overall

negatively affect reverse cholesterol transport and result in a subsequent rise in the risk of developing

cardiovascular disorders.110 111

In summary, therefore, HDL cholesterol is the “good” form of cholesterol in the body because it protects

against vascular disease by transporting cholesterol back to the liver for disposal through a process known

as reverse cholesterol transport. If HDL levels are low, then reverse cholesterol transport becomes

inefficient, allowing for increased accumulation of cholesterol in the vessel wall. HDL levels of at least

50-60 mg/dL have been recommended by some for optimal blood vessel protection.112 113 114

Triglycerides

Triglycerides are lipids that function as energy storage. They play an important role in metabolism and

naturally help to regulate energy production. Structurally, triglycerides have three fatty acids (hence the

“tri-” in ‘triglycerides’) bound to a glycerol molecule. The majority of our energy is derived from glucose



and indeed, glucose metabolism is the mechanism that most cells use for their energy needs. However,

glucose itself is rather bulky and doesn’t pack much energy per unit volume (so to speak). Therefore, to

be as efficient as possible the body will usually convert excess glucose into glycogen (done in the liver) to

make it more energy-efficient and thus suitable for storage. 115

The body thus stores much of its energy in the liver and muscles as glycogen. But, fatty acids are also an

extremely rich source of energy, and when ‘packaged’ as triglycerides, constitute even more dense forms

of energy than carbohydrates – this makes triglycerides and fatty acids the premium choice for long term

energy storage in the body. Ultimately, the body can only store roughly 12 hours-worth of glucose-

derived glycogen in an active human, whilst it can store substantially more energy in triglyceride form –

such is the disparity of the energy storage efficiency. 116

Triglycerides are one of the main constituents of human fatty tissue. They react with LDL cholesterol to

form “small-dense LDL”. “small-dense LDL”, as mentioned above, is able to penetrate the endothelium

and therefore progressively contributes to the formation of plaques.117 118

Hypertension (High Blood Pressure)

High blood pressure is one of the main causes of CKD, but it is also one of the major risk factors for heart

disease. In fact, high blood pressure can, over time, lead to impaired kidney filtration and degeneration,

and impaired kidney functioning can on its own lead to increased high blood pressure. This means that

there is a tight relationship between heart diseases like atherosclerosis and CKD – they can cause each

other to happen, and once both are present they can feedback into each other speeding up the progression

of both. This is one of the reasons why the main cause of death in CKD patients is heart disease events.119

Before we can talk about high blood pressure we first need to understand what blood pressure actually is.

Essentially, blood pressure is a human measure of the force your blood exerts on the walls of your arteries

from the inside toward the outside. To be a bit more specific, when blood pressure is measured, we take

two readings, the first reading is a measure of the average pressure your blood exerts on the arteries when

the chambers of your heart (ventricles) contract to force blood through the circulatory system – this first

measure of blood pressure is called systolic blood pressure. The second measurement that is taken then

measures the average force exerted on your arteries in between contractions and is called our diastolic

pressure. 120

When medical scientists first started measuring the average force exerted by blood on the arteries during

the heartbeat cycle they had no idea what results were normal or abnormal. Furthermore, they had no idea

whether blood pressure was in any way linked to health, wellness or disease.

Over time, enough data has been collected to correlate certain blood pressure measurement values with

certain states of health, disease, age, states of mind and many other factors. This is, in fact, the way the

scientific method expands our knowledge, and in the case of medicine, theory leads to observation, leads

to theory, which leads to observation and so on in an endless cycle.

The generally accepted (conventional) upper limit of ‘normal healthy resting blood pressure’ is 120

mmHg (systolic) over 80(diastolic) mmHg, however, most would agree that an ideal reading would be

around the 115/75 mark. Small deviations in blood pressure throughout the day are normal, it is only

when sustained abnormal measurements occur that there might be something awry - chronic sustained



abnormal measurements above 120 mmHg over 80 mmHg are strongly correlated with a plethora of

cardiovascular and kidney conditions.

Abnormal blood pressure readings are simply an indicator (not confirmation) of something being out of

balance. In a formal way, hypertension is either defined as ‘primary’ (essential) or ‘secondary’.

Approximately 90% of all cases of elevated hypertension are classed as ‘essential’, meaning that the

elevated blood pressure exists without any clear medical cause for it. The remaining 10% are classed as

‘secondary’ which means that some clear medical cause can be identified for the blood pressure reading,

common causes that lead to secondary hypertension are medical conditions that affect the functioning of

kidneys, arteries, endocrine system, or heart.121 122

Unfortunately, high blood pressure on its own can lead to physical illness and anatomical and systemic

damage or malfunction. Thus, many people are under the impression that high blood pressure is some

kind of disease that, like any other disease, can be ‘diagnosed’, ‘treated’, ‘managed’ and hopefully cured.

There is some truth to taking such a view, although it is hopefully clear from the discussion above that the

real factors at play with hypertension are whatever caused the elevated pressure in the first place, not

hypertension itself. However, given that hypertension itself can cause damage to the body it is useful to

wisely and carefully manage it until the underlying causes can be removed so that further, future damage

is prevented.

A number of factors contribute to elevated blood pressure, including genetics, stress, diet, smoking, and

lack of exercise. Because it is largely symptomless, hypertension is known as the “silent killer,” which is

why it is so important to have your blood pressure checked regularly.

Persistent hypertension is a clear risk factor for strokes, heart attacks/failure, and aneurysms, as well as

severe kidney damage.123Even mild or moderately elevated blood pressure is associated with shorter life

expectancy.

To list the complications of high blood pressure clearly, the following pathological conditions are all ones

for which high blood pressure is a major risk factor:

• heart attack

• stroke

• diabetes

• heart failure

• kidney disease

• vision loss

• metabolic syndrome

According to research data, one’s risk for the cardiovascular disease actually doubles for every 20 mmHg

systolic and 10 mmHg diastolic pressure increase above 115/75 mmHg.124 Even more worrying is the fact

that half of the adults globally have blood pressure in the 120/80 mmHg and 140/90 range.125 People in

the 120/80 mmHg to 140/90 mmHg range fall into what is called “prehypertensive” range, however,

being in this range of blood pressure immediately correlates with up to a 20% increased risk for kidney

dysfunction – especially in the elderly.126 Another disturbing result showed that people in this blood

pressure range, (which is considered mild, or prehypertensive) have roughly double the likelihood of



developing cardiovascular disease when compared with people that have a blood pressure below 120/80

mmHg.127

In 2002 a study was done that showed that lower blood pressure was always associated with lower risks

of kidney dysfunction and far less risk of cardiovascular diseases such as stroke or heart disease. 128

Finally, the prevalence rate for full-blown hypertension (higher than the ‘prehypertensive’ range) in the

United States of America stands at roughly one in three individuals. 129 Make no mistake about it,

hypertension is here and the stats are not in our favor.

“Hypertension” is simply high blood pressure – pathologically high. Blood pressure is a measurement of

the average force that blood exerts on the walls of blood vessels during a heartbeat cycle. Hypertension is

best viewed as a symptom of some underlying problem; however, far from being a mere symptom,

hypertension can lead to serious systemic health problems just on its own. With higher blood pressure

there is increased wear and tear on the heart and blood vessels - over time high blood pressure can lead to

endothelial damage and can raise the chances that arterial plaques can rupture and clot. Another effect of

hypertension is that artery walls can become less and less elastic over time due to overstretching because

of increased pressure. If arteries become less elastic they can become rigid and lead to far greater chances

of damage, hemorrhage or rupture.130

All the above consequences of hypertension can increase the likelihood of developing atherosclerosis and

if atherosclerotic plaques are already present then the rigidity and narrowing of the blood vessels can

further increase blood pressure – a catch-22 cycle of damage and disease.

Hypertension aggravates endothelial dysfunction and is a major risk factor for every heart disease and one

of the main causes and consequences of and for CKD itself.131 132

Elevated C-reactive protein

C-reactive protein (CRP) is a biomarker for inflammation in the body. Inflammation, as mentioned

previously, is one of the key mechanisms that drive the onset and development of heart disease. Higher

levels of CRP have been linked to an increased risk of stroke and heart attack. High CRP levels in people

who have had a stroke have triple the risk of experiencing further cardiovascular complications within

one year than those people who had had a stroke but did not have elevated levels of CRP. These research

findings further support the assertion that inflammation is one of the key factors (if not the key factor) in

causing heart disease.133 134 135

Elevated Lp-PLA2

Lp-PLA2 is like CRP in that it is also a biomarker for inflammation in the body. Unlike CRP however,

Lp-PLA2 specifically indicates inflammation in the blood vessels. The specificity of Lp-PLA2 with regard

to indicating vascular inflammation is due to the fact that Lp-PLA2 is released into the bloodstream by

inflamed vascular plaques. Thus, the number of inflamed vascular plaques in the body is directly

proportional to our levels of Lp-PA2. Blood serum levels higher than 200ng/mL have been clearly linked

to increased vascular plaque formation – clear risk factor or indicator of atherosclerosis, heart attack, and

stroke.136 137 138 139



The above is interesting for heart disease cases, but I would expect that CKD cases should also have

elevated levels of Lp-PLA2 because inflammation and kidney degeneration are tightly linked together

with heart disease. Unsurprisingly this is exactly what a team of researchers found in a study published in

2016.140 It turns out that CKD patients who are in stages 3-5 do have elevated levels of Lp-PLA2 which

shows that CKD is very likely able to both be caused by and be the cause of atherosclerosis.141

Omega-6 to omega-3 ratio

There is a lot of misinformation and confusion around the precise benefits or dangers of the Omega fatty

acids and our heart health. As far as the research literature shows, individuals with elevated omega-6 fatty

acids relative to the amounts of anti-inflammatory omega-3 fatty acids have a much greater risk of

cardiovascular disease and inflammatory complications.142 143

In related research, it was found that when levels of omega-6 fatty acids were low relative to omega-3

fatty acids a significant reduction in the size of atherosclerotic lesions was recorded. Lesions on the

interior walls of blood vessels are the sites where atherosclerotic plaques form. Researchers concluded

that low omega-6 to omega-3 ratios inhibit plaque formation; a further result of such a ratio is lower

levels of chronic information as measured by CRP and Lp-PLA2.144

In terms of CKD and CVD, we should make sure to keep our omega-3 fatty acids at levels high enough to

compensate for high levels of omega-6 fatty acids in order to protect from excessive inflammation and

damage to blood vessel walls.

High Glucose and Insulin Levels for Heart Disease

Mention has already been made in the section under “cholesterol” of the process of glycation and

oxidation and how it contributes to heart disease processes. However, direct research on excessive insulin

and glucose levels in the blood should be mentioned as well since this is a massive reason for chronic

levels of inflammation being seen in large sections of the global population and it is the main

characteristic factor in diabetes onset and progression - diabetes is one of the biggest causes of chronic

kidney disease.

The bottom line is that excessive blood glucose causes damage to small blood vessels. This means that

diabetes contributes to the acceleration of atherosclerosis and CKD.145 The research seems to indicate that

fasting blood glucose levels greater than 85mg/dL significantly increases a person’s risk of heart

disease.146

Insulin resistance is a condition in the body where cells do not respond to insulin correctly. Insulin signals

cells to absorb glucose out of the blood. In insulin-resistant people, cells do not respond to insulin

correctly and as a result, their blood glucose levels remain extremely high, especially after eating a meal.

High blood glucose is linked to chronic inflammation, diabetes and diabetic linked damage to the kidneys.

Not surprisingly, insulin resistance is correlated with an increased risk of heart disease.147 148

The Dangers of High Blood Sugar in Diabetes

Why is it that having chronically high blood sugar levels leads to such terrible consequences for our

health? What, exactly, is so bad about high blood sugar?



Well, there are basically three mechanisms or reasons as to why chronically high blood sugar directly or

indirectly leads to damage in the human body. These mechanisms are glycation, chronic inflammation,

and free radical damage149 150 151

Glycation, chronic inflammation, and free radical damage can all lead to serious complications like

endothelial abnormalities (abnormalities in blood vessels), nerve damage (diabetic neuropathy),

atherosclerosis, kidney problems (nephropathy) and many others. We explore these mechanisms in a bit

more detail below.152 153

Glycation & Blood Sugar (Glucose)

When a sugar molecule (glucose) is combined with a second molecule then we say that the second

molecule has been “glycated”. When a molecule becomes glycated its structure, shape, and properties

change which effectively renders it non-functional. Glycation can make deleterious changes in important

amino acids, proteins and cellular structures that severely impair functioning.

Essentially, the process of glycation is similar to the process of frying an egg. The application of heat to

the raw egg causes the egg to change shape and thus its properties. The egg turning white after cooking is

an outward sign that the proteins in the egg have changed their structure – now the egg is no longer able

to become fertilized and produce new chickens. The egg’s primary function (producing new chickens)

becomes destroyed when it is heated. In the same way, molecules that become glycated also lose their

primary function and may take on new properties – properties that also often have further negative

effects.

The newly formed molecules that result from glycation have been shown to be toxic to the body and

scientific literature has dubbed these glycated molecules, “advanced glycated end-products” or “AGEs”

for short. If we have too many AGEs circulating in the blood then proteins such as elastin and collagen

become damaged. Furthermore, damaged elastin and collagen proteins can clump together forming

fibrous complexes causing many different tissues to become inelastic, fibrous and rigid. Research

discussion has therefore proposed that AGEs may be a leading contributor to connective tissue

degeneration, aging and diabetic disorders.154 155 156

High levels of AGEs in the blood have been linked to type-2 diabetes. One study showed a significant

correlation between AGEs and glycated hemoglobin (hemoglobin-A1c) – hemoglobin-A1c is a blood

testing marker for type-2 diabetes.157 158 Another study showed a link between elevated blood AGEs with

abnormal heart and blood vessel physiology – which, as we shall see later when we discuss diabetic

causes and risk factors, is definitely linked to the onset and progression of diabetes type-2.159

Some studies have found that ingesting AGEs that are made outside of the body via food cooking

processes also results in the absorption of those AGEs into the bloodstream. The research found that

foods cooked at high to very high temperatures are most likely to generate AGEs. Common sources of

dietary AGE formation include searing meat or frying foods (e.g. potatoes).160 161

Thus, it seems that cooking our food at high temperatures like searing, grilling or frying will certainly

lead to the formation of absorbable AGEs. Cooking at lower temperatures, for shorter periods or

combining cooking methods with the use of lemon juice (or other acids) seems to minimize the formation

of AGEs.162



Bottom line, if you are going to grill, sear or fry something then make sure to do it with lemon juice,

vinegar, orange juice or some other delicious acid to minimize the formation of AGEs. Keeping blood

glucose levels down will also minimize the presence of free glucose in the bloodstream and thus make it

less likely that damaging glycated end products will be formed in the first place.

Chronic Inflammation in Diabetes

Inflammation is usually a part of our normal immune response to infection, damage or disease. As the

immune system activates and removes the invasive presence of foreign particles, chemical signals are

produced which cause inflammation as a byproduct of its body-protecting activity. So, inflammation is a

fundamental part of a normal healthy and vibrantly functioning immune system. Unfortunately, in cases

where inflammation is chronic or arises for the wrong reasons (such as in an allergy) then the body pays a

very high price. The research on this kind of chronic or mal-activated inflammation clearly shows that

such inflammation is linked to diabetes, cardiovascular problems, CKD, and general tissue damage. Many

factors associated with diabetes can lead to inflammation such as AGEs, high blood sugar levels, insulin

resistance, and others.163 164 165

More directly, studies have found that chronic inflammation can damage insulin-producing cells in the

pancreas which disturbs normal insulin production. The main controllers, or mediators of the

inflammatory response in the human body are a class of molecules called “inflammatory cytokines” of

which the main contenders implicated in the chronic inflammation seen in diabetics are C-reactive

protein, TNF-a, and interleukin-6 (IL-6) – all three of these exotically named inflammatory marker

chemicals have been shown to negatively affect the functioning of the pancreas – furthermore, these three

inflammatory markers are all elevated in diabetic patients as well as CKD patients; which shows that

diabetics and CKD patients suffer from chronic inflammation.166 167 168

Inflammation doesn’t just affect the pancreas. The above mentioned inflammatory cytokines also damage

other areas of the body. They have been linked to bone degeneration, muscle degeneration,

atherosclerosis, CKD and kidney damage, and damage to our DNA - all in addition to impairing

pancreatic functioning. So, the presence of elevated inflammatory cytokines is associated with an

increased chance of death due to any cause!169 170 Chronic inflammation is now beginning to be thought

as a core causal factor in almost every single chronic and degenerative lifestyle disease and in terms of

our discussion of CKD, it should take a particularly important role in any effective treatment because it is

central to the progression of CKD and it is central to the causes like diabetes and heart disease.

Oxidative Damage / Free Radical Damage in Diabetes

There are inevitably going to be waste products formed during normal body functioning. In healthy

people, these waste products pose no problem whatsoever since the body has excellently crafted

mechanisms to deal with them. However, some of these waste products can build up in the body because

of disease or overexposure to toxic stimuli like radiation, tobacco smoke, viral or bacterial infection, and

environmental pollutants.

Some of these waste products are extremely reactive in nature and will bind with almost any other

molecule causing damage. Free radicals are precisely one example of such a highly reactive chemical

species. Free radicals are so named because they are free ‘floating’ (unbound) highly charged molecules.



Typically these free radicals are made as a byproduct of energy metabolism and tend to react with

(oxidize) other body tissues causing damage. In scientific circles, free radicals are usually called “reactive

oxygen species” or “ROs” and one of the main ones is called “superoxide”.

So, free radicals are extremely reactive or volatile molecules that are produced in the body during normal

metabolism (a process of generating useable energy for the body). Normally the body can safely eliminate

these super-reactive molecules, but when they accumulate in excessive amounts the body can, over time,

become overwhelmed – this leads to tissue damage. Typically, ROs can lead to tissue damage, aging and

inflammation, thus proper elimination of ROs is essential to healthy living.171 172

Hyperglycemia (high blood glucose) has been linked to excessive superoxide production which, if left

unchecked, leads to damage to the body seen in classic diabetic cases.173 174 Proper elimination of free

radicals serves to prevent tissue damage and maintain the proper production and storage of energy in the

body. Diabetes is known as a ‘metabolic disorder’, thus factors that impair energy metabolism are key

factors in the onset and progression of the disease. We should take care to ingest antioxidants and watch

our diet and exercise to best support the healthy elimination of these ROs so that we do not contribute to

our CKD by supporting diabetes.

Homocysteine

When you consume protein in your diet then the body produces homocysteine as a natural byproduct of

metabolizing that protein. High homocysteine levels in the body are correlated with damage to blood

vessels (particularly the endothelium). Not surprisingly, the research literature has reported a significant

correlation between high homocysteine levels and heart disease, heart attacks, and strokes. In general

homocysteine levels soar when people have vitamin B deficiency. This is of particular concern to

diabetics on pharmaceutical drugs like metformin which can lead to vitamin B deficiency in addition to

having elevated blood glucose levels and commonly (though not always) concomitant obesity. Not

surprisingly, obese diabetics who consume large amounts of dietary protein in conjunction with poor

glycemic control should be extremely careful – their risks for cardiovascular disease and kidney damage

resulting from that could be extremely high. 175 176 177

Low Vitamin D

Low levels of vitamin D increase the risk of death due to heart disease, whilst normal ranges have anti-

inflammatory effects.178

Low Vitamin K

Vitamin K directs calcium to the bones which prevents the calcification of blood vessel walls. When

blood vessels become calcified they lose almost all their elasticity which contributes to increased blood

pressure, cardiovascular risks, and kidney blood supply problems.179 180 181 Vitamin K can also reduce

inflammation and helps the blood coagulate appropriately. Overall vitamin K is important for addressing

the root etiology of heart disease and may, therefore, be helpful for easing CKD progression indirectly.

Low levels of vitamin K would likely lead to over calcification of the blood vessels causing them to

become less elastic and raising blood pressure amongst other poor health outcomes – a definite ‘no-no for

CVD and CKD.182 183 184 185



The Bottom Line for Inflammation & CKD

Hopefully, I have shown the links between the kinds of inflammation mechanisms in CVD and diabetes

that operate chronically to contribute to CKD. Diabetes and heart disease and high blood pressure are the

three most common causes of CKD, and the mechanisms that lead from these causes to the onset and

progression of CKD tend to mostly be inflammation-based mechanisms that cause damage to the body

systems over time.

In CKD, as the kidneys become less and less able to filter waste products out of the body, toxins build up

in the blood which exacerbates inflammation in the long term. This is why CKD progresses faster and

faster once begun. CKD progression also contributes back to the progression of diabetes and CVD, which

then contributes back to the mechanisms that cause CKD. This is a very dangerous catch-22 cycle that

makes it very hard to treat CKD unless you break that cycle up first. The best way to break up that cycle

is to target inflammation mechanisms.

How do we target inflammation mechanisms in CKD that are linked to diabetes and CVD too? We can do

this through our diet. But before we can talk about what kind of diet we should be eating we should talk

about why shifts in the diet can actually have such a powerful effect on our health. Shifts in our diet are

able to powerfully treat CKD because such shifts can actually prevent and reverse the factors in CVD and

diabetes that contribute to CKD. This brings us to the topic of the next section, where I will discuss the

microbiome and show how it is important for ALL health, including CKD. It turns out that it is actually

our wonderful microbiomes that have the power to make choices turn into healing choices; especially in

diseases or conditions linked to lifestyles like CVD, diabetes, and CKD.

What is the Microbiome?

The term, “gut microbiome” (or just, “microbiome”) refers to the total population of little microorganisms

found in the gut, as well as the state of the environment that those microorganisms are living in. This is

because the term microbiome can refer to the environment in your gut that supports the flourishing of

certain microbes, as well as the specific microbes found there.

Another way to characterize precisely what the gut microbiome is is to think of it in terms of the total

number of genes contained in the special environment of the gastrointestinal tract (the GIT, or ‘gut’ for

short). This is a bit more of a technical description of what the gut microbiome is, but it does precisely

capture the fact that the gut microbiome contains little organisms that each have their own genetic

characteristics that interact with each other and the immediate gut environment.

There are literally trillions of different micro-organisms hosted by our bodies. 186 Most of those organisms

are happy beneficial viruses, with the second most common residents of the microbiome being helpful

bacteria – only a minority are harmful. 187 188 189 How many organisms are there, exactly? Estimates in the

scientific literature differ slightly but roughly speaking there are about 12 non-human elements in the

microbiome for each 1 single human element that is present there – by the numbers, humans are more

non-human than human!190 191 Putting that ratio into numbers, estimates of the total number of organisms

in the microbiome have reached as high as 100 trillion, which is about 3 times as much as all the cells in

every part of the body combined, not just in the microbiome itself!192 193



So, the truth is that our body is host to triple the number of little critters as there are human cells. Most of

these little critters are helpful viruses and bacteria. In the gut, for example, the presence of the right kinds

of helpful bacteria actually gives us an advantage in terms of being able to extract certain vitamins and

minerals that otherwise would be impossible to access in our diet. Most people think of viruses and

bacteria as disease-causing villains, but I would like to emphasize that when it comes to the microbiome

you should rather think of them as our beneficial little friends. They will be your main ally in any struggle

to heal from CKD.

It turns out that about 95% of the viruses and bacteria that we find naturally in the gut work for our

benefit.194

Important General Features of the Microbiome

In the few decades before the end of the 20th century, it was discovered that the microbiome was able to

affect the way our brain functioned and that it had the ability to interact with signaling from the brain in

unexpected ways. This was understood to be possible back then because it was discovered at the time that

the gut had more receptor sites for neurotransmitters in it than the brain. Neurotransmitters are little

chemicals that control our behavior, moods, appetite, everything. In fact, neurotransmitters are the body’s

main way to chemically control the functioning of the central nervous system. 195 196

Nowadays we know that the gut microbiome is actually intimately involved in just about everybody

system, and it has a powerful effect on the way each of those systems functions. So today, most

researchers of the microbiome consider the microbiome to be an organ in its own right because of how

many different important functions the microbiome handles in the body. 197 198 Indeed, the bottom line is

that if a person has a happy healthy microbiome filled with populations of positive beneficial critters, then

it is almost guaranteed that that person would be in good overall health too – the microbiome is that

important to human health! 199 As an example of what I mean, take a look at the following brief list of

important functions that the microbiome has:

The microbiome is able to:

- Affect human moods. Relieve stress. Enhance memory and attention. This is possible because of

neurotransmitter interactions and something called the gut-brain axis.200

- Affect the way the human body matures from childhood into adulthood and onward to older age

too.

- Help us to digest otherwise indigestible food like cellulose from plants.

- Help us deal with toxic waste products that come from ingesting certain foods and drinks.

- Help us to generate nutrients, vitamins, and minerals that our bodies cannot make on their own

like vitamin C, B vitamins, vitamin K, and certain types of short-chain fatty acids (“SCFA”, these

are important little fats that the body needs for key metabolic processes.)201

- Keep our weight at optimum levels when it is healthy. When the microbiome is packed with

unhelpful critters then it can contribute to obesity, or on the other hand, malnutrition202 203

- The microbiome is an important protector of the body from harmful chemicals in our foods as

well as harmful bacteria and viruses because it comes into direct contact with foods and

environmental influences during digestion.204 This means the gut is not as ‘internal’ as most



people might think, it is actually much more like our skin and serves many of the same functions

as being a ‘barrier’ and being a membrane for exchange of information with the environment.

- The gut microbiome interacts deeply with the human immune system and even influences the

way babies’ immune systems develop. If you want a healthy immune system, the microbiome

must also be healthy because it is one of the critical factors in creating a strong robust and

properly working immune system.205 206 207 208

That is quite a list, but this list doesn’t even scratch the surface when it comes to all the different things

the microbiome does for us. One of the most important points to remember is that the microbiome comes

into contact, directly, with our environment. This is true whenever you eat or drink something. This

means that our environment can influence all the factors I listed above because whatever interacts with

the microbiome and affects it, will have an effect on all those things. This means that people should really

take care, and pay attention to what they eat or drink or do on a daily basis.

Things like air quality, pesticides, weather, seasons, what you eat, how much you exercise, antibiotics,

almost everything will affect the population of little critters in the gut - Everything people do has an

impact on their gut environment because everything people do interacts with it eventually – be mindful of

what you do on a day to day basis since that determines the kind of microbiome you have, and the kinds

of little organisms that flourish as well as the kinds of organisms that can’t flourish because of the

characteristics of the gut environment. 209 The microbiome thus directly determines the kind of health you

have, and your behavior directly determines what your microbiome is like. This means that you have a

direct conscious way to affect your health by what you do on a daily basis; that is the bottom line. 210 211 212 213

One final thing to say about the microbiome is that there is significant evidence pointing to the fact that

the microorganisms in the gut (the “microbiota”) are able to explain all the inflammation-based disorders

that cause CKD or arise with CKD. The reason this is thought to be likely is that the presence of high

levels of uremic waste products in the blood and gut (more on this to come) impairs the ability of the gut

to act as a protective barrier. The gut becomes too permeable allowing things to pass through it into the

body that should not normally be able to do so.214

This kind of increased gut permeability is often informally referred to as ‘leaky gut’. A leaky gut allows

bacteria to freely enter into the body from the GIT, and as a result, the immune system becomes

chronically activated over multiple body areas and systems – leading to widespread systemic chronic low-

grade inflammation exactly like that seen in the cause and progression of heart diseases, diabetes, obesity,

and CKD!

That same bottom line was eventually understood by the scientific research community. This

understanding culminated in 2008 with the founding of, “The Human Microbiome Project”. The

Microbiome Project is active today and functions to co-ordinate research programs and collate data on the

microbiome, as well as to generate funding for research that will ultimately further our knowledge of the

microbiome’s importance and uses in health.215



The Development of the Microbiome

Your microbiome is seeded at birth, and then as you grow into infancy, early childhood, adolescence,

adulthood, and finally on into older age it tends to change slightly around key milestones.216 217

The initial seeding of the microbiome is linked to different factors like where you were born (home or

hospital), the kind of birth you went through (e.g. vaginal birth vs. caesarian birth), whether your mother

breastfed you and so on.218 219 220 221

The first seeding of the microbiome with bacteria usually involves about 100 different species, by the age

of three years that number grows to about 1000 species and at that time your microbiome resembles an

adult microbiome very closely. At puberty, and menopause further changes can be seen in response to

changing hormones in the body during sexual maturation and decline, but overall the major development

of the microbiome is completed by three years of age, and its characteristics from then on will vary based

on chance environmental inputs over the life span.222

In healthy people, the microbiome will be populated by a number of different healthy microbes. Each

microbial population in the gut contributes to an environment that supports itself and others like it. This

means that healthy gut microbe populations tend to thrive in situations where there are other healthy

microbes present too. The populations of microbes will be balanced with respect to each other in healthy

people. In people who are ill what happens in the microbiome is that certain populations of harmful

microbes might overly flourish and cause changes that suppress the proliferation of healthy strains.

Anyway, speaking generally the most common strains of bacteria found in the human microbiome include

Bifidobacterium, Lactobacillus, Bacteroides, Clostridium, Escherichia, Streptococcus, and

Ruminococcus.

There are various factors that affect whether a certain microbe will flourish or struggle. These can include

things that affect the acidity of the gut environment, what kinds of foods you put into the gut, how much

water you drink (or don’t drink), how much exercise you do, and so on. Briefly speaking here is a list of

some of the most powerful factors that affect the size and diversity of your microbiome microbe

populations:223

- How much you exercise.

- The consistency and amount of water you drink.

- The kind of nutrients/diet you provide your microbes.

lots of sugar, or only a little? (less sugar, particularly less simple sugars contribute to a

happy microbiome)

The kind of sugars you give them e.g. complex carbohydrates vs simple carbohydrates.

(complex carbs promote beneficial microbes)

A high fiber diet or a low fiber diet? (High fiber diets promote beneficial microbes)

Eating a diet with variety vs a diet with the same things each day. (balance and variety

promote healthy microbiomes).

- Taking medication, or antibiotics (usually a very negative effect on the microbiome, e.g.

antibiotics just destroy all the bacteria in the gut – like a nuclear bomb for the microbiome.)

- Your levels of stress (high-stress lifestyles tend to put the little microbes under stress too.

Being relaxed makes for more powerful and beneficial microbiome profiles)

- Exposure to other kinds of toxic substances affects the microbiome negatively:



Good examples include ethanol, certain food additives, and preservatives, pesticides.

Strong acidifying agents that change the pH radically and so on.

- Prebiotics help microbes to flourish. Prebiotics are slow-to-digest or non-digestible plant

fibers that act as food for little microbes. This is why a high fiber diet (mentioned just above)

has a positive effect on the microbiome.

- Probiotics – Probiotics are live bacterial cultures that can be used to introduce specific

bacteria into the gut. Unlike “anti-biotics” which are “anti”-“life”, “pro-biotics” are “pro”-

“life”. Probiotics are a powerful way to seed the gut with microbes that can directly support

health and act to treat certain diseases.

CKD & The Microbiome

It turns out that people with CKD have distinctive characteristics linked to their microbiomes - the same

is true for people with diabetes and CVD. 224 225 Before I share what these characteristics are I want to

remind you that one of the main features of chronic kidney failure is that waste and toxins build up in the

blood over time because the kidneys can’t handle getting rid of them. This situation is similar to someone

who has gout because in gout the kidneys can’t get rid of enough uric acid and then crystals form in their

joints which end up causing terrible arthritis-like swelling and pain. For CKD the situation is worse

because the kidneys can’t filter anything properly, not just uric acid.

One of the ways that the microbiome interacts with CKD is in the by-products that are formed from

digesting the food we eat. Some of the by-products formed when digesting foods will need to be

eliminated from the body via the kidneys, examples include uric acid and other by-products from

metabolizing proteins. The two main waste products that the kidneys must eliminate from the body, but

fail to do so effectively in CKD are called “p-cresol” and “indoxyl sulfate”.226 These two compounds

might have scary-sounding technical names, but all you need to know about them is that they are two of

the most important waste products that aren’t dealt with properly in CKD – they come from animal

protein digestion mainly and certain microbes in the gut make lots of these two compounds when they

interact with protein-rich foods.

The bad thing about these two toxins building up in the body in CKD is that these two toxins can actually

cause damage to the kidneys and impair kidney filtration too. This means that in people with CKD, their

diet can generate a catch-22 cycle where they keep making these toxins which keep damaging the

kidneys, leading to higher levels of these toxins…and so on and on. 227

Another problem with these two

toxins is that they contribute to changes in the microbiome that lead to the flourishing of microbes that

produce even more of the same toxins – so this constitutes a ‘double whammy’ catch-22.

Clearly, it stands to reason that people with CKD should try to cultivate a microbiome that is filled with

bacteria that don’t contribute to making “p-cresol” and “indoxyl sulfate”. Also, people with CKD should

try to eat foods that do not breakdown into these two uremic toxins either. It turns out that people can do

both and the factors that let us do this include:

A) Eating a largely Mediterranean diet helps promote bacteria that are mostly breaking down

carbohydrates rather than proteins.



B) Reducing protein consumption should less than the production of “p-cresol” and “indoxyl sulfate”

and encourage fewer bacteria in the gut that putrefy protein (proteolytic bacteria do this). 228

C) Increasing fruit, fiber, wholefood consumption with complex carbohydrates and a good variety of

vegetables should encourage the microbiome to take on a more carbohydrate fermentation centric

population (saccharolytic bacteria do this) – one that is beneficial to CKD patients. 229

What the above tells us is that we have a choice to cultivate two kinds of microbiome. Either we cultivate

one that putrefies proteins and releases kidney toxins, or we can cultivate one that ferments complex

sugars which will reduce kidney toxins and present many other benefits for CKD too. 230

So, we should cultivate a ‘saccharolytic’ microbiome. As you will see in the final two chapters, I have

recommended a form of the Mediterranean diet to accomplish just this feat.

For clarity, here are the main negatives associated with having a proteolytic based microbiome

characteristic of CKD patients:

- Protein fermentation leads to a number of short-chain fatty acids (SCFAs) as well as

ammonia, amines, thiols, and indoles. These compounds are toxic to human kidney function,

contribute to a wide range of chronic lifestyle diseases, and build up even more if the kidneys

are already beginning to fail.231

- As kidneys fail they try to adapt to increasing toxic demands. Changes happen in the body

which causes the colon to get involved in the excretion of waste products – uremic waste

products (waste products normally associated with the urine) are essentially dumped into the

colon for excretion.232 233

Involving the colon in uremic waste excretion helps the body detox the blood, but the

cost is that the environment in the colon changes – promoting the growth of proteolytic

microbes.

With more proteolytic microbes come more uremic toxins that in turn lead to more

pressure again on the kidneys -> which then adapts even more by dumping more waste

products into the colon -> stimulating the flourishing of more proteolytic microbes…and

so on and on in a dangerous catch-22 downward spiral of degenerating health.234 235 236

And, again for clarity, here are the main positives associated with having a saccharolytic microbiome are

quite the opposite, e.g. less uremic toxins are formed, better kidney filtration rate, better overall health

outcomes. A decrease in risks associated with CVD, diabetes, cancer, and CKD. And finally, better

nutritional status overall with better immune system function to boot.237

The only thing left to say is what kinds of bacterial families are conducive to a saccharolytic gut?

Research indicates that certain families in the Bacteroidetes and Firmicutes species of bacteria, especially

some Lactobacillaceae and Prevotellaceae species are the ones that you want to cultivate. The methods to

cultivate the right kind of microbiome for CKD health are covered in a later chapter. I can say in general

terms however that using probiotic seeding and eating more fiber and prebiotics, along with keeping

stress down, drinking more water and avoiding antibiotics and pesticide exposure are the key principles of

getting these bacteria species to flourish. In general, it is the Mediterranean style of diet that does the trick

for CKD and as I mentioned earlier I will give my own dietary recommendations based on this fact from

the scientific literature. 238



That brings us to the end of this chapter. What should you know up to now? Up to now, you should be

familiar with what CKD is, what causes it, what complications arise, what the causes are as well as what

the deeper causes are likely to be – this all from chapter one. Secondly, you should be very familiar by

now with the idea that underlying CVD, diabetes, obesity, and CKD are chronic levels of inflammation

that end up damaging the body in general and the kidneys in particular. From this chapter, you learned

how CVD and diabetes actually come to generate that inflammation. In the final sections of this chapter,

we covered the miracle that is the microbiome and how the microbiome is central to the explanation of

how your daily diet and activity contributed to CKD and the underlying mechanisms of inflammation too.

The microbiome is the reason why your daily lifestyle choices and actions can affect your health and are

the reason why you can use lifestyle changes and nutrition as medicine – something which I explore quite

deeply in the next chapter.

So diet and lifestyle are important because of our microbiome and the way it interacts with the rest of the

body to help or harm the kidneys. In the next section, I will look at these lifestyle factors in more detail

and describe how sleep, stress, and exercise link to CKD as well as what you can do about those links to

ensure your kidneys stay healthy. In the next chapter, I will also discuss the diet in more detail and talk

about the kinds of foods and drinks that should help you to heal.


Chapter Three

Lifestyle Perspectives for Healing CKD

In this chapter, I want to give you the ways in which you can manage your lifestyle choices and activities

to bring your body back to a state of health.

If all your choices up to this point contributed to bringing about a situation where you have CKD, then

what can you change to manage it or remove it now that it is here? That is what this chapter is all about.

I will start by exploring the topic of stress in day to day life and show how it can generate inflammation

and heart problems, or contribute to obesity and diabetes. If you can reduce stress, then you can ease the

pressure on your kidneys, reduce your heart risks, prevent diabetic issues from arising and generally be

more alert, alive, and healthy.

After stress, I will do the same exploration for sleep, and exercise. Sleep and exercise and stress are all

intertwined, the benefits of making healthy choices to reduce stress, sleep better, and exercise a little more

are cumulative and extremely potent for health. This potency shouldn’t be misjudged, the scientific

literature shows that making the right kinds of lifestyle choices in terms of sleep, exercise and stress can

radically improve health, in most cases much more strongly than any pharmaceutical intervention could

hope to achieve.

The last topic in this chapter that I will cover is diet. Finally, here, I get to discuss the best diet for CKD

and your microbiome. I get to share why such a diet works, how it works, and the kinds of foods that it

should contain. I also get to show what to avoid, and why.

The practical information that you need to know so that you can understand what to do to get better starts

in this chapter, and continues into the next. The trend of practicality increases from here forward and

culminates in the final chapter of this book where I give precise practical protocols to actually follow to

heal – based on the information in the rest of the book.

Stress & Sleep

Try to remember how it feels to go without sleep for just a single night – gritty eyes, foggy thinking, poor

energy, headache, grumpy mood, no muscle strength – a nightmare, right? This just goes to show how

important sleep is to the quality of your experienced day-to-day life.

Imagine further that after not being able to sleep for that one night, you had to go to work and maintain a

pleasant social demeanor, keep your attention on what your given tasks were, follow the flow of

meetings, and contribute to achieving milestones. That day at the office after not sleeping would be a

slow, stressful, and utterly dreary experience for most people - and your performance would definitely

have been below par.

Chapter 3 – Lifestyle Perspectives for Healing CKD


Enough working days like that and work becomes more stressful, people will notice how off your game

you seem to be, you might even be at risk of losing your job. That kind of scenario is just one way that

not sleeping can lead to increased stress in your daily life – it becomes much more difficult to meet your

obligations if you are sleep deprived. One of the surest ways of catapulting your stress levels into cosmic

orbit is to start gradually failing to meet the responsibilities you have to those that depend on you.

So, intuitively, just by imagination, you can get an inkling of how important sleep is to your quality of

life. But, what does the science say about it? Are there measurable biological effects? How much more at

risk of poor health outcomes are people who do not get enough sleep? Also, more importantly, what can I

do to sleep better? I’ll get to answer these questions a bit later in this chapter.

So, what about stress? I already showed just one way that sleeping badly raises stress levels. But, try to

remember back to a time where you were highly stressed or anxious over a period of a few days or more.

Many people have trouble sleeping when they are stressed out, you may have had trouble sleeping when

you were stressed too – it is a common symptom of high stress. The thing is that stress and not sleeping

go hand in hand – together they lead to more stress, which leads to less energy and worse decision

making, leading to more failure to meet responsibilities, which leads to more stress, leading to more sleep

loss….and so on, and on.

Stress is felt psychologically, but that psychological feeling of anxiety rides on top of and is a symptom or

sign of, many underlying biological processes that are happening in the body. These biological changes

are measurable, and if prolonged they tend to lead to severe health problems. Chronic anxiety/stress, sleep

loss, and horrible health consequences are so tightly linked together that they tend to cause each other and

feedback into each other in a cycle of ill health that needs to be broken as soon as possible.

So, to prove my point, consider that one-third of all visits to a doctor happen because of something related

to stress/anxiety or sleep - including the biological health complications directly caused by such things.239 240 241

Take a look at the following info reported in the scientific literature about the effects of insomnia and the

effects of stress:

Insomnia is linked to…

- Higher levels of the stress hormone cortisol, and other stress hormones.242 243

- Increased weight gain and poor eating habits. 244

- Poor immune system functioning 245

- Increased risks for Diabetes, and for diabetics. 246

- Increased risk for osteoporosis 247

- Many inflammatory conditions, e.g. heart disease and CKD. 248 249

- Insomnia increases inflammation in the body – this kind of inflammation is linked to arthritis,

gout, inflammatory bowel syndrome, heart disease, and CKD.250

- Decreased pain threshold (more sensitive to pain).251

- Increased risk of stroke. Adults who suffer from chronic sleep disturbances have up to four times

the risk of stroke than people who sleep well.252



Prolonged or chronic stress can cause or result in…

- An early death. 253 254

- High blood pressure 255

- Dementia256

- Increased anxiety and depression – stress causes changes in the brain. 257 258

- Chronic low-grade inflammation259

- Much higher risks of certain cancers. 260 261 262

- Increased inflammation 263

- Thickening of the walls of blood vessels 264 265

- Cardiomyopathy – a condition that comes about when the heart begins to beat irregularly. Over

time the heart muscle can degenerate and even this can even lead to an early death. 266 267 268 269

- Japanese people have a condition linked to chronic stress which they have called “Karoshi”.

Karoshi has been responsible for over 10 000 deaths every year since 1990 and is directly caused

by stress due to overworking. 270 271

- Irregular eating habits linked to poor nutrition, microbiome changes, and poor health. 272

Speaking about stress, notice that aside from dementia, cardiomyopathy (speaking specifically of course,

because you know that heart disease is directly related to CKD), and Karoshi, all the other mentioned

effects have been encountered in earlier parts of this book – they are all strongly linked to CKD.

The relationship between sleep and stress is also clear. Take a look at the following statistics:

If having problems sleeping is the main cause of your stress then…

- You are 170% more likely to die from any cause.

- 38% more likely to suffer a bad injury at work.

- You have an 80% increased risk to die from some kind of respiratory disease (disease of the

lungs)

- And finally, you will have a whopping 159% higher chance of having a heart attack.

If stress at work is your main cause of stress, then you are 180% more likely to die from a heart attack

than people who don’t really report that they have occupational stress when asked. 273 274 275

Looking at sleep in addition to stress the story becomes clear. You should be concerned about your

sleeping habits and your stress levels. CKD patients often have disrupted sleep because they often have

irregular urination patterns. It is quite common for kidney patients to need to urinate through the night and

this can severely disturb healthy sleep.

People who are chronically stressed in their work and home lives are much more likely to be pressed for

time. This pressure can often lead people to ‘cut corners’ on things like cooking - to save time and energy.

This means that people under such circumstances do what they can to feed themselves and their families

given the limited time and energy they have to focus on such things. This is one reason why stress is

correlated with worse eating habits. Another reason is that for some people, binge eating may be a way

that they cope with anxiety leading to poor outcomes.

People under chronic high stress are much more likely to eat poor quality premade convenience foods

from supermarkets, restaurants, or fast food outlets. These foods are often made for profit, and so it is



common that they don’t have the highest quality ingredients (exceptions exist, of course). Such foods are

usually packed with inflammation-causing additives, tons of omega-6 fatty acids (also inflammation

causing), and extreme levels of added sugar or salt. Eating foods like these are known to cause, or support

the causes, of many diseases. Examples include obesity, heart disease, microbiome problems, gout,

diabetes, kidney problems like CKD, erectile dysfunction, and many more. 276

Stress is no joke and should be reduced and managed carefully. Why do we stress, what is the point of the

body being able to respond in such a way? The point about stress is that it is really the body’s way of

going into high gear to save your life. In the wild, or nature, this is a response that can save your life from

predators, or get you out of dangerous situations. The response of the body to imminent threat is called

the “fight or flight” response and it is managed mostly by cortisol (the so-called stress hormone that

controls the flight or fight response) as well as by adrenaline in cases of a sudden fright or jolt.

Unfortunately, the flight or fight response was evolved to deal with natural life-threatening encounters.

The response was not really designed to deal with day-to-day urban life. Fight or flight responses

galvanize the body into action so that it gathers all available energy and focuses attention. Blood flow is

diverted to the muscles of the arms and legs, away from non-essential components, your attention is

enhanced and reactions become faster. The cost of all this ‘activation’ is energy, vast amounts of energy.

The body tends to pay a high price for survival, but in nature, it has been worth it. In modern city living,

the body still responds with the same biological mechanisms of ‘fight or flight’, but this time the stressors

may not be imminent. In fact, we are constantly bombarded with stressors in a city environment, or at

work, or at home. The flight or fight response can become chronically activated in a low-grade way and

this ends up being way too costly on its state of health.

Day by day, the body can wear itself out because of always being in a state of activated stress. The

consequences are going to appear and usually include heart and blood vessel damage, brain fatigue,

inflammation, chronic general fatigue, and all the other negative consequences that I have already listed

above.277 278 279

Ok, so I hope it is clear from the discussion above that you need to make sure your sleep and stress are

supporting your kidney health and not causing or maintaining your kidney disease, CVD, or diabetes.

You need to reduce your stress and ensure healthy sleep so that you keep your blood vessels happy, your

inflammation low, and your diet healthy.

Methods & Tools to get Good Sleep & Live Stress-Free

What can you do to sleep better and manage stress? Quite a lot actually! There are basically two broad

categories of things you can do to that are proven to help these lifestyle factors, and they are:

1. You can take supplements or ingest natural foods/drinks that help for sleep and stress

2. You can adopt behavior that supports better sleep, stress-free living, and healthier outcomes.

I recommend doing things in each category for the best results. If you do manage to sleep well and reduce

stress to a minimum, then the benefits you will gain will act as strong treatments for your CKD.



With that said I would like to start this section off by sharing some of the best stress-reduction tools that I

have found in my practice as a health professional. After that, I’ll suggest some healthy natural things that

can aid your sleep. I’ll wrap it all up by discussing some activities and lifestyle choices that you can adopt

to support both. Let’s get to it!

DHEA

DHEA (which is short for “Dehydroepiandrosterone”, pron. “De-Hydro-Epi-Andros’terone”) and is, in

fact, a hormone that interacts with the adrenal glands that lie on top of the kidneys. DHEA combats stress

because it balances the effect of the main stress hormone cortisol.280

As people get older, levels of DHEA relative to cortisol decline. This means that your ability to manage

stress when it happens gets worse as you age, so supplementing with DHEA can really prevent stress

from getting out of control and running away with your health. The main idea with DHEA is to get it in

balance with your cortisol levels.281 282

Other benefits of DHEA supplementation for CKD and health in general include:

- Protecting the brain from damage due to stress based inflammation. Reducing people’s risk of

getting dementia, or Alzheimer’s disease.283

- Protect the heart from damage due to stress mechanisms that generate chronic inflammation in

blood vessels, high blood pressure and so on.284 285 286

- DHEA reduces the risks linked to diabetes, obesity, and high blood pressure! Which means it’s

great for CKD patients.287 288

- DHEA supplementation improves mood and cognitive function.289 290 291

- DHEA can actually lower blood glucose levels, which is helpful for diabetes. This is great for

CKD too since diabetes is the most common cause of CKD and limiting diabetic damage is sure

to limit the progression of CKD.292 293

- DHEA can reduce the risk of cancer.294

Melatonin

Melatonin is a very strong antioxidant. It also happens to be the main chemical in the body that tells the

body that it is time to sleep. So, if there ever was a sleepy chemical, then this is it! Melatonin is often

prescribed to people for jet lag because it helps people to rebalance their circadian rhythms (day-night

cycles). The antioxidant properties of melatonin are great at combating the negative biological effects of

stress, and the sleep correcting properties of melatonin are great at helping people to have great quality

sleep. Getting to sleep properly also mitigates stress and promotes health. Thus, melatonin is a wonderful

supplement to take for both sleep and stress and health. 295 296 297 298 299

Melatonin is safe to use and has potent effects when taken in dosages of as little as 0.3mg all the way up

to 15mg. Generally, it is best to take melatonin at night, 30 minutes before you want to sleep, and for no

more than five nights in a row with two nights break before taking it again. You don’t need to keep taking

melatonin if you don’t have problems sleeping, there are other antioxidants that can be as good an

antioxidant as melatonin, but if you need help getting to sleep, then I cannot recommend anything more

than melatonin.



Vitamin B

The family of B vitamins all works together to synergistically benefit the body. Each different type of

vitamin B usually helps other vitamin B types to work better. For this reason, it is best to supplement

vitamin B as a complex (a collection) containing several vitamin B family members at once. Most

standard B-complex vitamin supplement products have the right combination of B-vitamins to promote

good effectiveness. Vitamin B is best absorbed whenever your gut microbiome is happy, healthy and

flourishing, so to get the maximum out of your B-supplements, you should also be looking after your gut

microbiome with probiotics and a good diet.

The short and simple statement that I can make about B-vitamins and stress is that they massively reduce

stress. In fact, the B-vitamins are so good at combating stress that they also prevent the negative effects of

being stressed even when you are stressed.300 301 302 303 304

Vitamin C

Vitamin C is used to balance our levels of cortisol (the main stress hormone) and DHEA (the main

regulator of cortisol).305 306 There are too many benefits of vitamin C to list them all here, however, I will

just mention that vitamin C helps the immune system, reduces stress, prevents and combats cancers, helps

with diabetes, protects the kidneys from oxidative damage, helps the heart…basically, vitamin C is the

superstar vitamin and people who are ill should always consider supplementing with it.307 308 309 310

Multi-Mineral Supplement

Calcium, magnesium, sodium, and potassium are all minerals that are needed to balance the functioning

of our adrenal glands. This means they are important substances for our stress response system which is

regulated by the adrenal glands. If you have appropriate amounts of these minerals in the body then you

will be better able to deal with stress biologically and suffer less damage from the effects of stress

overall.311 312

Chromium, Zinc, Manganese, and Selenium are also important to the adrenal glands and deficiencies in

the trace minerals can prevent the adrenal glands from coping with the demands placed upon them by

lifestyle stressors.313 314 315

So, taking a multimineral supplement would go a long way to preventing any deficiencies and help to

make sure that the kidneys and adrenal glands have what they need to function properly. Without these

minerals, the kidneys and adrenal glands will not be able to function correctly and this is likely to make

stress have much worse effects on the body and lead to a worsening of CKD.

L-theanine (Found in Green Tea)

If you drink green tea then you can benefit from this amazing compound. Green tea has many other

compounds in it which are super potent and beneficial for your health. In this section, I only want to point

out that L-theanine is great for reducing stress because it enhances relaxation and improves brain

function. 316 317 318

L-theanine protects brain cells from toxic damage by keeping networks of nerves in the brain from being

over-stimulated. 319 320 321 322 323 Basically, L-theanine calms the body and nerves which prevents too much



stress from building up at a biological level. Green tea has many beneficial properties for CKD because it

contains very powerful antioxidants that are also very good at reducing and preventing inflammation. I

will talk about green again in the next chapter where I discuss nutrients to help bust inflammation and

help CKD.324 325 326 327 328 329 330

Omega 3-Fatty Acids (Krill Oil)

Krill oil is rich in omega-3-fatty acids. The benefits of ingesting omega-3 fatty acids are impressive, and I

will talk more about them in the next chapter because they are important tools for healing from CKD,

healing the microbiome, preventing kidney damage and living a healthy life. For now, I wish to

emphasize their ability to combat stress.

Krill oil not only reduces the negative effects of stress but also actively improves people’s ability to

respond to stressors in the environment – it helps you deal more pro-actively with things that stress you. I

talked about omega-6 fatty acids in chapter two when I discussed inflammation and heart disease and the

relationship between those things and CKD. Here I just remind you once again that the omega-3 fatty

acids are necessary to balance the inflammation-causing omega-6 fatty acids. This is very important to do

because in the typical modern western diet there seems to be an overabundance of omega-6 fatty acids

with too few foods containing sufficient omega-3 fatty acids to compensate properly.

An amazing property of the omega-3 fatty acids is that they tend to be adaptogenic. What this means is

that if ingest them, then your body will use them to balance whatever is out of balance in terms of the

stress response. E.g. if you are overstressed, then the omega-3’s will help the body reduce your stress, if

you are lethargic, lacking in energy and need to raise your body’s baseline activation a bit, then omega-

3’s help the body to raise levels of good stress to balance you out. The omega-3 fatty, therefore, let you

adapt and respond appropriately to day-to-day events in your life.331 332 333 334 335 336 337 338

Depression and anxiety have been successfully treated by using omega-3 fatty acid supplements. Both

depression and anxiety are closely linked to stress responses and chronic inflammation. This means that

omega-3’s are very good for us stressed out CKD patients.339 340 341

Probiotics & the Microbiome Can Help With Stress

The microbiome is central to our health, as you know from the discussion in chapter two. The

microbiome is also important for managing stress. The main link between the microbiome and stress is

that the microbiome and the gut are heavily linked to neurotransmitters that affect mood, appetite, and

behavior – the so-called “gut-brain axis”.342 343 344 345 346 347

Probiotics are prepared colonies of helpful bacteria that can be taken to seed the gut with helpful critters –

resulting in massive benefits to our state of health.348 Because probiotics can affect the gut-brain axis they

can help reduce stress, anxiety, pain, and depression.349 350 351

The best probiotics for stress are Lactobacillus helveticus (L. helveticus) and Bifidobacterium longum (B.

longum) which both prevent runaway stress responses and inflammatory conditions linked to the bowel.

Consider them for your microbiome when cultivating the diet that is recommended in the practical

protocol in chapter five.352 353 354 355 356 357 358



Sleepy Herbs/Plants

The poppy plant, the chamomile plant, and powder made from valerian root are all quite well-known

soporific herbals that reduce stress AND help with sleep problems. Less inflammatory damage and better

sleep are well worth the trouble of preparing a cup of tea – they are to be recommended for your stress

relief.359 360 361 362 363

Ashwagandha (Withania somnifera)

Ashwagandha is a medicinal herb that has been in use by tradition Indian healers for millennia. They use

it for stress, fatigue, pain, diabetes, and Used for treatment of stress, fatigue, pain, diabetes, and diseases

of the bones and joints characterized by chronic inflammation.364 This amazing herb can protect your

nerves from damage, reduce blood pressure, as well as reduce the negative effects of stress on blood

vessels.365 366 367 368 369

Ginseng (Panax Ginseng)

This specific species of ginseng has strong anti-stress and anti-oxidant effects that protect the body from

diabetic linked damage as well as protect the blood vessels from inflammation-based damage. Ginseng is

a mild mood enhancer that has been reported to reduce depression.370 371 372 373 374 375

Holy Basil (Ocimum tenuiflorum)

Holy basil helps control blood sugar and blood cortisol levels. Meaning it protects against diabetic

problems and reduces stress.376 377 Holy basil was also reported as being able to boost the immune system

and help people respond better to stressful events.378 379

Reducing Stress and Improving Sleep with Behavioral Methods

There are active things you can do to relieve stress and promote good sleep apart from eating well and

taking supplements.

The first such thing that has a proven ability to reduce stress and promote healthy outcomes for people

who are stressed is mindfulness observation practice which is a westernized mental activity that is similar

to meditation but without any religious baggage associated with it.

The other thing we can do to help us reduce our stress and improve our sleep is to exercise. But, the issue

of exercise for CKD patients is tricky because most forms of exercise are likely to be dangerous for

someone with CKD. Still, I have found a way that CKD patients can benefit from exercise without any

risk of suffering a fatal complication.

Mindfulness Observation Practice – For Stress

Mindfulness practice is a meditation-like activity. It involves the intentional mindful activity of focusing

your attention on the present moment – including the immediate surrounds, sounds, smells, sights, touch,

and tastes; as well as the internal processes going on in your mind like the word thoughts, images,

daydreams and fantasies one is having. The process of applying mindfulness in each moment helps people

to become aware of their thoughts and circumstances in real-time and should allow you to instantly detect



any stress or anxiety and work with that feeling so that it doesn’t unconsciously dominate your choices

and activities throughout your day.

Mindfulness techniques have been pretty well studied by science and the results are impressive,

particularly with regard to reducing stress and improving memory. The stress-busting properties of

mindfulness observation practices aren’t really surprising since calming down, focusing on breathing and

taking stock of your immediate environment tends to slow the heart rate and breath and induce relaxation.

Some of the impressive benefits of these practices have been reported in journals, they include:

- One scientific study reported that mindfulness techniques were able to increase neurons in the

brain, essentially allowing the regrowth of grey matter after only 8 weeks in people who had

damaged areas.380

- Mindfulness practices reduce ADHD symptoms and increase your ability to concentrate. 381

- Mindfulness meditation practices reduce blood pressure which is particularly beneficial for CKD

patients.382 The American Heart Association has publicly stated that meditation reduces blood

pressure. 383

- A study found that meditation reduces stress in almost everyone who does it. The benefits of that

stress reduction were measured and found to be correlated with a 23% blanket reduction in risk

for dying earlier than what average life expectancy would predict.384

- Meditation has been proven to be able to alter certain genetic mechanisms implicated in the aging

process. This means that meditators are likely to live longer, or more likely to retain the youthful

capacities of their bodies as they age. In other words, meditation, or mindfulness observation

practice, keeps you young!385

The easiest method of practicing mindfulness is to simply become aware of your breathing. You can do

this by stopping what you are doing and focusing on your breathing without changing or interfering with

your breath, just let it happen, by itself – mentally start counting your breaths to keep your focus there.

See how many breaths you can count before you get distracted and end up moving your attention

elsewhere. You can try recording your highest counts and then see if you can beat your own records. Over

time you would get quite good at holding your focus on your breath.

Once you get pretty good at holding all of your focus on your breath, e.g. being able to undistractedly

count 400 breaths in a row without your mind moving to other things or losing count, then you can try to

make your practice a bit more advanced.

To take your practice to the next level you could then become aware of your breath whilst you are doing

other things. For example, while you are preparing a cup of tea, see if you can be aware of your breath

and count your breaths as before whilst also preparing the tea. I.e. do all the little things like boil the

water, fetch and rinse a cup, place the teabag into the cup, steep the teabag by dipping, add sugar, stir the

sugar in, add milk to the tea, stir again, and then drink the tea until it is finished – all while counting your

breath. This is actually really difficult to do without practice, you are going to lose track of your breath all

the time until you master it.



Once you can do tea making while being aware of your breath at the same time, see if you can do other

simple things like being mindful of your breath while getting dressed in the morning, or while cooking

dinner. If you can, then it’s time to move to the next stage of practice.

In the next stage, you must still be aware of your breath while doing other things but remove the mental

counting. You may have to return to the first phase of your practice focusing all your attention on your

breath only and sitting quietly while doing that without counting. The mental counting is actually a

mental set of ‘training wheels’ to help you focus, so when you get to this point you can attempt to remain

focused on your breath without any mental counting. If you can manage that, then eventually try to see if

you can have a conversation with someone while subtly being aware of your breath.

The final step is to start including different things into what you want to focus on or track. So, in addition

to your breath, try to be aware of the thoughts you are having, or emotions you are feeling, or the

sensations of your body, whether your heart rate is up or down. Become aware of these things whilst

going about your daily routine.

What this will end up doing for you is that it enables you to detect what thoughts, feelings, or body

sensations you’re having the moment they happen. This is a potent way to catch stressful sensations, and

or stressful patterns of thinking, or hyperventilating breathing as they arise in real-time. If you catch them,

then you can just breathe and focus on relaxation no matter where you are, or what you are doing. That is

why the practice is called “mindfulness”. It brings your mind’s attention to exactly what is happening

here and now, and it is an extremely potent way to clarify your thoughts, improve memory, and eliminate

stress. 386 Good luck, relax, and enjoy!

“Sleep Hygiene Therapy” – A practical way to sleep better, for longer.

“Sleep Hygiene” Therapy

Sleep Hygiene therapy actually happens to be a formal behavioral therapy that involves simple strategies

to help you get to sleep on time and sleep better when you do sleep. It is well worth taking note of the

kinds of things a formal sleep hygiene therapy approach advocates and then pick and choose the strategies

or actions that you think would help you to sleep at night. You can also just try out the methods presented

below in total too and see if they work for you. Reports in the scientific literature seem to show that this

behavioral approach to helping people with insomnia has some significant benefits. According to the

method of “Sleep Hygiene Therapy”, the following tidbits of advice when taken together can be helpful

for sleeping well, I present them below: 387 388

• Control the light, noise, and temperature in your bedroom to encourage the perfect conditions for

deep sleep.

• Eating large meals during lunchtime rather than during dinner time to avoid factors like

indigestion and bloatedness when attempting to go to sleep.

• Refrain from ingesting stimulants prior to attempting to sleep (like coffee/caffeine). In some cases

restricting the total daily consumption of stimulants to within narrow ranges. (catering

consciously for possible withdrawal effects)



• The incorporation of daily exercise into one’s weekly routine. Avoiding extreme or strenuous

exercise just prior to bedtime. (see the next section below on safe ways for CKD patients to

exercise)

• Abstain from activities in bed that are not related to sleep such as reading, studying, watching

television or planning for the next day’s events.

Sleep hygiene therapy has been shown to be remarkably effective in improving sleeping patterns for

many people, with research showing strong correlations with the application of sleep hygiene therapy and

decreased daytime drowsiness and increased self-reported quality of sleep. Since these methods are

cheap, free and very effective for some people, these measures should always be considered as first-line

efforts in any sleep management program.389 390

An adjunctive therapy called “sleep restriction therapy” is often used in combination with sleep hygiene

therapy to increase the efficacy of both therapies. Sleep restriction therapy comprises of simply restricting

the time a person is allowed to spend in bed. This is done to increase the body’s biological need for sleep

at nighttime. Initially, persons who undergo sleep restriction therapy are deprived of a full night’s sleep

(in favor of a partial night’s sleep e.g. 6 hours instead of 8 hours) in order to increase their need for sleep.

The body learns to fall asleep more quickly and spend most of its time in bed sleeping as opposed to

being wakeful – a measure of ‘sleep efficiency’.

Restricting the total time spent in bed per day helps to reset people’s circadian rhythms and helps people

to fall asleep faster and more deeply. Research has shown that when sleep restriction therapy is used in

conjunction with sleep hygiene therapy both behavioral techniques were more effective than either

alone.391 392

Exercise for Stress, Sleep, & CKD?

How beneficial is exercise generally?

Exercise raises your heart rate and peripheral temperature. It helps to circulate all your body fluids and

flushes everything with life-affirming oxygen whilst promoting the removal of waste products. More

oxygen around the body means more energy is available for thinking, healing and living your life.

Exercise effects repairs on the energy factories inside cells (mitochondria), and repairing damaged

mitochondria improves the health and functioning of every single system in the body! This means that

exercise is potentially the most beneficial thing that you can possibly do for your health, bar none!393 394 395

If you don’t believe me then check out the following list of disorders and diseases that exercise prevents

or helps to heal…



Exercise has the proven capacity to both prevent and be part of treating…

- Heart diseases396

- Certain cancers397

- Diabetes398 399 400

- Obesity401

- Alzheimer's disease402 403 - Parkinson's disease404 405

- Insomnia406 407 408

- And just about every other major illness or condition ever recorded or discovered in humans.409 410

So, in general, exercise is so massively healthy and life-affirming that everyone should be doing it. The

standard recommendation is 30 minutes of moderate exercise three times a week.

Unfortunately, Exercise is Dangerous for CKD Patients

When I first learned that exercise is off the cards for CKD patients I was devastated. I’m sure that you can

understand my feelings after reading about all the amazing benefits of exercise above. It turns out that

exercise is dangerous when your kidneys are damaged.

The reason why exercise is dangerous for kidney patients is that the kidneys are responsible for your

electrolyte balance and fluid balance. Exercise will simply put way too much strain on the kidneys and

heart and force changes in the electrolyte balance that could end up being fatal. The other factor in CKD

that makes exercise unappealing and dangerous is fluid retention.

It can be very uncomfortable to exercise when you have swollen feet and ankles - which are common

symptoms that appear in CKD patients. Another problem with exercise and CKD is that fluid can build up

around the heart, this puts extra pressure on the heart. This extra pressure on the heart, in combination

with very unbalanced potassium and sodium levels, is just too dangerous – the risks of heart attack or

damage to the heart are massive. Finally, CKD patients are often lacking in energy to spare and often

suffer fatigue which would make it hard for them to have the endurance to exercise for any beneficial

length of time.

Nevertheless, there is a way to exercise safely so that at least some benefits can be taken advantage of. If

CKD patients make sure to do very gentle easy exercise like walking short distances around the block,

then they can remain active and slowly build their fitness up. It is far worse to just stay inside and not

actively move your body for long periods than it is for you to go for a very slow gentle walk around your

neighborhood. Importantly, I advise you to take a friend with you so that they can keep you in good

company and conversation. A friend can also be there if you suddenly need to rest or feel dizzy. Slow

gentle walking is actually a very good way that CKD patients can exercise as it should be extremely safe

and will give some benefits at a biological level too.

Now that isn’t the only exercise you can do. I have discovered a way for CKD patients to exercise while

sitting in front of the TV in a chair! I used to call this exercise routine, “Yoga for Couch Potatoes”, but,

when I actually sat down and thought about how CKD patients could safely benefit from everything

exercise had to offer I realized that this tongue and cheek exercise routine was actually perfect for CKD

patients.



This is great news because CKD patients would stand to benefit a lot from being able to reduce stress and

improve sleep by keeping their bodies active and healthy. Moving the body helps with fluid exchange and

oxygen supply and waste removal – all things that CKD patients need support with to heal.

Yoga for Couch Potatoes – Perfect for CKD Patients!!!

Yup, believe it or not, some enterprising couch potatoes out there have found a healthy conscience and

developed an ingenious way to get some beneficial low-intensity exercise while watching television –

fortunately for you, this is EXACTLY the kind of exercise regime that can help keep you active. Just

follow the simple outline below to benefit. Now it must be admitted that this exercise regime will

certainly not give you the same benefits as the research on standard moderate exercise practices, but

doing these exercises will still improve just about every system in the body. This is especially true if you

also make time each week to walk with a friend for several kilometers. Give it a try and see for yourself.

The only guidelines or advice that is needed to do this set of exercises properly is to avoid jerky, bouncy

movements; keep everything slow, controlled, gentle and smooth. Furthermore, your back should be kept

straight and you should try to maintain good posture throughout the routine. As with all exercise that

CKD patients and high heart risk patients do, never ever hold your breath.411

Start with the first bullet point and work your way slowly and methodically through each instruction in

turn until you complete the last point – then you’re done.

• Ankle Flexing: Sit on the floor with your feet straight out in front of you. Keeping your heels on

the floor, lift your toes up as far as you can. Hold for a count of five.

• Knee straights. Raise your foot to fully straighten your knee out in front of you. Hold for a count

of five. Lower your foot to the floor. Repeat on other side.

• Hip elevator. Lift one knee up toward the ceiling. As you lower this knee, raise your other knee.

Alternate each leg as if you were marching in place (while sitting.)

• Reach for the sky. Raise one arm straight over your head, with your palm facing away from you.

Keep your elbow straight. Slowly lower your arm to your side. Repeat with other arm.

• Shoulder grasps. Sit with your arms at your sides and your palms facing up. Bend your elbows

until your hands are touching your shoulders. Lower your hands to your sides.

• Arm lifts (singles). Sit with your arms at your sides, fingers pointing toward the floor. Raise one

arm out to your side, keeping your elbow straight and your palm facing down. Slowly lower your

arm to your side. Repeat with your other arm.

• Shrugs. Keeping your back straight, lift your shoulders up and forward toward your ears. Release

your shoulders down and back in a smooth circular motion.

• Arm ballers. Sit with your arms at your sides, fingers pointing toward the floor. Raise both arms

out from your sides (about 1 or 2 feet from your body). Keeping your elbows straight and your

palms facing toward you, rotate your arms in small circles.

• Shoulder ballers. Put the fingertips of one hand on that hand's shoulder. Rotate your shoulder

and elbow clockwise, then counterclockwise. Repeat with other arm.

That’s it, done. Effortless health just exactly where you are!



Let Food be your Medicine

“Let food be your medicine and medicine be your food”

Hippocrates 406 BCE

Getting back to our Roots

At the dawn of the 21st century scientists are rediscovering the wisdom of Hippocrates, aptly called the

Father of Medicine because he knew that nature provided all the cures for our physical ailments. The

simple truth is that eating a healthy, natural diet allows us to slash risk factors for every chronic disease

that exists on our planet today. Don’t let this simplicity confuse you, nature is extremely sophisticated at

the nano level and our bodies are designed to work in harmony with our environment and regenerate and

repair its imbalances.

When it comes to CKD scientists have discovered that one of the healthiest ways we can create health is

through what is known as the Mediterranean Diet that has been proven to reduce cardiovascular disease,

diabetes, high blood pressure and obesity to mention a few – and yes it makes sense that if it helps

modulate the risks for getting these systemic diseases then it will also support a return to healthy kidney

function too.412 The research clearly shows that the Mediterranean Diet is able to cut the risk of death

from all causes of disease including kidney failure.413

This chapter is all about reclaiming our natural ability to empower ourselves to true health and it all

begins with our dietary habits.

How A Mediterranean Diet Helps to Protect and Reverse Damage in Our Kidneys

In general, healthy Mediterranean’s eat large amounts of fruit and vegetable, with legumes, olive oil and

nuts along with unrefined grains and plenty of fish. They even drink red wine in moderation but limit

eating red meats and dairy products.414 This diet is rich in natural antioxidants that provide powerful

healing protection to all systems in our body.415

In the west, we have constantly been told that eating a diet high in fruit and veggies and low in fats will

keep us healthy and lean, and yet after five decades we have exponential increases in diabetes, heart

disease and obesity that are all able to be avoided through our dietary lifestyle habits. So, if this advice is

correct then why are many people who make repeated attempts at following strict diets not achieving their

true health potential? Looking at the Mediterranean diet in more detail we can start to understand where

we are going wrong and how easy it is to correct and achieve the health and vitality we dream of.

No, the Mediterranean diet is not another fad diet. In fact, it is not a diet that you adopt until you reach a

goal and then return to your regular diet. To reclaim your health, you will need to do something different

than you’ve done before otherwise nothing will change, and this is perhaps one of the most important

principles to understand – that the way to healthy kidneys requires a complete lifestyle transformation

along with health benefits that are permanent! When it comes to your diet then this way of eating needs to

be completely embodied by you to achieve lasting health and vitality.



Why is the Mediterranean Diet a healthy choice for Kidneys?

There is a growing mound of scientific research that shows impressive health benefits of following a

traditional Mediterranean diet. It certainly ticks nearly all the important boxes when it comes to having

healthy functioning kidneys. I will share some of the interesting facts that were reported in multiple

studies – this science influenced my personal decision to incorporate the Mediterranean Diet into my own

lifestyle.

One of the critical factors is that this diet significantly reduces the risk of developing cardiovascular or

metabolic disorders such as diabetes and obesity.416 Interestingly, researchers have shown that it also

improves symptoms in patients with dementia especially Alzheimer’s disease. It’s curious to note that

some scientists refer to Alzheimer’s disease as ‘diabetes type-3’, because of the similarities with diabetes.

Why this is important for kidneys, is that all of these disorders are independent risk factors for developing

CKD too, therefore it makes sense that this diet would also reduce CKD risk.

In another study people who followed the Mediterranean Diet showed a decrease in all causes of death

indicating that it may well be a good choice for many people in our current era.417

Olive Oil

This diet is surprising in terms of its high fat intake, which is usually off limits for CKD, but looking

deeper and it’s easy to see that this diet relies almost exclusively on Olive oil as its principle source of fat

intake. Through daily generous portions of extra-virgin olive oil for sauces, vinaigrettes, cooking and

baking.

Olive oil contains oleic acid along with many different plant chemicals (polyphenols) that combine to

provide a culinary oil with potent medicinal properties. It is reputed to be a powerful antioxidant that

gives it strong anti-inflammatory effects. Olive leaf extract and olive oil are considered to be broad

spectrum antibiotics, offering protection against harmful microbes.418

This ancient oil is known to have anti-atherosclerotic properties and research is under way to test its

ability to protect the skin from damage as well as its ability to regenerate damaged skin.419 It could mean

that olive oil taken as part of your normal diet would protect your blood vessel walls from inflammatory

damage and repair damage as it happens. Considering that skin covers most surfaces lining our body

including every organ then it makes sense why many people are starting to view this as an anti-aging diet

too!

Emphasizes Fruit and Vegetables

The evidence is now compelling that a diet full of fruits and vegetables that are rich in antioxidant

nutrients and fibre protects us from having cardiovascular and metabolic problems.

The Mediterranean Diet is abundant in foods rich in fibre, vitamins especially folate and natural

antioxidants such as Resveratrol. It is found in the skins and seeds of dark red grapes grown in high

altitudes to produce some of the Mediterranean’s fabulous red wines. Resveratrol has been shown to

increase the lifespan of a cell by up to 23%. I discussed this remarkable chemical in the previous section

as it is a medicinal superstar.420



This diet has so much going for it considering the points I shared so far and this is only the tip of the

iceberg really! Other remarkable activities from eating antioxidant rich fruits and vegetables include:

Preventing fats from being oxidized and blocks harmful accumulation of LDL (low density lipoproteins)

fats along blood vessel walls – this is one of the major factors behind blood vessel damage that is a

hallmark feature in all chronic inflammatory disorders. Antioxidants help to keep molecules from

clumping together and attaching to the skin lining our vessels over the entire body; even molecules of

inflammation (chemokines) are reduced along with other inflammation markers.421

The Mediterranean Diet counteracts each and every one of the major players contributing to CKD:

• High Blood Glucose Levels (Diabetes)

• High Blood Pressure (Hypertension)

• Obesity

• Dyslipidemia (Malfunctioning lipid metabolism)

• Chronic Inflammation (Persisting over a long period of time)

• Oxidative stress in the body

• Malnutrition

The best news for CKD came from a study proving that the Mediterranean diet stabilized the glomerular

filtration rate (GFR) in CKD patients!422 These spectacular findings have been confirmed by other

researchers423 and provides proof that your GFR can be improved and evidence that CKD can be reversed.

This is fabulous news because it means that we can take back our health and engineer our own recovery.

After all, what I choose to eat is something I can exercise control over and because of this I can step out

of being the victim of CKD to becoming the maestro of healthy kidneys - all through my own diet and

other lifestyle choices.

The Mediterranean Diet is definitely effective at protecting from systemic diseases but what about its

effects on the gut and kidney microbiome? Since microbiome research is revolutionizing the way we are

viewing the human body, disease and health then it stands to reason that this diet would also promote

healthy gut and kidney microbiomes filled with beneficial microbiota. This is exactly what scientists have

shown to be the case.

The Gut Microbiota: a bridge between diet and health

By now you are aware that your gut is home to a large diverse microbial community known as the

microbiota. The whole gut ecosystem is viewed as a ‘supplementary organ’ because it is actively involved

in metabolic processes, immune system functioning and intimately linked with our overall health status.424

Every person has a unique microbiota teeming with different species. Collectively the combined genetics

of our organisms (called the microbiome)425 is a whopping hundred times greater than the human

genome426 – truly a very humbling fact.

I was amazed to learn that what you eat determines what bacteria live in your body. There are two main

ways that our food is broken down or digested. These are listed below:

1. Saccharolytic – most bacteria are involved in fermenting carbohydrates

2. Proteolytic – most of the bacteria are protein fermenters – putrefaction



Understandably, people who are vegan will have a microbiota that is home to a broad spectrum of

saccharolytic bacteria compared to people who are carnivores that have high levels of proteolytic

bacteria.427

Healthy balanced microbiotas are generally saccharolytic with many beneficial Bifidobacteria and

Lactobacilli species.428 These bacteria break down sugar molecules and convert them into wonderful

short-chain fatty acids like butyrate that regulates our immune system responses in a positive healthy

manner.429

The processes performed by bacteria in the proteolytic pathway produce many different chemical

products - some of these are extremely toxic for kidneys, they are also known as uremic toxins:430

• Ammonia

• Thiols

• Phenols

• Indoles

• Amines

Studies have shown that all CKD sufferers have an imbalanced microbiota with their microbiomes

dominated by proteolytic bacteria.431 The proteolytic bacteria are the ones that most often cause gut

imbalances (dysbiosis) in the microbiome paving the way for chronic lifestyle illnesses that affect

multiple people living in the processed lifestyle of the western world today.432

Protein especially from red meat and dairy products tends to cause an acidic medium in the gut and body

– this contributes to mineral imbalances. Minerals are moved from our bone matrix to the body in an

effort to compensate and protect from harmful effects of an acidic environment. Over time our diet and

other lifestyle choices that increase acidity in the body, such as stress, insomnia, smoking or drinking

alcohol, will eventually lead to osteoporosis and other more serious disorders.

The Mediterranean Diet modulates CKD gut microbiota

It is well known that people who have CKD or any inflammatory disorder such as diabetes or

atherosclerosis are healthier when they eliminate meat and dairy products from their diets. Does this mean

that you need to become vegetarian or vegan if you have CKD? The short answer is almost … eliminating

red meats and limiting animal-based food in your diet is essential to repairing damaged kidneys.

Currently medical and nutritional experts agree that it is better to restrict your protein intake when you

have CKD or in conditions where the kidneys are not functioning optimally. A recent study showed that

the greater the amount of red meat you eat, the greater your risk for end stage renal disease.433 Replacing

red meat with fish, eggs and plant-based sources of protein improves kidney outcomes by up to 62%.



Red meat replaced by % risk reduction

Poultry 62.4

Fish 48.6

Eggs 44.9

Plant proteins 50.4

In fact, an alkaline diet such as the Mediterranean Diet is often recommended due to its profound health

benefits, especially in reducing risks for cancer and cardiovascular diseases.

This is one of the reasons why the Mediterranean Diet is such an attractive option with its emphasis on

alkaline promoting fruits and vegetables, rich in fibre, nuts, seeds and healthy fats whilst limiting intakes

of red meats and dairy products.

However, the diet does include salmon and other deep-sea fish, which are rich in omega-3 essential fatty

acids. The omega-3 oils are slowly being recognized as critical for our health and need to be actively

included in our daily diet. As extremely powerful antioxidants they are used by our bodies to help manage

painful inflammation and keep blood vessels flexible and healthy. These essential fatty acids play a star

role in helping regenerate and repair tissues.

It is striking to notice how quickly our microbiota responds when we change either to a plant-based diet

or to an animal-based diet. Within 5 days of switching to an animal-based diet, rapid changes occur in our

genes causing a preference for bile-resistant and sulphite producing organisms. This literally shifts our

microbiome from being a saccharolytic fermentation environment to an acidic proteolytic one.434 The

products made by proteolytic bacteria that ferment animal products are thought to promote the onset of

diseases, such as colon cancer and chronic systemic disorders.435

The same is true when we start eating a plant-based diet, within 5 days we start to see beneficial

saccharolytic microbes making short chain fatty acids (SCFA). These fatty acids completely regulate our

immune system functions and strengthen the gut barrier preventing inflammation and providing

protection from infection. A microbiota that is full of these beneficial bacteria is considered to be the

hallmark of a healthy microbiome.436

I think the real take-away message is that everything we eat or drink modifies our microbiome and

determines whether we host beneficial communities of bacteria that work synergistically with our bio-

suits, or whether bacterial gangsters move in and take control of our inner terrain. From this perspective,

it is easy to realize that foods you eat on a regular basis will play a larger role in determining your health

status. It’s true – your health is largely determined by what you eat.

Scientists believe that our rapid ability to shift between herbivorous and carnivorous diets is a distinct

genetic advantage because it allows us to respond quickly to different environmental situations and adjust

to new diets if required to do so. This shows how adaptable (plastic) our microbiota is and why diet is

arguably the single most potent method we have, in our own control, to regulate our own health and well-

being.



Other interesting observations …

When kidney nephrons stop functioning in CKD, the colon steps in and provides an extra route to

eliminate toxic kidney waste and preserve our electrolyte balance. This compensatory pathway alters the

normal population of the colon microbiome too.437 Although these changes also cause digestive

problems, it is definitely much better to remove toxic loads from accumulating and to decrease the burden

on failing kidneys.438

Scientists also report that low fibre intake was commonly found in diets of people with CKD and this was

even more noticeable once patients began dialysis treatment.439 Eating a low fibre diet increases the

conversion of urea into toxic ammonia and promotes an increase in proteolytic bacterial growth.440

Protein fermentation causes different waste chemicals to be produced that are known uremic toxins found

in CKD and responsible for increasing CKD progression.441

Uremia increases intestinal permeability allowing bacteria to move into easily into the blood stream and

can cause widespread toxicity. This causes a dramatic response from our immune system causing an

inflammation cascade to be released and setting the stage for chronic low-grade inflammation to persist

throughout the body. In a nutshell this explains why there is widespread inflammation and harmful

oxidation forming part of the CKD picture.442

Special bacteria (probiotics) that can help us to combat kidney disease

Lactobacillus delbrueckii443 Reduces plasma urea concentrations

Bacillus pasteurii444 Reduces Blood urea-nitrogen (BUN) levels

Slows down the progression of kidney disease

Increased lifespan

Bifidobacterium longum445 Reduces uremic toxins

Balances gut and kidney microbiomes

Decreases triglycerides

Lowers homocysteine by making its own Vitamin B12 and folate

Reduces phosphorous levels in heart disease446

L. casei447 Decreases serum urea

Probiotic Combination448

(L. acidophilus Decrease in plasma glucose

L. casei Decreases Inflammation (CRP)

B. bifidum) Decreases serum insulin and diabetes marker (HbA1c)

Increases plasma total antioxidant capacity

L. Rhamnosus449 Reduces uremic toxins phenol and p-cresol



Special Prebiotics for CKD

Oligofructose & Inulin450 (4 wks) 10 – 20 g daily 20 % decrease in uremic toxins

Reduces Blood Urea Nitrogen (BUN)

Amylose corn starch451(4 wks) 15 g daily Reduces uremic toxins

Lactulose syrup452 (8 wks) 90 mm daily Increases Bifidobacteria &

(30mm x3 doses) Lactobacillus numbers

Reduces Creatinine levels

Amylose corn starch453 (4 wks) 20- 25 g daily Decreases Inflammation

Relieved severe constipation

Reduced serum urea

Reduced creatinine

If you enjoy berries then you will be pleased to hear that the anthocyanidin polyphenols found in the dark

red, blue and black colored berries such as, açaí, blackberry, strawberries, red grapes and cherries also

alter the gut microbiota in a positive way.454

Cranberry extract has been shown to increase mucus production to protect the walls of the gut and urinary

tract from harmful species.455 This potent extract also increased the amount of healthy bacteria in the gut,

suggesting that other anthocyanidins and plant chemical compounds such as, catechins, resveratrol456,

quercetin and tannins457 may also play a similar role in promoting beneficial changes in the gut

environment.458

Curcumin is another polyphenol that is one of my favourite health superstars because it is such a powerful

anti-inflammatory and potent immune booster was also able to introduce friendly bacterial communities

in the gut including Prevotellaceae, Bacteroidaceae and Rikenellaceae.459 In another study curcumin once

again proved itself to be an impressive medicinal agent by increasing the number of bacterial species that

make butyrate in the gut – this is the main short chain fatty acid that is so healthy for combatting CKD.460

Given these facts, it is easy to agree that the Mediterranean Diet is a perfect dietary platform for

preventing and reversing chronic kidney disease. It does mean that the diet needs to place more emphasis

on prebiotic foods to promote a happy healthy kidney and gut microbiota.

This relatively recent understanding of our microbiome is revolutionizing our view of health and disease.

Medicine of the future will probably be managed with prebiotics, probiotics or a combination of both

(synbiotics).

In my opinion, the time is long overdue for doctors to be taught nutrition in medical school, so that they

can accurately treat and reverse chronic lifestyle disorders. Until the medical profession catches up with

ancient knowledge, I hope that you will agree with Hippocrates … let food be your medicine!



Chronic Kidney Disease

Dysbiosis Symbiosis

Leaky gut Gut Barrier Integrity

Alcohol Red wine polyphenols

Medicines Prebiotics (High Fiber)

Artificial Sweeteners Honey or Stevia

Low Fiber Diet High Fiber Diet

Refined / Processed Foods Fermented Foods

Acidic Foods Alkaline Diet

Gluten & Lectins Fermented Foods

Saturated Vegetable Oils Olive Oil and Fish Oils

High animal protein diet Low in animal protein

Low in vegetables & fruit Vegetables & whole fruit

Refined grains Whole grains

High Sugar intake Rich in nuts & seeds

Low in antioxidants Rich in antioxidants

Food additives / colorants Low food additives /

colorants

Sodas & sweetened fruit juices Water & herbal teas

Pesticides & GMO foods Organic non-GMO foods

Sedentary Lifestyle Active Lifestyle

Proteolytic bacteria Saccharolytic Bacteria

Weakened Immune System Strong Immune Function

Stress & Anxiety Energy & Vitality

Poor Sleep Quality Deep Restorative Sleep

In this chapter, I presented some of the most important ways that you can use diet and lifestyle to help

you to heal from CKD.

This chapter outlined the way to live free from CKD. In particular, it outlined the way to eat foods that

reduce inflammation, promote a microbiome that prevents CKD progression, sleep well, exercise gently,



and keep your stress down. All of these factors taken together are a good description of how you could

live a simple day-to-day life that would completely prevent CKD from arising in the first place. This is

why this chapter is so important because the advice and tips and guidelines in this chapter are the kinds of

things you want to be doing daily so that you can heal from CKD and then never have it return after you

have healed.

Sometimes an already ill body needs an additional ‘kick’ to jumpstart its own powerful natural healing

mechanisms. The kinds of things that provide this kind of ‘kick’, or extra support, to help start and

maintain the healing process are usually powerful medicines. If you think about it, that is what is left for

me to share with you - The natural tools, supplements, and remedies that can really help your body to get

better.

Natural tools, supplements, and remedies are especially useful and potent at the beginning of the healing

process where your body is likely to be in the worst shape. Once you regain some of your functionality

again and your body is more able to handle itself, then supplementation can ease off and simple lifestyle

practices can naturally take over. Lifestyle practices like those I shared in this chapter. In the very next

chapter, you will get learn about the most powerful natural compounds for CKD health that you can use

as part of a protocol aimed at healing from CKD.


Chapter Four

The Tools to take us Home

I called this chapter, “The Tools to take us Home” because every entry in this chapter is useful as a tool in

a well-thought-out protocol for healing from CKD. I also mention the word “Home”, and by this, I imply

that you can return home, to your ultimate home, your original home – that is, return to your healthy,

happy, vibrant body.

I like this turn of phrase because in my experience as a professional clinician, people learn to be

disheartened about their bodies as they fall progressively more and more ill. For people with CKD, their

bodies have begun to fail them. The kidneys aren’t working properly and toxic waste products accumulate

in the blood instead of being cleaned out. Gradually these patients succumb to ever-increasing

unpleasantness. That is why I wrote this book. I wanted to be able to give my patients the chance to return

to trusting and enjoying their bodies once again so that they could enjoy the last several decades of their

life to the full.

In this chapter, I will share different supplements, foods, compounds, fruits, exotic spices, herbs, and

others that all have the power to help with one or more aspects of chronic kidney degeneration and its

consequences. This is your toolkit, filled with potent remedies for every aspect of CKD health.

Broadly speaking there are three basic sections to this chapter. The first section describes what I would

term as ‘natural supplements’. These are potent high concentration preparations of vitamins, or minerals,

herbal extracts. Each entry is rich with bio-compounds taken from natural sources.

They are supplements in the sense that they will usually be taken in pill form, with each pill constituting

some kind of dosage. Natural supplements are like nature’s potent healthy medications. I have time and

again witnessed the power of a well-planned supplementation program to rapidly improve a person’s

health status, and treat intractable lifestyle diseases. So in the first section of this chapter, I describe some

of the best supplements that I have found that can really help with CKD.

The second section in this chapter will explore some dietary foods that we can emphasize in our daily

food regimen. This section is different from the first section in this chapter because many of the things

listed here will tend to be whole foodstuffs e.g. blueberries, or the herb basil, or olives, nuts, or certain

kinds of vegetables or fish. These types of things aren’t supplements per se because they aren’t potentized

extracts put in pill form in very high dosages or concentrations. They aren’t like taking natural medical

pharmaceuticals but are instead more the kinds of foodstuffs that contain radically beneficial compounds

that would help with CKD. Another factor to consider in the second section is the way we can ingest

foods that have great benefits for CKD while supporting the kind of microbiome we would like to

cultivate things like probiotics and prebiotics. By and large, this section is for listing things we should

make an effort to ingest more of on a day to day, or week to week basis.

The third and final section in this chapter is where I will describe natural compounds that don’t quite fit

into the first two sections. In addition, if the main effects of a compound help support sleep, exercise

Chapter Four – The Tools to Take us Home


fitness, and/or help deal with stress, then I’ll also include them in this section. This section might include

an eclectic mix of supplements, foodstuffs, or other kinds of things like topical creams or tinctures that

have proven to be extremely effective by reports in the scientific literature.

Some of you reading this may be wondering as to the criteria that I used to select each tool. In the main, I

checked the reported scientific literature to see if it clearly showed some kind of benefit for CKD patients

along some axis. What do I mean by “axis”? What I mean by, “axis”, is that there are a number of

possible ways a compound or tool could be of some benefit to a CKD patient. For example, one kind of

herb might have powerful antioxidant properties and would, therefore, protect the heart and blood vessels,

or fight inflammation. Another tool might turn out to be a potent kidney regulator that helps the kidneys

to handle their filtration workload by smoothing out the blood flow to the kidney filtration units.

The two examples I just gave were both beneficial to CKD patients, but they were beneficial in different

ways – i.e. they operated their benefit on different ‘axes’ of CKD. This is what I mean when I mention

that some tools written about here operate on multiple axes, while others are super beneficial on one axis.

As long as the tool has a powerful beneficial effect on at least one axis, that would have been good

enough for inclusion.

To help you see at a glance what kinds of benefits an entry might have I have drawn up a small table that

appears under each entry which looks like this:

(Example Table)

INFLAMMATION BUSTING (ANTIOXIDANT) x IMPROVES FILTRATION (GFR) PREVENTS CVD (ATHEROSCLEROSIS) NATURAL DIURETIC

BLOCKS AGE FORMATION (BLOCKS GLYCATION) GIVES ENERGY/COMBATS

FATIGUE

PREBIOTIC BENEFITTING KIDNEY HEALTH HELPS KIDNEY ELIMINATE

TOXINS

PROBIOTIC BENEFITTING KIDNEY HEALTH HELPS LIVER ELIMINATE

TOXINS x

IMPROVES BLOOD VESSEL HEALTH PROTECTS KIDNEYS/HEART

In the example table above, the natural tool in question apparently has two beneficial properties which

are: a) It busts inflammation, and b) it actively helps the liver to eliminate toxins. The axes of benefit can

be seen instantly by the highlighted boxes marked with an “x” which indicates the substance has the

corresponding property.

By the end of this chapter, you will be acquainted with a huge list of extremely powerful tools that you

can pick and choose from to help you combat your CKD and return once again to your pristine home –

renewed and improved and ready to trust in your body again. At least, that is my wish.



Natural Supplements for CKD

Grapefruit Seed Extract

INFLAMMATION BUSTING (ANTIOXIDANT) IMPROVES FILTRATION (GFR) PREVENTS CVD (ATHEROSCLEROSIS) NATURAL DIURETIC


FATIGUE


TOXINS


TOXINS

IMPROVES BLOOD VESSEL HEALTH PROTECTS KIDNEYS/HEART x

Grapefruit Seed Extract is a fantastic treatment option for urinary tract infections (UTI). Using this extract

might allow you to avoid the use of antibiotics for many known UTI’s. A case study done between 2001

and 2003, showed that extracts of grapefruit seeds were extremely effective when used to treat antibiotic-

resistant UTI’s. The participants in the study recovered when using the extract, but did not respond to a

variety of strong conventional antibiotics such as gentamicin, tarivid, and augmentin. The treatment

showed successful effects after just two weeks of taking 5-6 seeds every eight hours for 14 days. The

scope of the case is small, but the results are so impressive that we should not ignore this study. Other

proven benefits of GSE include being a potent antifungal agent, safe, less toxic to the microbiome than

commercial antibiotics, and often more effective than them too.461 462 463 464 465

Grapefruits are safe to eat, easy to get, cheap to buy, and delicious – unlike most antibiotics. For these

reasons we should consider using GSE instead of antibiotics when we want to prevent wiping out our

microbiome and avoiding any other dangerous consequences of many commercial antibiotics.

Polyphenols – Health Super-Stars!

INFLAMMATION BUSTING (ANTIOXIDANT) x IMPROVES FILTRATION (GFR) x PREVENTS CVD (ATHEROSCLEROSIS) x NATURAL DIURETIC x

BLOCKS AGE FORMATION (BLOCKS GLYCATION) x GIVES ENERGY/COMBATS

FATIGUE x

PREBIOTIC BENEFITTING KIDNEY HEALTH x HELPS KIDNEY ELIMINATE

TOXINS x

PROBIOTIC BENEFITTING KIDNEY HEALTH x HELPS LIVER ELIMINATE

TOXINS x

IMPROVES BLOOD VESSEL HEALTH x PROTECTS KIDNEYS/HEART x

The term “polyphenols” refers to a broad category of bioactive compounds found in fruits, nuts, and

plants. It is an umbrella term for a certain family of chemical compounds. Included in this family are

other sub-families like “flavonoids” which are sometimes called “bio-flavonoids”. It turns out that

polyphenols in general, and flavonoids, in particular, are extremely potent health compounds.

For example, a study published in 2019 clearly and unequivocally stated that polyphenols and some other

nutritional compounds used as medicines (so-called ‘neutraceuticals’) had potent beneficial effects for

CKD patients – particularly because these compounds helped to heal blood vessels and prevent

inflammation.466



That last line in the paragraph above expresses why the polyphenols are so good for CKD. They improve

blood vessel health and bust inflammation. As of 2019, there are two ‘premiere’ super celebrities of the

polyphenol world, the first is Resveratrol, and the other is the White Mulberry plant.

Resveratrol is a chemical compound, a polyphenol that has captured the attention of everyone in the allied

health field in the last eight years because it is so good at promoting health for just about every chronic

condition imaginable.

White Mulberry is a little bit less well known than the chemical compound resveratrol in health circles,

but it is starting to get high praise from multiple corners of the health community because it contains so

many beneficial flavonoids that it may end up outclassing resveratrol in many situations.

The power of polyphenols to enhance the health of the human body is prolific. There are so many benefits

to taking polyphenols for just about every major chronic lifestyle disorder that there is simply too much to

list in this book, that is why I have restricted the scope of my discussion to the properties of resveratrol

and white mulberry. You can consider these two examples as being completely and comprehensively

representative of most of the properties of other polyphenols unique to other sources.

In general, the polyphenols are plant-based bioactive compounds that act as supreme antioxidants and

protectors. This means that they decrease inflammation, protect the body’s tissues and promote massively

improved health outcomes. But in some cases, certain polyphenols just seem to be able to do everything.

This is the case with white mulberry extracts and resveratrol.

Remember to keep in mind during the discussion that anything that helps heart or blood vessel health, or

with diabetes, or inflammation, any of those will be very beneficial for helping with CKD – all other

things being equal.

White Mulberry – The Premiere Polyphenol Plant



FATIGUE x


TOXINS x


TOXINS x


White mulberry is the perfect example to illustrate the power of flavonoids to treat CKD. Every box in the

table above is ticked! Buckle up, and prepare to be amazed!

Morus alba (The White Mulberry tree) grows in China and usually grows to a height of about five or six

meters.467 For centuries, the Chinese have used preparations from this medicinal tree to treat fever, sore

throat, coughs, colds, flu, eye infections, nosebleeds, headaches, and dizziness. However, findings from

modern scientific research have uncovered even more applications of white mulberry.

White mulberry contains several different polyphenols that are known to have significant health benefits,

and the leaves of the white mulberry plant contain the highest amounts in the highest concentrations.468



The Benefits of White Mulberry

Here is a quick run-down of the benefits of white mulberry for CKD related health factors:

White mulberry…

- Contains “Mulberroside-A” which potently helps the kidneys excrete toxins preventing uremic

toxicity and slowing the progression of CKD

o “Mulberroside-A” protects the kidneys and prevents CKD progression.469 470

- Combats inflammation directly. 471 472 473 474 475

- Can calm the immune system helping to keep immune responses at appropriate levels in the body

(indirectly keeping inflammation at appropriate levels) 476

- Prevents and fights cancer. 477 478 479 480 The effects on cancer are strong and include the

prevention of certain cancers even forming, and even if they have already formed, large

reductions in size and toxicity have been measured. WM is particularly good as a method for

fighting some aspects of colon cancer.481

- It slows the signs of visible aging and keeps the body chemically young. 482 483

- The fruit of the white mulberry tree has compounds in them that prevent obesity and reduce

inflammation. 484 485

White Mulberry (WM) also helps the heart and blood vessels and by extension prevents CKD onset and

progression…

- WM can reduce hypertension.486 487

- WM prevents cholesterol build-up and prevents fatty depositions in blood vessels. This reduces

the risks of developing atherosclerosis and higher blood pressure which protects the kidneys

indirectly. 488 489 490

- WM combats the causes of diabetes by reducing glucose levels in the blood and increasing

insulin sensitivity. Since diabetes is a cause of CKD this helps to prevent and slow the

progression of CKD. Helping lower blood glucose levels prevents damage to blood vessels via

glycation – this also benefits kidney health. 491 492 493

At least three compounds (Albanol-A, Aldosteroid, and Moracin) found only in the white mulberry tree

and nowhere else (completely unique to the tree) each has potent health benefits that are unique to the

plant, and each one of these three has the ability to promote our health.

For example:

• Albanol-A kills cancer cells.494

• Aldosteroid protects the stomach and gut lining from ulcers while also being able to reduce

inflammation and damage because it is a strong antioxidant.495

• Moracin is really good at reducing inflammation as well as being able to prevent and fight certain

cancers.496 Moracin achieves these effects because it acts on certain enzymes in the body, helping

to prevent immune responses from cascading out of control. 497

CKD patients often suffer from impaired memory, fatigue and loss of function (see chapter one). WM has

specific effects on the body that can help with these concerns too, including:

- Proven to provide energy and reduce tiredness.498



- Increases the ability to learn new information possibly by improving the functioning of

memory.499 500

- Brain function is seemingly enhanced by WM in certain animal studies. One such, done on rats

showed that WM seemed to increase the number of nerve cells in their brains, alongside measures

of increased performance. The researchers noted that WM had a protective effect on nerves in the

brain because of its multiple antioxidant properties. 501

That last point above hints at a possible role in combating dementia. Unfortunately, dementia is a topic

that is way beyond the scope of this book; I only mention it because this plant continues to impress me

with its health properties.

• In chapter three I discussed the relationship between stress and poor health, along with sleeping

and exercise. It turns out that WM can help reduce stress too because it modulates neuro-

receptors (particularly cortisol) known to be linked to stress502 and anxiety, mood, and

depression.503 504 505 506 507

Finally, WM has some other effects too that make it useful in certain situations. A good example is that it

has a mild antimicrobial effect which can make it suitable for improving dental health by discouraging

bacterial overgrowth in the mouth. 508 509 510

Other general properties that come out of the research into WM include: 511 512 513

- It can fight obesity by reducing appetite and improving fat metabolism.

- It protects the liver from damage and protects against the kinds of damage in the body seen in

diabetes, obesity, cardiovascular disorders and, by extension, CKD.

Resveratrol



FATIGUE x


TOXINS x


TOXINS x


Resveratrol, as we already mentioned, is a polyphenol. It acts on CKD along multiple axes. Primarily,

resveratrol has the power to help with obesity, CVD, diabetes, and of course CKD.

Resveratrol is abundant in certain bitter foods, or darkly colored foods, examples include blueberries,

pomegranates, red grapes, and dark chocolate (very dark).

Resveratrol & Diabetes

The polyphenol resveratrol is one of the most potent fat-burning natural compounds with a few studies

reporting that it burned fat completely away in lab experiments. Combined with its many anti-aging

properties, this compound is a potent anti-oxidant life extender. 514 515 516

In studies, resveratrol decreased blood glucose-insulin levels and increased insulin sensitivity as well as

HDL cholesterol (the ‘good’ kind, see chapter two). 517 The results proved more effective than



conventional anti-diabetic drug treatments for the same set of clinical targets.518 Resveratrol also helps

regulate blood pressure (good for CKD and CVD) and improved creatinine levels when administered to

patients on pharmaceutical diabetes drugs. Improving levels of creatinine is extremely good for CKD

patients too who often suffer from chronically high levels of the protein as a consequence of poor kidney

functioning.519 520

Resveratrol & CVD

Resveratrol is very beneficial when it comes to protecting the endothelial cells that coat the walls of our

blood vessels! It actually promotes new growth in blood vessel walls after they have been damaged.521

Resveratrol in a certain Brazilian wine (VitisLabrusca grapes) was shown to be able to reduce the risk of

cardiovascular disease when ingested in moderation (1 glass); by lowering all levels of triglycerides, LDL

cholesterol (the bad kind), total cholesterol, and even improving the ability of blood vessels to dilate,

which is a good way resveratrol can protect against blood vessel based damage to the kidneys.522

Resveratrol helps with preventing heart attacks because it improves the blood flow in the peripheral parts

of the body and normalizes blood clotting.523 An amazing study showed that resveratrol radically reduced

the risk of having irregular heart rhythms, it prevents them from occurring.524

Although I mentioned the benefits of resveratrol found in wine (because of it being present in dark grape

skins), I do not recommend alcohol at all to CKD patients – a big ‘no-no’ for your health right there.

Nevertheless, similar benefits could be gained by eating the grapes, provided they are clear from

pesticides and any other toxic pollutant.

Other Notable Findings on Resveratrol

Grape seeds and grape seed skin extracts are rich in proanthocyanidins525, Ellagic acid, resveratrol, and

polyphenols. When these compounds were looked at in further detail, it was shown that they yielded

results 50 times more potent than Vitamin E in terms of health benefits linked to inflammation!526 Grapes

have anti-inflammatory effects and their phytochemicals can penetrate the blood-brain barrier, extending

their antioxidant abilities to the brain.527 528

Resveratrol was found to be able to prevent kidney fibrosis (scarring of the kidney) and oxidative stress in

CKD patients.529

In addition to this, people who are on dialysis had better antioxidant activity and much

better lipid levels in their blood in some studies.530

531

One study found that trans-resveratrol, oxy-resveratrol and related compounds (different forms of

resveratrol) were significantly effective at preventing the formation of biofilms which means that

resveratrol is effective at preventing UTIs (urinary tract infections) – this is especially important for CKD

patients. The researchers noted that resveratrol reduced the number of bacteria and other pathological

microbes that typically infected the urinary tract.532

Resveratrol was shown to be able to prevent the negative effects of muscle wasting in people with CKD.

Muscle wasting is something that happens in late-stage renal diseases and it is particularly debilitating for

people to suffer from. Resveratrol lessens the amount of creatinine in the blood which is helpful for the

kidneys.533



I hope it is clear from the many examples above just why resveratrol has captured so much attention from

health professionals in multiple different disciplines and industries. Hopefully, it has captured your

attention too. It stands out as one of the best polyphenol compounds you could be taking for your CKD –

it does just about everything you could want it to, whilst also being pretty safe to use.

Curcumin 534

INFLAMMATION BUSTING (ANTIOXIDANT) x IMPROVES FILTRATION (GFR) PREVENTS CVD (ATHEROSCLEROSIS) x NATURAL DIURETIC


FATIGUE


TOXINS x


TOXINS


Curcumin is a potent bioactive compound found in turmeric (Curcuma Longa) and it has tons of benefits

for CKD patients, not just the ability to color foods a beautiful yellow and taste delicious.

Curcumin has potent anti-inflammatory properties and is suited for treating CKD. In a large and

comprehensive review paper, scientists reported that significant evidence showed that curcumin is able to

reduce inflammation associated with CKD all its comorbid disorders! (e.g. obesity, diabetes, and CVD).

535

Further findings in the same paper also pointed to the fact that curcumin prevented the gut from becoming

too permeable which prevented many of the inflammatory and infectious problems related to CKD

progression and microbiome unbalances.536

Curcumin has been suggested as a good therapeutic because it is easily available and extremely safe to

use and might offset the costs associated with expensive conventional kidney treatments.537 538

Vitamin D

INFLAMMATION BUSTING (ANTIOXIDANT) IMPROVES FILTRATION (GFR) PREVENTS CVD (ATHEROSCLEROSIS) NATURAL DIURETIC


FATIGUE


TOXINS


TOXINS


*Maintains the immune system in severe CKD cases (deficiency is common)

Vitamin D has plenty of amazing benefits for CKD and plays a critical role in many of the most important

mechanisms in CKD onset and progression. The following information about vitamin D with regard to

CKD has been reported: 539

- Deficiencies in vitamin D are clearly linked to the progression of CKD.

- Levels of vitamin D are good predictors of heart complications in CKD patients



- People with CKD have a much higher rate of severe vitamin D deficiency. In addition to this,

they may also not be able to efficiently convert vitamin D into other needed forms for the body

causing disruptions in the way their immune systems function.

Magnesium



FATIGUE


TOXINS


TOXINS x


Magnesium lowers insulin resistance which is an important factor in the way that diabetes develops. Since

diabetes is one of the main causes of CKD, improving your insulin resistance is very helpful in preventing

the progression of diabetes and by extension CKD. Magnesium is also an important mineral for building

and maintaining healthy bones.

One good effect that improving insulin resistance has is that it helps to keep blood sugar levels in optimal

ranges. Keeping your blood sugar in good ranges is important for kidney health because high blood sugar

can lead to inflammation and blood vessel damage because of glycation (refer to chapter two for a

discussion of glycation and diabetic based inflammation). CKD patients will also benefit from having

lower levels of insulin in the blood because having higher levels of insulin puts pressure on the kidneys to

excrete magnesium.

Research has suggested that magnesium is useful in preventing the calcification of blood vessels which is

a key factor in CKD that contributes to serious heart problems. Not only that, but such calcification is also

implicated in the development of CKD in the first place. 540

To summarize, magnesium has the ability to: 541 542

- Boost athletic performance

- Ease symptoms of depression

- Improve bone and heart health

- Lower blood pressure – which prevents CKD and slows its progression.

- Reduce the risk of chronic inflammation

- Improve insulin sensitivity

- Lower risks for diabetes

- Slow the progression of CKD by improving blood vessel health as well as by improving defunct

mechanisms found in diabetics with CKD that lead to inflammation.

Most healthy adults need about 310 to 420 mg of magnesium per day. Some good foods that are rich in

magnesium include almonds (one handful has approx. 75 mg of Mg), Brazil nuts, figs, collard greens,

avocados, parsley, and garlic.



Prevent AGEs from Forming with Pyridoxamine (P-5-P)

INFLAMMATION BUSTING (ANTIOXIDANT) x IMPROVES FILTRATION (GFR) x PREVENTS CVD (ATHEROSCLEROSIS) x NATURAL DIURETIC


FATIGUE


TOXINS x


TOXINS


Pyridoxamine is a compound found in p-5-p, an active form of vitamin B6. Amazing research has

emerged over the last 30 years that clearly shows its power to benefit many aspects of CKD.

In Chapter Two, I talked about how glycation causes oxidation and forms end products that can damage

the walls of blood vessels. This happens in diabetes and heart disease, and it is an important issue for

people with CKD too since it is a key process behind the progression of kidney degeneration in CKD.

Thus, if you could prevent this process from happening then you would eliminate one of the prime factors

that contribute to CKD.

Exciting research shows that pyridoxamine is able to prevent advanced glycation end products (AGEs)

from being made.543 544 545

Biochemists have also shown that P-5-P is able to trap harmful fats that result from lipids becoming

rancid and escorts them safely out of our body – this effectively protects your kidney from these life-

threatening molecules before damage can happen! 546 547 548

Scientists have confirmed that by supplementing with P-5-P it eliminated AGEs and dangerous reactive

free-radicals produced by rancid fats. This effectively stopped CKD from even occurring in diabetic rats.

They showed that P-5-P supplementation did the following compared to diabetic rats that did not take

Pyrodoxamine: 549 550 551

• Reduced levels of protein (albumin) in urine

• Lowered levels of creatinine

• Fewer fats in the blood

These same results were also shown in obese rats too. Amazingly rats that were not given this form of

vitamin B6 experienced 3 to 4 times the amount of AGEs and free radicals than the lucky rats that took

this protective vitamin.552 553 This is an amazing result in terms of CKD and it basically means that p-5-p

is a potential superstar for CKD treatment and prevention.

Numerous other studies have been done with equally staggering results too. I briefly summarize the

conclusions that are relevant to CKD below:

Pyridoxamine or P-5-P…

- Completely reversed high blood pressure and thickening of blood vessel walls in a study done on

rats. In contrast, rats who did not receive p-5-p in this study actually developed CKD; the treated

rats did not develop any kind of kidney problems.554



- P-5-P outperformed the medical pharmaceutical drug Enalapril (a standard pharmaceutical drug

prescribed to prevent CKD) in a study done on diabetic rats in 2004. o In fact, it was found that Enalapril performed worse than all the other methods used to

prevent CKD which included P-5-P (the best), Vitamin E (second-best performer), and

lipoic acid (a strong antioxidant, and 3rd best performer in the study). 555 556

- A follow-up study repeated the findings of the 2004 study, once again showing that p-5-p alone

had better performance than any other CKD treatment method in the study. They also noted that

using both p-5-p and enalapril together had a synergistic effect reducing kidney disease mortality

by a significant margin.557

- P-5-P was shown to reduce uremic waste products building up in the blood (e.g. creatinine) as

well as reducing levels of pro-inflammatory cytokines in the urine which indicates that

inflammation was reduced. 558

- P-5-P has been confirmed in multiple studies to be the best frontline intervention for CKD.

Treatment with p-5-p has also been shown to drastically improve the health outcomes of kidney

transplants too. 559 560 561

The above results all came out in 2008, and unfortunately less than a year later the FDA reclassified

pyridoxamine (specifically) as a drug, making it more difficult and more expensive for people to get a

hold of without a prescription. This was done even though pyridoxamine is safe, low cost (before the

reclassification), and more effective than any other pharmaceutical options over its strongest treatment

domains. P-5-P, a slightly different form of the molecule that still contains pyridoxamine is just as

effective and has been shown to be effective at preventing the progression of CKD since way back in

1988. 562 563

Grape seed Extract

INFLAMMATION BUSTING (ANTIOXIDANT) x IMPROVES FILTRATION (GFR) x PREVENTS CVD (ATHEROSCLEROSIS) NATURAL DIURETIC


FATIGUE


TOXINS


TOXINS


Grape seed extract (GSE) is filled with potent polyphenols that have antioxidant and anti-inflammatory

properties. A study done in 2016 showed that GSE is able to reduce the risks of kidney failure in chronic

kidney disease patients, improves GFR, reduced the oxidation of lipids in the blood, and radically reduced

inflammation linked to kidney disease onset and progression.564 Most notably, supplementation with GSE

actually led to improvements in kidney function which basically defies the definition of CKD as being

characterized by irreversible degeneration.

GSE is quite well known to be an excellent anti-microbial too, similar to grapefruit seed extract.



Dietary Foods/Drinks Having Potent Properties to Combat CKD

Green Tea



FATIGUE x


TOXINS x


TOXINS x


Extracts made from green tea leaves contain a compound called Epigallocatechin-3-gallate (EGCG).

EGCG is the main reason why green tea is such a potent force for health and healing.

Generally speaking, EGCG is a potent antioxidant and anti-inflammation molecule making it perfect for

CKD treatment. However, the truth is that green tea has so many benefits across so many different health

conditions that it could rightly be considered as the best tea for your health, hands down. A few of

EGCG’s amazing health properties are listed briefly below:

- EGCG can reduce blood sugar levels, and keep insulin levels in healthy ranges. EGCG is also

able to increase the body’s sensitivity to the signaling effects of insulin which leads to less fat

accumulation and better body weight profiles. Basically, EGCG is really good for anything

related to diabetes and obesity. Further examples include: 565 566 567

o Reduces fat accumulation in the liver.

o EGCG can improve energy production in the body.

o EGCG prevents damage to the retinas in diabetes patients.

• EGCG helps to slow down the rate at which sugars are absorbed from digesting food. This is

helpful for the body because it keeps your blood sugar levels from spiking too high after meals.

Lower blood sugar maximum values mean less glycation, which means less damage to your

kidneys via inflammation.568

• EGCG prevents inflammatory mechanisms and protects against damage that happens from

inflammation.569 • EGCG can reduce blood pressure and lower the amounts of LDL cholesterol (the bad kind of

cholesterol) in circulation. Both of these effects promote heart health, protect the blood vessels,

and slow the progression of CKD. High blood pressure is a cause of CKD, so keeping blood

pressure under control can help prevent CKD from occurring.570 571 572

Green tea does contain caffeine so it is important to avoid drinking green tea after five o’clock in the

afternoon otherwise it is possible to disrupt your sleeping cycle; depending on your sensitivity to caffeine.

Green tea also contains a host of other polyphenols that have a protective function for the kidneys.

Research has shown that green tea is able to protect against CKD, gout, and other related kidney disorders

because of these polyphenols.573



Honey



FATIGUE


TOXINS


TOXINS


It turns out that honey is actually a really potent source of antioxidants. There is good evidence that honey

is a good candidate for inclusion in the treatment of chronic lifestyle diseases that are linked to

inflammation – like CKD, gout, diabetes, heart disease, and others. 574

Honey is also quite a good source of natural ‘sweetness’. It is a little better to use honey to sweeten your

drinks and foods than it is to use processed cane sugar. This means that honey is also a useful substance

for keeping blood sugar and insulin levels lower than if one used highly refined and processed white

sugar. This means that honey can contribute to preventing damage to the body linked to diabetic

mechanisms, but only if it is used as part of a total strategy to reduce glycation and control sugar and

insulin levels. Nevertheless, it is a good idea to make more use out of your honey than your cane sugar.

Kombu



FATIGUE


TOXINS


TOXINS


Kombu is actually a sea plant popular in China. Compounds contained in Kombu have been shown to

reduce the oxidation of lipids (fats) which helps to prevent heart disease progression and protects blood

vessels from damage. A study found that the activity of compounds in Kombu linked to its antioxidant

properties specifically helped to prevent CKD. 575



Flaxseed Oil (PUFAs)



FATIGUE x


TOXINS


TOXINS x


The oil extracted from flax seeds is very high in what are called poly-unsaturated fatty acids (PUFAs).

People have known about the numerous beneficial effects of PUFAs for years. PUFAs are typically very

good at fighting inflammation, lowering blood pressure, protecting the heart and keeping us young and

well-nourished. However, not that much investigation has been done on the relationship between PUFAs

and CKD and whether they could be used as an effective treatment – until relatively recently that is.

In 2012 a fantastic result was reported in a study that investigated the effects of using PUFAs to treat

CKD in the laboratory. It was found that the PUFAs present in flaxseed oil was effective in treating CKD

because they reduced creatinine levels in the blood, reduced inflammation, and protected the kidneys

from damage. The researchers concluded that PUFAs were a good way to treat CKD because they were

very good at slowing the progression of CKD and preventing most kinds of CKD linked kidney

damage.576

Ginger & Turmeric

INFLAMMATION BUSTING (ANTIOXIDANT) x IMPROVES FILTRATION (GFR) x PREVENTS CVD (ATHEROSCLEROSIS) x NATURAL DIURETIC


FATIGUE


TOXINS x


TOXINS x


Ginger and Turmeric (G&T) are delicious herbs that are commonly used in cooking exotic meals from

eastern and far eastern cultures – e.g. Indian and Chinese cultural dishes often contain turmeric and/or

ginger. Of course, if these spicy aromatic herbs were only good for flavor and color in exotic eastern

dishes then I wouldn’t be mentioning them here.

It turns out that these relatively common and well-known cooking ingredients actually contain potent

compounds for health. In particular, the compounds contained in ginger and turmeric are very good at

treating chronic diseases related to energy production, metabolism, and inflammation – so-called

‘metabolic’ disorders. What kinds of conditions are considered to be linked to metabolic disorders? Good

examples include diabetes, obesity, and chronic fatigue syndrome, but there are others too.



The thing about metabolic disorders, in general, is that the mechanisms at play with them tend to be very

strong risk factors for blood vessel disease. They tend to contribute to strokes, heart attacks, blood vessel

damage, inflammation, and of course in some cases CKD.

There are many research results showing that turmeric and ginger both contain compounds that seem to

directly help with these mechanisms. I list some of the better findings below:

- Studies have shown that G&T reduce the risk of metabolic disease because they improve glucose

balance and lipid levels in the blood. 577 578 579 580

- G&T also promote blood vessel health because they prevent inflammation that damages the blood

vessels. This property of G&T is specifically linked to preventing atherosclerosis – which is a

known cause of CKD.581 582 583 584

- Animal studies show that G&T reduces inflammation in the veins and arteries. They protect the

blood vessels from damage due to high blood pressure. They reduce the risk of stroke, heart

attack, and slow onset and progression of CKD.585 586

Some of the amazing research results on the effects of G&T with regard to different metabolic disorders

include…

- Many studies show time and again that G&T alleviates the inflammation linked to obesity,

diabetes, heart disease, kidney disease, certain cancers, and other chronic inflammatory

conditions related to arthritis.587 588 589 590 591 592 593 594 595

- One study showed that mice who were fed high fat or high refined-carbohydrate diet did not

suffer from the normal ill effects of such diets. The normal ill effects that such diets usually

induce in mice are obesity, abnormal blood lipid levels, and systemic inflammation. Ginger was

particularly good at completely preventing any of the usual negative symptoms. 34,35

- Animal studies have also consistently shown that ginger is able to protect organs from damage,

especially in diabetes. More specifically, ginger has strong protective effects on the kidneys and

the brain in diabetic subjects. 596 597

- Investigations into the benefits of taking G&T in high doses as supplements discovered that both

ginger and turmeric were actually able to fully reverse the many of the metabolic abnormalities

common to pre-diabetic patients.598 599 600 601

- It turns out that taking a daily supplement of G&T will help to control blood sugar levels,

triglycerides, and bad cholesterol (LDL). At the same time, G&T supplements boost levels of

good cholesterol (HDL) and improve insulin sensitivity.602 603 604

The results of the G&T are impressive. They clearly show that CKD patients can benefit from

supplementation with G&T, which should slow progression and protect the kidneys whilst also improving

heart and blood vessel health. The results are particularly promising for CKD patients whose CKD was

caused by diabetes. If that’s you, then definitely consider supplementing with appropriate doses of G&T

daily.



Garlic (Allium sativum)



FATIGUE


TOXINS


TOXINS x


I mentioned garlic a little earlier because it is quite a good source of magnesium. However, garlic is

impressive for many other beneficial qualities too. Aside from being delicious in foods, garlic is a potent

immune system activator. Garlic is also a protector of the heart and blood vessels because it busts

inflammation and regulates lipids and cholesterol and blood pressure.

Finally, garlic is a good antifungal herb so it helps prevent fungal infections too.605 606 607 608 609

The bottom line is that if you want to be healthy, one of the easiest ways to achieve that is to eat lots of

garlic every week. Your heart, kidneys, blood vessels, liver, immune system, and pancreas will thank you

for that.

Cranberries



FATIGUE x


TOXINS x


TOXINS x


Cranberries are delicious fruits. They also have tremendous beneficial effects on the urinary system. One

good rule of thumb that I can share with you is: If you ever have some kind of bladder or kidney or

urinary complaint of some kind – think cranberries and cranberry juice! These berries are nature's best

way to treat anything to do with bladder and kidney health.

Supplementing with cranberries… 610

- Prevents UTI’s (urinary tract infections).

- Gives antioxidant protection to the kidneys, bladder, blood vessels and microbiome!

- Boosts the immune system

- Helps with diabetic linked mechanisms.



Blueberries



FATIGUE x


TOXINS x


TOXINS x


I mentioned blueberries earlier in my discussion of resveratrol – they are a fantastic source of it.

However, it isn’t just the resveratrol in blueberries that give them their properties, they actually have a

whole bunch of additional properties that are ultimately beneficial for CKD too. In fact, blueberries have

so many benefits for CKD that they deserve their own entry here.

Broadly speaking, the main effects of blueberries are mostly due to them being super potent antioxidants.

This means that they have the power to protect the body from free radical damage, reduce inflammation,

and prevent and cure disease. Speaking in more specific terms, the antioxidant effects of blueberries will

show themselves most strongly in certain tissues and body systems based upon the unique compounds in

the berries themselves. Below are some of the specifics…

Blueberries benefit the brain: 611 612 613 614

- They prevent the brain from aging prematurely.

- They are able to reverse the effects of aging on the brain.

- They improve memory function and general cognition to youthful levels.

- Blueberry polyphenols help reduce inflammatory responses in brain cells. This is why they are

useful in controlling inflammatory conditions in the brain like Alzheimer’s disease, Parkinson’s

disease, and some dementias.

- One study showed that after only two months of blueberry supplementation the animal

participants in their study had significantly improved navigation skills.615

- A few other studies have shown that a diet rich in blueberries is linked to more efficient learning

ability depending on the brain pathways involved in the learning tasks.616

- Eating blueberries protect brain cells from dying due to stroke. This effect was thought to happen

because the compounds in blueberries improved blood supply and oxygen levels to nerves in the

brain. 617

Blueberries combat disease:

- Protect against cancer, particularly they showed efficacy for cancer of the mouth, breast, prostate

gland, and colon.618 619

- Blueberries cause the death of cancer cells 620

- Protect against diabetic linked cellular damage. 621

- Prevent urinary tract infections (UTI’s) 622

Blueberries are extremely rich in polyphenol compounds – some of the most powerful antioxidants

known to promote health:623



- The United States Department of Agriculture (USDA) compared the antioxidant capacity of more

than 20 different fruits. Blueberries came out on top of that list.

- A single cup serving of wild blueberries had more antioxidant capacity than the equivalent

amount of cranberries, strawberries, plums, or raspberries – and several times the capacity of a

similar amount of other fruits tested.

- Wild blueberries actually have a 48% higher antioxidant capacity than cultivated blueberries –

which means you should try to get wild blueberries to reap maximum benefits – if you can’t find

wild blueberries then don’t worry, cultivated blueberries still contain some of the highest amounts

of antioxidants of any other fruit.624

Nutritionally speaking blueberries are a powerhouse. Just take a look at the sheer variety of vitamins and

minerals contained in a typical serving of blueberries:

VITAMINS & MINERALS CONTAINED IN A TYPICAL SERVING OF BLUEBERRIES

Vitamin A: 79.9 IU Magnesium: 8.9 mg

Lutein and zeaxanthin: 118 mcg Iron: 0.4 mg

Vitamin E: 0.8 mg Phosphorus: 17.8 mg

Folate: 8.9 mcg Sodium: 1.5 mg

Thiamine: 0.1 mg Potassium: 114 mg

Riboflavin: 0.1 mg Zinc: 0.2 mg

Niacin: 0.6 mg Copper: 0.1 mg

Calcium: 8.9 mg

Other Tools

Leafless, or Jointed Mistletoe (Viscum articulatum Burm. f.)



FATIGUE x


TOXINS x


TOXINS x


The mistletoe family of plants can be found in many different places all over the world, but it is the

special characteristics of the species Viscum articulatum Burm. F. which are important CKD. This

particular mistletoe grows widely in Asia and the far-east and can be found in India, the Philippines,

China, Vietnam, and other related geographic areas.

The plant has been used in many traditional healing practices for centuries for an incredibly wide range of

ailments including simple scrapes, insect stings/bites, burns, fertility, high blood pressure, bone fractures,

urinary problems, muscle pain, dysentery…the list goes on.



The highlights of this plant’s amazing capacity to specifically benefit your CKD health include that it acts

as a diuretic helping with urination, it also protects the kidneys, it comprehensively prevents and reduces

inflammation, and it lowers blood pressure – that ticks all the boxes for good CKD recovery in my books.

To put it mildly, jointed mistletoe is an extremely potent natural source of compounds that can be

specially prepared to treat just about every aspect of health-related to CKD. This one is a keeper. If you

are interested in finding out everything there is to know about this wonderful medicinal plant just follow

the reference and digest the story there, 625, the details are impressive indeed.

Aloe Vera

INFLAMMATION BUSTING (ANTIOXIDANT) x IMPROVES FILTRATION (GFR) PREVENTS CVD (ATHEROSCLEROSIS) x NATURAL DIURETIC x


FATIGUE x

PREBIOTIC BENEFITTING KIDNEY HEALTH X* HELPS KIDNEY ELIMINATE

TOXINS x

PROBIOTIC BENEFITTING KIDNEY HEALTH X* HELPS LIVER ELIMINATE

TOXINS x


*(Indirectly) Promotes microbiome health because of gut protecting effects

Most people think of Aloe Vera as a pretty looking desert succulent that is far too over-hyped in the

cosmetics industry. Marketing agents are always quick to slap a nice picture of an Aloe plant on to your

soap or shampoo packaging and then claim the world for their product. The truth is that they aren’t over-

hyping anything, at least in this case.

However, I want to stress that even though aloe is an amazing medicinal plant with fantastic benefits, the

benefits of aloe in commercial cosmetic products are often completely trashed because it is often mixed

with a lot of other synthetic compounds that can be pretty toxic.

So, here I will just discuss the pure unadulterated plant source and make mention of the fact that you can

prepare it into healthy pastes, tinctures, and ointments without mixing in harmful petrochemicals and

synthetic toxins. Some products are better than others.

Most people would be surprised to learn that Aloe Vera can be ingested, internally, for great health

benefits.

People usually know about the skin-soothing, moisturizing, and rejuvenating properties of Aloe Vera.

But, people don’t usually realize that it can be safely used internally for benefits too.

What are the benefits of Aloe Vera if we list both topical and internal benefits together? Take a look at the

following list of potent properties:

- It prevents certain cancers from growing.

- Lowers cholesterol.

- Modifies blood and reduces the chances of heart attack and stroke.

- It improves energy and blood oxygen levels.

- Reduces inflammation

- Protects the body from damage linked to diabetes and obesity.



- Prevents kidney stones, and makes people more resilient to the negative effects of coffee and tea.

- It has an alkalinizing effect on the body making it really good for certain inflammatory conditions

like gout and CKD.

- Is able to cure stomach ulcers, Irritable bowel syndrome, Crohn’s disease, and other digestive

based conditions.

- It lowers blood pressure by preventing negative changes in blood vessels.

- Reduces the risks of developing CKD and slows its progression.

- It is packed with a wide variety of minerals, vitamins, and enzymes making it a good source of

micro-nutrition.

- Has proven efficacy for helping skin wounds to heal faster – particularly burns.

- It has a positive effect on the gut environment, prevents colon cancer and halts its progression.

- Aloe Vera removes gut congestion and helps constipation. The lubricative effects of Aloe Vera

on the gut also carry with them the ability to heal the intestinal tissues.

- It can help to keep blood sugar in healthy ranges and reduces blood triglyceride levels in diabetics

– two things that are beneficial in a majority of CKD cases.

- Antimicrobial effects prevent and treat common systemic infections like candida infection,

amongst others.

- Protects the kidneys from disease, and when kidney disease is present it slows the progression of

that disease.

- It helps to maintain and replenish electrolyte levels. This is great for sportsmen and women and

can be really beneficial for certain CKD patients.

- It helps the heart to perform at peak levels and boosts endurance which supports the body

effectively during prolonged periods of physical exertion.

- Aloe Vera can help to reduce the length of post-exercise recovery periods or post-operative

recovery time.

- Of course, Aloe Vera hydrates the skin, speeds up skin repair, and delays the onset of the visible

signs of aging.

So, does Aloe Vera tick my boxes as a good tool for CKD healing? Yes, for sure it does. It protects the

kidneys (tick), reduces inflammation (tick), promotes blood vessel health (tick), controls blood sugar,

insulin, and blood pressure (tick tick tick), natural and organic (tick tick) easy to get a hold of (yup) and

relatively inexpensive (yup). Does it have bonus properties that make it attractive for other areas of health

too (oh definitely it does…TICK!).

You should be looking at ways to incorporate Aloe Vera into your treatment plans for CKD.

Baking soda for kidney patients



FATIGUE


TOXINS


TOXINS x




A small case study reported on in 2009 said that a daily dose of baking soda (sodium bicarbonate)

radically helped three patients with chronic kidney disease to avoid having to undergo dialysis altogether.

Compared to other patients who received standard methods of care, the three members in this case study

registered a 33% reduction in their kidney damage compared to those who go through with standard

methods of treatment without bicarb. The only difference in their treatments was the inclusion of a daily

dose of baking soda. The 33% reduction was seen after only one year of taking the baking soda, but

participants safely took baking soda over a total two year period and the reductions became even more

pronounced. 626

The results from this initial study were so positive and powerful that a follow up was immediately done

the following year. This time the study was randomized and controlled (not a case study) and the findings

confirmed and extended the initial findings.627

I quote the researchers in the follow-up paper as saying, “Preliminary findings suggest that oral sodium

bicarbonate administration could become a major addition to the armamentarium of renoprotective

measures for individuals with chronic kidney disease.”

Translating through the jargon, the message basically reads as follows, “Our findings show that drinking

baking soda solution should be628 added to the standard methods of treating kidneys and protecting

kidneys when people have CKD.”

The original researchers of the first small ‘case study’ paper (629) concluded that bicarb supplements,

when taken daily for extended periods of between one and two years significantly reduce the risk of CKD

patients progressing to stage 5 – also known as “end-stage renal disease” as mentioned in chapter one.

This would essentially prevent the need for dialysis in many CKD patients globally every year.

What an interesting find! Such a natural, safe, inexpensive, super effective, and effortless thing that

anyone can do with just the things you could find lying around your own kitchen. That makes bicarb

(baking soda) an instant include on my list of great tools for CKD.

A Stem Cell Treatment Tool to Regenerate Kidney Tissues from

Supposedly Irreversible Damage!

If asked, your doctor would likely tell you that kidney damage is almost always irreversible. In fact, your

doctor might just say that it is always irreversible. To a large extent, this has been true. But, our

knowledge and methods are always evolving and updating. As our understanding of the human body,

health, and disease keeps getting better, so does the technology we invent to implement that

understanding.

Consider that the medicine of 200 years ago looks totally barbaric and downright dangerous to people of

our generation. Things have changed so much since then, and in two centuries time, I wouldn’t be that

surprised if the medicine of today seems just as barbaric to some future generation of shocked medical

historians.



Yes, up till only very recently it has been widely believed and taught in medical schools around the

western world, that kidney damage or degeneration is irreversible once it starts going – especially as

people enter stage four or five kidney disease.

That being said, despite such a negative sentiment existing in the field of CKD treatment, I have not once

emphasized or stated categorically that kidney damage is irreversible. The reason why is because new

discoveries in the field are happening all the time and in recent years I am beginning to see new

discoveries that shed doubt on the prevailing opinion. Secondly, it isn’t really true of even the methods

and tools we have available at present to deal with CKD. I have given so many in this book, each with

fantastic benefits, and each benefit can contribute to a well thought out protocol that actually does have a

good chance of returning people back to a state of good kidney health – I have no doubt of that.

The other reason for being optimistic about regenerating the actual tissues of the kidney is because of

modern findings in stem cell research. Stem cells are found all over the body. These cells are very special

because they are like primordial cells or progenitor cells. Stem cells exist in a blank state where they have

not specialized or turned into any other kind of specific cell.

What this basically means is that stem cells can turn into just about any other kind of cell by ‘choosing’ to

specialize (differentiate) into that kind of cell. So, for example, if a stem cell got just the right signals, it

could in theory change divide itself up and turn into a red blood cell, or a bone cell, or even a brain

neuron. Stem cells hold the key to regenerating tissues that have apparently been irreversibly lost or

destroyed.

The idea is pretty simple, but so far people haven’t managed to develop good ways to signal stem cells to

turn into other kinds of cells. Either the results are unsafe because we don’t understand enough about the

process to artificially force it, or we simply do not have the knowledge, yet.

However, we don’t have to force the cells to do the transformations artificially with some lab technique,

all that needs to be done is to find a plant or herb in nature that when used in the right way will lend all

it’s highly evolved smart biology to achieve the results we want. This means that we can piggy-back on

the way evolution has solved these problems through trial and error over millions of years, instead of

waiting for the slow development of our artificial technologically based methods of interference.

It is pretty easy to apply a plant extract to a situation, observe the effects on stem cells and record the

recovery of the kidneys, check for safety, and then develop a safe set of practical guidelines to use the

plant to induce the re-growing of the kidneys. This still takes careful painstaking research and

investigation and it still requires guidelines for safety and efficacy to be developed and tested, but it is a

lot quicker than developing a whole technology from scratch.

So, what is the good news for CKD patients’ kidneys? The good news is that research has finally begun to

come out showing that such a plant substance does, in fact, exist that seems to regenerate the kidneys. We

are far from being sure of the best methods for safety and efficacy, but we are sure that it works. What

that means is that early research results are extremely promising and that the idea that kidney damage is

irreversible is now simply an outdated, old-fashioned idea.

The compound that has been discovered to have this ability is called icariin. I’m going to briefly describe

what benefits we know about so far.



The benefits of Icariin

Icariin has been shown to increase the numbers of kidney stem cells in studies done on rats. These stem

cells were linked to better protection of those rats from chronic kidney progression and kidney tissue

regrowth and repair was reported with some improvement in kidney function too. The researchers

actually surgically removed 5/6 (over 83%) of the rats kidneys and Icariin was able to stimulate stem cells

to repair and regrow the kidneys such that many of the rats did not suffer so strongly from kidney failure

(the expected result would be that the rats would suffer catastrophic total kidney failure; this did not

happen). These results were only just recently reported back in 2015 – researchers are still developing the

theory and practice needed to use Icariin properly.630

The reason why it is difficult to regenerate the kidneys is that they have a complicated anatomical

structure and no zone from which new kidney tissue can really grow from to form new filtration units.

Notice that researchers are now using terms like “difficult to do”, and not “impossible” or that damage is

“irreversible”, why is this, because our understanding of stem cell genetics has advanced to the point

where we can finally imagine such a possibility – before this we could not even imagine such a thing.631

As of now, many studies have shown that kidney cells can, in principle, be manipulated into promoting

kidney regeneration.632 633 It is just that Icariin has some of the best performing results for CKD and helps

for many other conditions too.

So why am I interested in Icariine for you to use in a protocol to heal from CKD. Here’s why…

- Icariin is a flavonoid (polyphenol!) from plants of the genus Epimedium (the Barberry family of

plants). I have already given two examples of the power of flavonoids/polyphenols to promote

good health (see resveratrol and white mulberry entries above)

- Icariin has the ability to induce actual kidney tissue regeneration by activating kidney stem cells

(I already mentioned this above)

- In addition to the stem cell effects of Icariin, it has also been proven to have therapeutic potential

for treating: 634 635

o Nerve cell degeneration (seen in dementias),

o Improving memory (helpful to Alzheimer’s patients, the elderly, and healthy people)

o Acts to improve the condition of people with depression and depressive disorders.

o Completely wipes out chronic inflammation, especially protective of the kidneys in this

regard.

o Heart diseases of all types

o Fights diabetes on multiple axes

o Prevents and might even treat osteoporosis

o Potent anti-cancer properties,

o It has good potential treatment value for healing reproductive disorders

o Icariin can modulate the immune system which makes it especially suitable as a therapeutic

in immune disorders.

Icariin seems to work with most stem cell lines, not just kidney based ones. For example, one study found

that Icariin promoted self-renewal of mouse nerve cells636, another study found that it could activate



dormant nerve stem cells in aged rats!637 Heart, bone, and skin stem cell lines have also shown to respond

to Icariin promoting regeneration and reactivation of youthful tissue profiles.638 639 640 641

So, Icariin is essentially a wonder substance for treating many disorders and it can activate tissue

regeneration too which makes it very likely to combat the effects of aging. Such is the pedigree of Icariin,

and I am sure we will be hearing a lot more about this substance in the future.

That brings me to the end of an impressive list of powerful tools that you can use to heal your CKD and

boost your health. In the next, and final, chapter I make specific practical


Chapter Five

The Rainbow Renal Lifestyle Protocol to Reverse CKD

I have taken the Mediterranean Diet and included foods that promote kidney balance and excluded foods

that are unhealthy for kidney repair. This diet is the combined wisdom of my own clinical experience as

well as incorporating the latest scientific findings to make it easy for you to achieve balanced kidneys that

function to support your vision of a healthy life.

Why is called the Rainbow Renal Diet? Simply because it emphasizes eating bright colorful fruit and

vegetables. Each of these intense color pigments (polyphenols) are medicinal plant chemicals with unique

properties and specific health actions.

Remember Resveratrol? It is found in the skins of dark purple, blue and red berries and grapes. All of

these colors are known to have anthocyanidins that protect us from heart disease, as well as having very

powerful antioxidant effects that drastically reduce inflammation in the body.

Deeply intense orange veggies or foods often contain Beta-carotene or Vitamin A that is essential for

protecting your gut and blood vessel wall linings.

Including an entire rainbow spectrum of foods into your daily diet will ensure that you receive all the

nutrients you need for your ‘inner tribe’ to repair and your body and to keep it functioning in optimal

health, as long as you make this your own(ly) diet.

In the last section I discussed the Mediterranean Diet in more detail and shared some of the research so

that you could understand why and how this diet can truly help you to heal. A good diet is not helpful if it

is one you won’t follow, and this is why it’s essential to present the Rainbow Renal Diet in an easy

combined that’s simple to follow.

It’s really not important to remember all the science and medical names that are listed in this book – you

can always refer back to the relevant section if you need to. All that is really important, is that you

understand that the Rainbow Renal diet is your passport to health and vibrant longevity.

Everything you need is included here - what foods to select or avoid, beneficial lifestyle choices you need

to make and what supplementation is needed to support the different stages of your healing journey.

Be patient with your progress and kind to yourself on this exciting healing journey. Remember that your

condition took years to develop so it would be unrealistic to expect healing to happen overnight. The

process of healing is like a spiral – it often feels as if you take 2 steps forward and then 1 step backwards

again – this healing waltz is normal and honestly, it’s a happy dance because at the end of the tunnel there

is a full life waiting for you to enjoy. All you need to do is begin …

Chapter Five – The Renal Rainbow Diet For Complete Kidney Healing


Goals to Achieve Healthy Kidneys for Life

Your focus is on healing your kidneys in 3 main treatment phases over a two-year period. These phases

are broken down into smaller action steps that are the roadmap for your journey home. By the end of this

program you will also achieve the secondary goals because these are the real underlying problems that

need to be sorted, if you want your kidneys to smile again.

Primary Goals

1. Protect from kidney damage – first 3 to 6 months

2. Restore kidney function – 6 to 12 months

3. Repair and renew kidney tissue – 12 to 24 months

Secondary Goals

• Stabilize Blood Sugar levels – Reverse risk for Diabetes

• Normalize Blood Pressure – Protection from Cardiovascular Disease

• Reduce weight – Manages obesity and protects from Metabolic Syndrome

• Longevity – regenerate and renew body tissues

The Rainbow Renal CKD Program

Phase 1 Prevent Kidney Decline - Stabilize Your GFR (Appendix 1)

• Eliminate all items that cause stress to the kidneys - The Big No-No List (Appendix 6)

• Improve blood supply to the kidneys – Supplements & Diet (Appendix 1)

• Reduce Inflammation with natural antioxidants – Supplements & Diet (Appendix 1)

• Restore balance to the gut microbiome – through dietary prebiotic fiber foods (Appendix 10)

• Reduce build-up of uremic toxins by strengthening the gut to support elimination (Chapter 3)

• Address vitamin & mineral deficiencies – Supplements & Diet (Appendix 1)

• Reduce blood sugar levels to prevent glycation – Supplements (Appendix 1) & Low Glycemic

Foods (Appendix 8)

• Follow healthy lifestyle guidance for stable sleep, stress reduction and gentle exercises (Chapter

3)

• Follow Meal Plan to get you started (Appendix 9)

Phase 2 Restore Kidney Function - Improve Your GFR (Appendix 2)

• Establish & Maintain balanced blood sugar levels – Supplements (Appendix 2) & Low Glycemic

Foods (Appendix 8)

Test Hemoglobin A1C before starting and after completing 3 months on Phase 2 – Your

goal is to get a test result that is less than 5.6% if it isn’t already and maintain this result in

Phase 3

• Strengthen kidneys – Supplements (Appendix 2) & Diet (Appendix 4)

• Maintain balanced kidney & gut microbiota – dietary prebiotic fiber foods (Appendix 4)



• Monitor & support nutrient status – Supplements (Appendix 2) & Diet (Appendix 4)

• Continue healthy lifestyle guidance for stable sleep (Refer to Lifestyle Chapter 3)

Increase gentle exercise to 3 – 5 times weekly

Mindfulness meditation to support goals and keep stress away

How well are you doing?

After Phase 2 you need to undergo a full set of tests that include:

Hb A1C Test

Your goal is to get a test result that is less than 5.6%

Creatinine Levels

The standard reference ranges for creatinine levels are: 642

• Women (15 years and older): 0.57–1.00 mg/dL

• Men: 0.76–1.27 mg/dL

BUN/Urea Levels

• The standard reference range for BUN/UREA levels is: 6–20 mg/dL643

Albumin Test

• The standard reference range for Albumin is: 3.5–5.5 g/dL644

Blood Pressure

• Goal is to maintain blood pressure readings at 140 / 90 or lower

Glomerular Filtration Rate (GFR)

• Any improvement is fabulous news

Phase 3 Repair and Renew Kidney Tissue - Normal GFR (Appendix 3)

• Maintain balanced blood sugar levels – Supplements (Appendix 3) & Low Glycemic Foods

(Appendix 8) Goal - Keep Hb A1C below 5.6 %

• Maintain Blood Pressure at 140 / 90 - Diet

• Monitor and maintain kidney progress – Pathology Tests, Supplements (Appendix 3) & Diet

(Appendix 5) Creatinine and BUN have reduced and are close to or are within normal ranges

• Continue the Rainbow Renal Diet – get creative and make it your own

• Generate new kidney tissue – Golden Nugget Supplements (Appendix 3)

• Generate new cardiovascular tissue– Golden Nugget Supplements (Appendix 3)

• Increase Energy – Golden Nugget Supplements (Appendix 3) & Increase Exercise (Refer to

Lifestyle Chapter)

• Maintain balanced kidney & gut microbiota – dietary prebiotic fiber foods (Appendix 10)



• Monitor & support nutrient status – Pathology tests, Golden Nugget Supplements (Appendix 3) &

Diet

• Continue healthy lifestyle guidance for stable sleep, stress reduction and enjoy moderate exercise

in nature and take up a new hobby (Refer to Lifestyle Chapter)

Quick aid to help alleviate swelling and painful kidneys

• Bicarbonate & Epsom Salt Soak

Run a warm bath

Add 1 cup Bicarbonate of Soda to bath

Add 3 heaped tablespoons of Epsom salts to bath

Soak for 20 minutes to get full benefit

Notes:

Take a large glass of water to sip on whilst in the bath

It’s a good time to mindfulness meditation or listen to some of your favorite music

Take a clock or timer with you

Don’t dress immediately after your bath as you may perspire – rather slip into a towelling robe

and lie down on a towel until the perspiration subsides

If you don’t have a bath you can halve the ingredients and take a foot bath instead

Although a bath is far more therapeutic

You can do these 3 times a week to help alleviate edema

It’s a good idea to have someone on standby to help you out of the bath in case you feel dizzy, or

have heart palpitations – don’t worry these will go away once you have taken a short bed rest



General Principles for CKD

• Restrict meat and dairy products to prevent CKD from progressing (Refer to FAQ - APPENDIX

4 )

• Choose Alkaline Foods – Refer to Appendix 1

• Low Glycemic foods are best if you have been diagnosed with diabetes – Refer to Appendix 2

(The Glycemic Index)

• High Fiber Foods – Prebiotics to support healthy microbiota

• Avoid Lectins – Lectin free diet

• Avoid Foods high in Phosphorus and Sodium (Refer to FAQ - APPENDIX 4)

• Limit Potassium rich foods (Refer to FAQ - APPENDIX 4)

• Make sure you are in bed by 22h00 to enjoy a deep restorative sleep (Chapter 3)

• Important exercise options for people with CKD (Chapter 3)

• Reduce stress as much as possible (Chapter 3)



Chronic Kidney Disease Overview

Chronic Kidney Disease

Dysbiosis Symbiosis

Leaky gut Gut Barrier Integrity

Alcohol Red wine polyphenols

Medicines Prebiotics (High Fiber)

Artificial Sweeteners Honey or Stevia

Low Fiber Diet High Fiber Diet

Refined / Processed Foods Fermented Foods

Acidic Foods Alkaline Diet

Gluten & Lectins Fermented Foods

Saturated Vegetable Oils Olive Oil and Fish Oils

High animal protein diet Low in animal protein

Low in vegetables & fruit Vegetables & whole fruit

Refined grains Whole grains

High Sugar intake Rich in nuts & seeds

Low in antioxidants Rich in antioxidants

Food additives / colorants No food additives/colorants

Sodas & sweetened fruit juices Water & herbal teas

Pesticides & GMO foods Organic non-GMO foods

Sedentary Lifestyle Active Lifestyle

Proteolytic bacteria Saccharolytic Bacteria

Weakened Immune System Strong Immune Function

Stress & Anxiety Energy & Vitality

Poor Sleep Quality Deep Restorative Sleep


Appendix 01

The Rainbow Renal Diet Program - Phase 1

Primary Aim: Prevent Kidney Decline - Stabilize Your GFR

Method: Optimize Blood Pressure to achieve 140 / 90 BP

Eliminate all items that stress kidneys

The purpose of this protocol is to halt the progression of CKD. By eliminating kidney stressors &

normalizing your blood pressure, you will be able to keep the GFR stable and prevent it from

deteriorating further.

To balance your blood pressure, I have selected supplements that target possible causes involved. This

means that you will start to address some of the issues that lead to insulin resistance, balance blood

glucose levels, reduce weight, control hypertension, reduce inflammation, improve your immunity and

increase blood circulation.

Supplementation is not meant to be taken indefinitely, rather it is a tool we can use to support our body

when we need time to heal through our diet, which takes longer to be effective but is a lasting solution to

health problems.

How can you do this? It’s easy, just follow this guide that combines natural holistic strategies

incorporating effective lifestyle, diet and nutritional factors that have been validated through scientific

evidence-based research.

Phase 1 - Prevent Kidney Decline - Stabilize Your GFR

• Eliminate all items that cause stress to the kidneys - The Big No-No List (Appendix 6)

• Improve blood supply to the kidneys – Supplements & Diet

• Reduce Inflammation with natural antioxidants – Supplements & Diet

• Restore balance to the gut microbiome – through dietary prebiotic fiber foods (Appendix 10)

• Reduce build-up of uremic toxins by strengthening the gut to support elimination

• Address vitamin & mineral deficiencies – Supplements & Diet

• Reduce blood sugar levels to prevent glycation – Supplements & Low Glycemic Foods

(Appendix 8)

• Follow healthy lifestyle guidance for stable sleep, stress reduction and gentle exercises (Chapter

3)

• Follow Meal Plan to get you started (Appendix 9)

APPENDIX 01 – Rainbow Renal Diet – Phase 1


What to do – From Theory to Action

What to Increase - The Best Guide for CKD (Appendix 5)

What to Avoid – The Big No-No’s (Appendix 6)

Prebiotic Guidance (Appendix 10)

7 Day Meal Plan (Appendix 9)

Shopping Ideas (Appendix 9)

FAQ (Appendix 4)

Phase 1 Supplement Protocol (3 – 6 Months) See Below

Discussion of Diet and Lifestyle Factors Chapter 3

Assessment

Pathology tests at start of Phase 1 and after 3 months on the program allow you to assess

whether your GFR has remained constant or improved.

If your blood pressure is 140 / 90 and your GFR results are stable then you can continue

to Phase 2. If not then continue Phase 1 for another 3 months and reassess.

Foundational Principles Used in Phase 1

• Low Glycemic Index Fruit and Vegetables (Appendix 8)

• Increase dietary intake of Polyphenolic / Antioxidant foods

• Increase alkaline food (Appendix 10)

• Increase complex carbohydrates – whole foods

• Increase Fiber-rich prebiotic foods (Appendix 10)

• Increase foods rich in omega-3 – (Appendix 4)

• Only eat organic non-genetically modified foods

• Introduce more raw foods into diet through salads and smoothies

Lifestyle Factors (Chapter 3)

• Physical Exercise – stretching, gentle short walks

• Deep regenerative sleep – Camomile tea half an hour before sleep

• Meditation Exercises – daily mindfulness and stress relaxation



Suggested Supplementation Protocol

N.B. Refer to Appendix 12: Supplement Safety Guidelines

Supplement

Breakfast

Lunch

Dinner

Dose

Before

After Befor

e After

Before

After

Astaxanthin

x x x Product guide

Alpha-Lipoic Acid – Dual R Form x 250 mg

Resveratrol** x x 500 mg

Ubiquinol (potent CoQ10)

100 – 250 mg

Vitamin K2 x 10 mg

Vitamin C x x x 1000 mg

Olive Leaf Extract

x x

500 mg Vitamin D3

x 800 - 2000 IU

CBD oil x x x Product guide

Codliver Oil

x 1 Teaspoon

Methyltetrahydrofolate x x 300 μg

Chromium x x 200 μg

Vitamin E (Gamma Tocopheral) x x 800 IU

Methylcobalamin x 50 μg

P-5-P x x 50 mg

Benfotiamine x x 25 mg

Note: It is important to let your health practitioner know that you intend to follow this protocol.

Especially if you are on dialysis or take pharmaceutical drugs.



Lower Blood Pressure Support Smoothie

Ingredients

• 1 cup of coconut milk or coconut water

• 1 cup of watermelon (cubed)

• ¼ cup white mulberries

• 1 teaspoon of coconut oil

• ½ teaspoon cinnamon powder

• 1 tablespoon raw organic honey

• ½ cup blueberries – or any dark colored berries of your choice

• ½ cup organically grown dark grapes - washed well

Method

Place all the washed ingredients into a glass blender.

Blend until smooth and Enjoy!


Appendix 2


Primary Aim: Restore Kidney Function - Improve Your GFR

Method: Normal Blood Sugar Levels & Weight Reduction

The purpose of phase 2 is to improve your GFR. There is very little difference to this protocol except that

supplementation is changed to introduce more potent natural therapies to reduce diabetes risk and stable

metabolic abnormalities.

All the previous guidelines still apply except you can start to introduce more potassium foods into your

diet – with moderation. By this I mean that you can increase your fruit and vegetable choices as long as

they are still low-glycemic and alkalinizing in the body. A glass of dry red wine once a week is also an

option and more nuts and seeds too. Consider adding organic cottage cheeses, feta, avocados and

mushrooms to tempt your taste buds and let your body know that you are returning to a state of good

health.

Another change is to increase gentle exercise activity on a daily basis if possible, otherwise be sure to

bump it up to at least 3 - 5 days every week. Take the opportunity to have a picnic in a natural

environment or contact a friend and go for gentle strolls together. Do exercises in a swimming pool now

and again.

The new supplement protocol will help you to feel more energized and creative too. You are still

addressing the underlying issues such as insulin resistance, balanced blood glucose levels, weight loss,

hypertension, inflammation, immune system status and improving blood circulation.

Phase 2 - Restore Kidney Function - Improve Your GFR

• Establish & Maintain balanced blood sugar levels – Supplements & Low Glycemic Foods

(Appendix 8)

• Strengthen kidneys – Supplements & Diet

• Maintain balanced kidney & gut microbiota – dietary prebiotic fibre foods (Appendix 10)

• Monitor & support nutrient status – Supplements & Diet

• Continue healthy lifestyle guidance for stable sleep (Chapter 3)

• Increase gentle exercise to 3 – 5 times weekly

• Mindfulness meditation to support goals and keep stress away

APPENDIX 02 – The Renal Rainbow Diet – Phase 2



Follow the exact same guidelines as given in Phase 1 but increase some potassium rich foods listed in

FAQ (Appendix 4).

Change Supplement Protocol for the next 3 months to see an even greater improvement in all areas of

CKD.

NB: Take a one-week break from all supplements before starting your new protocol.

Take new supplementation for 5 out 7 days – maybe taking weekends off? This is to start moving

away from supplements because your diet and microbiome can do most of the good work.

What to Increase

• Increase Cranberry, White Mulberries & African Mango Fruits

• Introduce more Potassium foods into your diet especially avocado and some bananas to increase

variety of rainbow foods you’re eating (Appendix 4)

• Feel comfortable to have more nuts and seeds (still no peanuts or cashews)

• Weekly glass of organic dark red wine if so inclined (Resveratrol)

• Keep up with celery smoothies, chia seeds & green tea & berries

What to Decrease

Some supplements have been stopped

Relevant Info for Phase 2

• FAQ – Check Potassium food lists (Appendix 4)

• Natural Tools used in Phase 2 Chapter 4

• Phase 2 Supplement Protocol (3 Months) See Below

• Discussion of Diet and Lifestyle Factors Chapter 3



Assessment

Pathology testing at end of 3 months on the Phase 2 program allows you to monitor your progress.

Hopefully you are starting to feel a lot healthier as well as seeing a steady improvement in the following

areas:

• Improved GFR

• Improved blood sugar measurements

• Weight loss

• Maintain stable blood pressure

• Decrease in Albuminuria

• Decrease in creatinine

• Decrease in BUN

• Lower uremic toxins through better kidney and colon elimination

• Better mood and more creative



Suggested Supplementation Protocol

Supplements to be taken 5 days a week only!

N.B. Refer to Appendix 12: Supplement Safety Guidelines

Supplement

Breakfast

Lunch

Dinner

Dose

Before After Before After Before After

Astaxanthin

x x x Product guide

Magnesium citrate x

Resveratrol

x x 500 mg

Chlorella x Product Guide

Vitamin K2 x 10 mg

Vitamin C x 1000 mg

Multi Mineral

x Product Guide

Vitamin D3

x 800 - 2000 IU

Tart African Cranberry x x Product Guide

Codliver Oil

x 1 Teaspoon

Methyltetrahydrofolate x 300 μg

Chromium x 200 μg

Viscum Articulatum Burm. Product Guide


P-5-P x 50 mg

Benfotiamine x 25 mg





Nobesity Smoothie

Ingredients

1 teaspoon turmeric

3 carrots

1 medium apple

1 peeled cucumber

1 peeled and cubed African Mango

2 stalks celery

slice of ginger

1/8 lemon with peel

1 teaspoon moringa powder

1/4 cup chia seeds

1/2 cup green tea to help lubricate the smoothie

Method

Blend all ingredients in the smoothie add more green tea if more liquid is needed and blend until smooth.

This formula will give energy and a balanced blood sugar level for hours all while feeling satisfied. Store

in a large container in the fridge and make sure to finish all of it as it will lose its potency if stored for

more than a day.

Additional

Mix it up by adding organic well washed blueberries, beetroot or a couple of pieces of pineapple for a

change in taste.


Appendix 03


Primary Aim: Repair and Renew Kidney Tissue - Normal GFR

Method: Stimulate Stem cell regeneration of body tissue

The purpose of phase 3 is to have your kidneys and health functioning optimally with a normal GFR. The

main focus in this protocol is to generate stem cells to repair kidney and heart muscle tissue. It also

repairs the hormonal system by regulating the hypothalamus, pituitary and adrenal gland axis. The Golden

Nugget is a perfect way to complete your dance to wellness. It’s like getting a second chance to live life

to its fullest potential. Use this opportunity well …

By the time you have completed Phase 3 you should be experiencing yourself as a new being full of

vibrant health. I hope that you will agree that the Rainbow Diet is the best lifestyle diet to lead a life full

of energy that extends life span whilst keeping your vitality intact.

At the same time, by following this program you reduce the risk of developing any of the major chronic

lifestyle diseases that currently plagues the modern world. The protocol is designed not only to protect

and repair but to extend your lifespan naturally brimming with vitality. You have become your doctor,

empowered to make decisions about your health and the life you want to lead.

Phase 3 - Repair and Renew Kidney Tissue - Normal GFR

• Maintain balanced blood sugar levels – Diet & Low Glycemic Foods (Appendix 8) (Goal - Keep

Hb A1C below 5.6 %)

• Maintain Blood Pressure at 140 / 90 - Diet

• Monitor and maintain kidney progress - Pathology Tests after 3 months and again at 6 months

• Continue the Rainbow Renal Diet – get creative and make it your own

• Generate new kidney tissue – Golden Nugget Protocol (Chapter 4)

• Generate new cardiovascular tissue– Golden Nugget Protocol

• Increase Energy – Golden Nugget Protocol & Increased Exercise Activity (Chapter 3)

• Maintain balanced kidney & gut microbiota – ongoing dietary prebiotic fiber foods (Appendix

10)

• Support nutrient status – Golden Nugget Protocol & Diet

• Continue healthy lifestyle guidance for stable sleep and take up a new hobby (Chapter 4)

APPENDIX 03 – The Rainbow Renal Diet – Phase 3



Follow the exact same dietary principles as Phase 2 – By now you should be able to call it your new

lifestyle and manage your diet without much trouble. Keep inventing new dishes and make it enjoyable

for yourself … you’re worth it!

The Phase 2 Supplement Protocol is now going to be replaced with The Golden Nugget Protocol but first

take one week off all supplements.

NB: Take a 3-week break from all supplements before starting your new protocol.

Schedule Blood tests outlined at the end of stage 2 while you are on a supplement break. Do not

continue with Phase 3 if your tests show that you have not made progress – go back to Phase 2

protocol if that is the case.

If your Phase 3 tests are positive, then take a 3 week break before continuing with supplements

that are coded in red – these are to be taken at least for the entire 12-month period. After This you

have come ‘home’ … tune into your body regularly to see what you need to fine- tune your

health. The golden nugget

Take golden Nugget Protocol daily for the first 3 weeks and go back to taking supplementation

for 5 out 7 days again.

What to Increase

• Apples

• Blueberries – Strawberries, all dark berries & cherries

• Cranberry concentrate daily

• White mulberries daily – just a small handful will do the trick

• Celery smoothies

• Omega-3 is important now so make sure you have plenty of chia seeds on hand

• Mango

• Red Grapes

• Artichokes

• Asparagus (cooked)

• Beetroot

• As many vegetables as you enjoy

• Banana and berry / fruit sorbets

• Cultured Bifidobacteria Yoghurt

• Fresh herbs – add to salads and steamed vegetables

• Olive oil

• Coconut oil

• Coconut water

• Kombucha

• Deep sea wild fish from uncontaminated oceans

• Nuts – walnuts, almonds, pistachios



• Seeds – Pumpkin, Chia, Flax, Hemp & Sesame

• Organic Butter – not for cooking purposes

• Whole grain Pita’s

• Legumes – Adzuki, Mung Beans & Kidney Beans

• Avocado – 3 per week maximum

• Onions

• Garlic

• Cinnamon

• Honey

• Turmeric and curcumin - liberally

• Ground black pepper

• Holy Tulsi Tea if stressed

• Rosehip meal (40g) – steep in hot water & drink as a daily tea

• Moringa Oleifera extract makes an ideal tea to support kidneys

• Green Tea – drink 3 cups daily but not after 16:00

• Chamomile Tea at Night for a sleep aid that supports kidneys too

• Filtered water – drink 4 - 6 glasses daily with a squeeze of lemon or lime to alkalinize

your body – add spearmint or mint leaves for refreshing change

• Pink Himalayan Salt / Maldon salt

• Pomegranate Juice (Pure unsweetened) – ¼ glass daily to support blood vessel walls

• 1 glass of red wine per week if inclined

All the normal fruits and vegetables are still important.

What to Decrease

Some supplements have been stopped

Relevant Info for Phase 3

• Natural Tools used in Phase 2 Chapter 4

• Lifestyle Factors

Take up a new hobby – the idea is to get interested and celebrate being alive, meet new

people and get about more – settle on a project that really excites you!

Ideas – learn to play a musical instrument, take up an art program, learn to knit, learn a

new language, become an expert at Sudoku, learn to sing … the possibilities are endless

Consider consulting a sports expert to design an exercise program specially for you

Exercise in water may be a really good way to go



Assessment

Pathology testing at end of 3 months and again at 6 months after starting The Golden Nugget Protocol.

Take a break from supplements for 3 weeks after each 3-month period. Try to schedule your tests when

you are taking a supplement holiday for more accurate test results. By now you are ready for the last leg

of your journey home and see healthy test results to confirm your progress in the following areas:

• Improved GFR

• Improved blood sugar measurements

• Steady Weight loss

• Stable blood pressure

• Normal Albumin result

• Normal creatinine levels

• Stable BUN

• Kidney and colon elimination normal

• More energy and creativity



Suggested Golden Nugget Supplementation Protocol

Important Notes:

First take a 3-week break from all supplements before starting on this protocol

Supplements to be taken daily for first 3 weeks and then back to 5 days per week

Every 3 months take a 3-week break from all supplements and arrange to have your tests done during

your supplement holiday

Supplement

Breakfast

Lunch

Dinner

Dose

Before

After Befor

e After

Before

After

Astaxanthin

x Product guide

Resveratrol

x 500 mg

Chlorella x x 1000 mg

Vitamin K2 x 10 mg

Vitamin C x 1000 mg

Vitamin D3

x 800 IU


P-5-P x 50 mg

Benfotiamine x 25 mg

Codliver Oil

x 1 Teaspoon

Methyltetrahydrofolate x 300 μg

The Golden Nugget - Icariin

Epimedium brevicornum Maxim x x x

250 mg – 300 mg




Appendix 04

Rainbow Renal Diet - FAQ

Is a low-potassium diet important when you have kidney disease?

When it comes to Potassium and CKD, it’s all about keeping your minerals (electrolytes) in balance. The

kidneys can no longer perform their normal function of regulating electrolytes and these become more

disturbed as kidney disease advances.

Having a normal balance of potassium is important to keep your muscles, especially your heart muscle

working naturally. For most folk, the daily recommended intake of potassium is 2.6 – 3.4 g however,

people on a renal rainbow diet need to restrict their total potassium intake to below 3 g daily.

Restricting potassium in your diet depends on your actual potassium levels and these need to be

monitored by having regular blood tests. If your potassium test results indicate that you are in the normal

range between 3.5 mmol/L – 5.5 mmol/L, then you don’t have to follow a low-potassium diet. Although

on this point I still recommend that you limit very high potassium foods because these cause extra work

for your kidneys when they are already overburdened.

If your blood tests show that you have a high level of potassium then you need to be diligent about

avoiding foods that will stress your kidneys out. Follow a low-potassium diet as if your life depends on it

– and it does.

Don’t be alarmed when you discover that many foods contain potassium but these are fine to have in your

diet.

Choosing low potassium foods (< 200mg) most of the time will help you – look at some of these delicious

options listed below:

• Low potassium foods (< 200mg)

• Apples or homemade applesauce

• Apricots – soaked and washed

• Berries – go wild!

• Cranberries – natural and unsweetened

• Fruit salad

• Grapes – dark ones are the healthiest

• Grapefruit or freshly squeezed grapefruit juice

• Lemons and limes – add a twist of these to water at the start of every morning to alkalinize your

biosuit and start your day in a healthy way

• Mangoes

• Papayas

• Pears

APPENDIX 04 – The Rainbow Renal Diet - FAQ


• Peaches

• Plums

• Pineapple

• Tangerines

• Watermelon

• Alfalfa sprouts

• Bell peppers

• Bamboo shoots

• Broccoli - needs to be steamed for 10 minutes to remove oxalates that remove minerals from your

biosuit

• Cabbage – all types are great

• Carrots

• Cauliflower

• Celery and onions (raw)

• Corn

• Cucumber

• Eggplant – watch your response to eating this lectin and avoid if you get bloating or digestive

pains in the hours after eating

• Green beans

• Kale

• Lettuce

• Mushrooms (fresh)

• Okra – a wonderful type of squash crammed with health benefits

• Summer squash (cooked)

It’s the foods that are very high in potassium that you need to mindful about. Some of the main offenders

are listed below:

Limit these foods that are rich in potassium (> 200mg)

• Apricots

• Raisins

• Prunes

• Oranges

• Bananas

• Lentils

• Squash

• Potatoes

• Beans

• Dried fruits

• Salt substitutes

• Instant coffee

• Dried Fruits

• Cantaloupe

• Dates



• Nectarines

• Kiwi

• Acorn and butternut squash

• Avocado

• Baked beans

• Broccoli (cooked)

• Brussels sprouts (cooked)

• Chard

• Chile peppers

• Mushrooms (cooked)

• Potatoes

• Pumpkin

• Spinach (cooked)

• Split peas, lentils, beans

• Sweet potatoes, yams

• Vegetable juice

• Tomatoes/tomato juice/tomato sauce

I know, many of my personal favorite foods are on this watchlist. Ask yourself whether you want your

health and energy back or whether you really want to spend the remainder of your life continuing to

suffer. If you are like me then the answer is obvious – I am grateful to have a body to experience, enjoy

and explore life. There is no real problem when you see it this way besides there are many fabulous

‘goodies’ on the low potassium list too!

You can be more flexible with your diet if your test results come back within a normal range. If this is the

case then it’s fine to take potassium rich foods in small quantities - For example, use a skinny slice of

tomato, or add small wedge of avocado to your salad.

You can eat high potassium foods in moderation if you take a little extra time to prep well before meals.

Its really simple to do!

• Peel vegetables

• Wash in water

• Slice or grate

• Place in warm water to soak for two hours before boiling

• Don’t boil your foods for too long as you don’t want to boil all your nutrients away

Its best to generally restrict your intake of these foods if you want to be kind to your kidneys, but now and

again it won’t hurt if you do indulge, as long as your blood tests agree and you take a little time to prepare

your vegetables properly.

Note for diabetics:

Choose organic GMO-free apple, grape, or cranberry juice when your blood sugar level drops.



What is a normal serving or portion of food?

One serving of fruit is equal to one small piece of fruit or:

• ½ cup fresh or cooked fruit

• ¼ cup dried fruit

• ½ cup juice

One serving of vegetables is equal to any of the following:

• ½ cup fresh or cooked vegetables

• 1 cup raw leafy vegetables

• ½ cup of veggie juice

Should I be on a low-protein diet?

Proteins are most abundant in animal food products and are found in meats, fish, poultry, dairy products,

nuts and some grains too. Your body needs proteins to make muscle and tissue and to make enzymes that

are used in every chemical reaction that our body does. Proteins are essential for health but if your

kidneys are not functioning properly then it can become problematic when proteins need to be broken

down and eliminated. During this process protein breakdown releases by-products that build up in your

blood and circulate throughout the entire body when your kidneys are not able to eliminate them properly.

Naturally this makes your kidneys work really hard and stresses them out.

Generally, many people start to lose their appetite and zest for food and life, as kidney disease progresses.

Often people report that they don’t even feel like eating as much protein as they used to … food just

doesn’t taste the same anymore! You still need to make sure that your nutritional needs are met but

listening to your body and eating less animal protein can be a natural and beneficial strategy to help

exhausted kidneys.

Even so, it is vital to avoid malnutrition when you have CKD, so if you feel unsure about your nutritional

status it’s a really good idea to get some blood tests done. I recommend testing for albumin, a common

protein found in the body. Your albumin level should be greater than 4.0 g/dL if you are eating healthy

quality food. If you need to bump up your protein intake then I recommend eating plenty of Chia seeds

that are a rich source of proteins and the best source of plant-based omega-3 fatty acids too yet don’t have

the same effects on the kidneys as meat does.

Too much protein can cause uremia, where large amounts of urea build up in the kidneys. Uremia

symptoms include fatigue, nausea, and lack of appetite. It’s important to find the balance between what

your body needs are based on how your kidney is functioning.

Recommended daily intakes for dialysis patients range from 0.6 – 1.3 g per kg of body weight. For a 150

lb person, this would be fall between 40.8 and 88.4 g (1.4 and 3.1 oz) daily.

If you are on dialysis and your kidneys are barely functioning, then protein intake will be drastically

reduced and monitored along with all your fluid intake - hopefully you are ready to begin a journey where

dialysis is no longer an option in your world!



Must I become a vegetarian to get well again?

This is a personal choice although there is a lot of scientific evidence pointing to the real health benefits

of being vegetarian. In the past, consensus reality promoted carnivorous diets as being healthier than

vegetarian diets for CKD but this rapidly changing as more and more research shows that red meat and

animal products are linked to a wide spectrum of health disorders – especially cancer and cardiovascular

diseases.

Only a decade ago the World Health Organization was recommending 30% of your daily diet should

consist of proteins – a difficult target for vegans! Nowadays scientists propose that to be healthy we

should be not be eating more than 5% in animal proteins. Medical experts used to believe that vegans

were undernourished, lacking sufficient proteins and often depleted in the B Vitamins causing anaemia.

We’ve come a long way since then because these days scientists know that by combining different foods

vegetarians get all the basic amino acid building blocks to assemble all proteins needed. When it comes to

vitamin B, it turns out that if your microbiome is healthy then our friendly bacteria manufacture all the B

vitamins and even vitamin C for us! Of course, if you are eating meat, you are hosting different bacteria

that don’t manufacture these and then you will have to get your nutrients through meat or

supplementation.

Helpful Protein Info

Protein means ‘primary substance’. Protein is second to water in the cell, making up 20% of our body

weight. It is the major component of most tissues and cells in the body including hair, skin, nails, eyes,

internal organs and genetic material – just about everything in the body!

Proteins are made up of twenty different amino acids, eight of these are essential, meaning that they

cannot be synthesized by the body and therefore have to come from the food we eat. We need all the

amino acids in the correct proportions for the body to be able to use the protein.

Complete proteins come from animal sources such as meat, fish, dairy and eggs. These contain the

proportion of amino acids we need. Whereas, incomplete protein comes from plant sources i.e. legumes,

grains, nuts and seeds. It is important to combine our plant proteins properly to make sure we supply our

bodies with the natural building blocks to be able to make its own complete proteins.

The following incomplete proteins can be combined to make a complete protein:

• Legumes and Grains

• Grains and Nuts / Seeds

• Nuts / Seeds and Legumes

These do not have to be combined in the same meal, but should be eaten in the same day e.g. if you have

chia porridge for breakfast and afternoon almond afternoon snack then you will have successfully

combined your proteins.

Healthy Sources of Plant Proteins

• Spirulina

• Chlorella – green algae with all amino acids you’ll need

• Wild blue-green micro-algae



• Bee pollen and Royal Jelly are rich sources of protein and vitamin B12

• Seaweeds have high protein content

• Hemp seeds

• Chia seeds

Why do so many vegans get anaemia if they have bacteria that make all the good nutrients?

I personally think it is because there is a world of difference between being a healthy vegetarian and a

vegetarian. What I mean is that you can avoid all animal products but still eat canned foods, refined and

processed foods like crisps, cookies and a variety of unhealthy foods as a vegetarian and your microbiome

will not be healthy either! It’s about being a healthy vegetarian! All the underlying principles needed for a

healthy diet are the same whether you are following an animal-based or plant-based diet. The bottom line

… it’s true that healthy vegetarians fare far better than their omnivorous counterparts.

Traditionally a vegetarian diet has not been considered as an acceptable approach for treating CKD. This

is because plant-based foods are packed full of potassium. These days this view is changing rapidly, with

the latest nutritional research clearly showing that these opinions are not based on solid scientific

evidence. In any event there are a plethora of vegetables and fruits available to choose from and many

have low potassium levels. Some diet experts are finding that when you eat whole foods then individual

nutrients combine and work to protect you from harmful effects. There appears to be a difference between

the effects in the body when potassium is taken as a supplement or when it is eaten as part of a whole

food. More research needs to be done but until then you just need to be informed, tune in to your body

and make your own decisions.

If you follow a carnivorous diet whilst having CKD then you will need to limit your intake of meat to a

maximum of 8 ounces daily and avoid red meats completely. I recommend switching to a vegetarian diet

until you have your kidney health back and then making a choice to continue or not. In my experience

people rarely want to return to their old dietary habits because they feel wonderful once they are healed.

Why is phosphorus a problem if you have CKD?

We need phosphorus to grow and maintain tissues, especially our bones and teeth. Most adults need at

least 580 mg per day to prevent deficiency, and researchers recommend that people with CKD should not

exceed 1 g per day.

Foods with high phosphorus content can be easily moderated

• Whole grains

• Seeds

• Bran

• Cheese

• Smoked salmon

• Meat - especially bacon and organ meats

• Nuts and nut butter

• All smoked or cured products



Earnestly read nutrition labels on food products to check content. In the end this is not such an issue

because all processed, commercially prepped foods and refined products are eliminated from being part of

a normal healthy diet. When it comes to kidney disease this is even more important. I think it is good to

sprout seeds and have a few walnuts, macadamias and pistachio nuts available as snacks every now and

then. I also think its excellent to include sesame seeds, pumpkin seeds and flaxseeds (soaked) into healthy

varied diet.

Why do CKD patients have to restrict Sodium in their diets?

Reducing salt (sodium-chloride) is essential because without efficient filtration in the kidneys, sodium

will raise your blood pressure to dangerous levels. Table salt is a definite No-No! Commercial table salts

contain sodium bound to chloride. These salts also add aluminium anti-caking agents to allow the salt to

flow and not clump, making it easier to use but seriously not attractive as a health option.

Optimal sodium intake depends on your individual GFR – this means that you will need to tailor your

sodium intake based on your personal kidney health. If your filtration rate changes then your sodium

intake will need to be adjusted accordingly – less filtration means you need to reduce your sodium input.

Although the American Heart Association recommends less than 2400 mg of sodium a day for everyone,

if you have CKD then this is way too much. The best way to assess if you need less sodium is to check

your blood pressure. You want a reading of 140 / 90 as a realistic achievable goal – anything higher is an

indication that you need to reduce your sodium intake. It may take some fine tuning on your part but

persist and hypertension will no longer be a real problem now or in the future – especially if you

successfully follow your Rainbow Renal Diet lifestyle.

Besides table salt and salted snacks, some of the foods that are highest in sodium include:

• Beef and chicken broth

• Prepared soup mixes

• Prepared gravies and sauces

• Prepared desserts like pudding

• Fermented or pickled foods like tofu, capers and olives

• Any foods stored in brine

• Cured (smoked) meats like bacon or salt pork

• Cured (smoked) sausages like salami

• Some cheeses like Roquefort and parmesan

Keep your sodium intake low by avoiding salted, pickled, smoked, commercially fermented or highly

processed foods.

Must I restrict my Fluid Intake?

Generally, you don’t need to adjust your water intake unless you have Stage 5 CKD or are in renal failure.

Fluid intake under these conditions is seriously controlled because the kidney is hardly managing to

produce urine at all. In this case total liquid intake is usually restricted between 600 -1000 mL of fluids

daily. Otherwise you can aim to drink at least 6 – 8 glasses of water and herbal teas combined on a daily

basis. If this is difficult then start with 4 glasses daily and slowly increase your intake as you start feeling

better.



What Fats should I use for cooking?

I often wonder what my ancestors were eating over a century ago before modern agrarian and commercial

food practices were in place. I think we need to realize that our carbon-based bio-suits evolved together

with nature and that for us to be healthy, it is vital for us to eat whole foods that are as to close to their

original natural state as possible. We just need to remember the ways we cultivated our foods and what

we ate more than a century ago.

In our current technological age, it appears that humanity has become confused between real and fake

food. Isn’t real food supposed to provide all the nutrients and vital goodies that work to repair, renew and

keep our bodies in homeostasis - a healthy balanced state?

When we find ourselves limited by a serious lifestyle disorder that can be changed through natural

nutrition, it causes us to ask questions such as these …

• Are our foods natural, organic and nutritious by the time they land on our supermarket shelves?

• These days anything you eat is considered food, but is it really?

I don’t think so … everything is refined, processed, has multiple synthetic chemicals added and often

exposed to unnaturally high heat processes, which alters and denatures natural plant chemicals. The well

packaged versions of food commonly presented to us are no longer real foods, the modern idea of food is

more like an abstract image of fake food dressed up to look like the organic food that truly works to

nurture our bodies. Our bio-suits are not designed to eat synthetic foods simply because we are not

synthetic – we need to keep it real and this is particularly important when it comes to what fats are healthy

and compatible with our bodies!

The healthy story is simple … avoid all commercial vegetable oils as these are true health pirates! They

cause radical inflammation and serious mitochondrial damage that depletes your energy and immune

system status. These oils pave the way to multiple modern health problems that accelerate aging and

death. By eliminating these commercially produced oils you will already start to begin the process of

recovering your energy and health status.

What fats are healthy to cook with? The biggest clue is found in the Mediterranean diet because they

actually eat a high fat diet with a high ratio of omega-3 compared to omega-6 fat intake compared to

unhealthy diets that have an overwhelming abundance of omega-6 fats with very little omega-3’s in their

diet. Instead of our omega’s being in balance our modern diet contains 25 times more omega-6 fats for

every omega-3 that we eat. Why is this so bad?

It’s really bad for us because generally omega-6 fats activate inflammation pathways whilst omega-3 fats

are anti-inflammatory.

Good fats are organic, cold-pressed and act as natural superfoods with many health benefits.

• Olive oil

• Coconut oil

• Fish oil

• Hemp oil



• Sesame seed oil

• Omega-3 oils in chia seeds

Do environmental factors affect my diet?

Absolutely! Please be aware that plastic, polystyrene, cling film etc. all contain small amounts of xeno-

oestrogens (hormone like substances) that leach into packaged foods.

Also think about where the packaging ends up after you throw it away…

Everyone can benefit by …

• Avoiding all food that has plastic that comes into contact with our foods and drinks

• Avoiding all foods exposed to aluminium - in containers, wrappings, packaging; and avoid

aluminium cooking utensils

• Avoiding tinned and polystyrene food packaging – both are really toxic...

• Avoiding food additives, colourings, flavour enhancers, cleaning agents and heavy metals, dyes

and sugar derivatives or replacements

Try to make sure that all fruit, grains and vegetables you eat are organic and non- genetically modified,

without organophosphate pesticide contamination. These nasty chemicals cause hormonal (endocrine)

disruption and are serious harbingers of harmful health effects. This is why it is really important to take

time to wash your vegetables properly so that you can reduce these residues that are highly acidic for

our body and contribute to mineral imbalances. With CKD you can’t take this risk.

Soak vegetables, fruits and whole grains in water with either Apple Cider Vinegar added or Bicarbonate

of Soda. I usually use 1 teaspoon of either and soak for at least 10 minutes.

What percentage of proteins, carbohydrates and fats are needed daily in a healthy diet?

Complex Carbohydrates – Up to 50 % of our diet in fruit and veggies

The research is clear - eliminate all simple sugars from your diet and instead increase the amount of

complex carbohydrates you eat. These won’t cause your blood sugar levels to spike.

Use the Glycemic Index to help you select low glycemic foods (Appendix 8). Generally simple sugars

like glucose, fructose (fruit sugars) and lactose (milk sugars) all cause blood sugar levels to escalate

dramatically, whereas complex sugars that need to be broken down do not cause these problems.

To increase the polyphenolic content of our diets we need to make sure we eat a variety of colours every

day. This is why we talk about the Rainbow diet as being the most optimal.

Proteins – Up to 25% of our diet in plant proteins & 5% animal proteins

Note: If you decide to eat meat then make sure that you limit it to a maximum of 5% of your daily intake

sourced from free range or wild animal products.

Lipids – Healthy fats need to make up 30% of our diet

Our modern lifestyle has resulted in us taking in too many saturated fats from farmed animals and this



has caused our omega-6 to omega-3 ratio to be unbalanced. Omega-6 imbalances cause a chemical

waterfall of inflammatory pathways to be triggered in the body. These form the foundation of chronic

lifestyle disease and highly implicated in CKD, Diabetes, cardiovascular disease, obesity, early aging

and dementia.

The evidence is overwhelming …

• Increase healthy omega-3 foods in our diet

• Reduce saturated animal fats (except GLA) – butter and ghee are fine in moderation

• No margarine ever!

• Eliminate trans fatty acids from our diets

• Eliminate hydrogenated fats from our diets – vegetable oils that are cold pressed are not

dangerous but most commercially prepared oil is devastating for our health. Examples include,

canola, cottonseed and sunflower seed oils

How do I overcome negative thoughts and doubts about changing my lifestyle…?

To be honest, you can’t really afford the luxury of negative thinking if you want to heal from CKD!

It may seem daunting to you to change your lifestyle, especially in the beginning when confronted by all

these overwhelming facts. You may even feel that your body has let you down and that there is not a lot

to look forward to. Not only do you feel that life is not fair, and may even wonder why you have to

anything at all because you are a victim of disease and it feels like it’s not your fault and you can’t control

what happens … If this is similar to how you’re feeling then this is the time you need to sit down and

have a serious chat with yourself!

Realize that if you continue doing the same things that got you into this mess, then nothing will actually

change.

In my own healing journey this moment arrived when I realized that things would not improve on their

own! Nothing would change unless I took responsibility and actively did something different to the things

that I had done before. To do this I had to decide if I wanted to heal or if I was content to continue to

suffering.

To heal I would have to let go of all the behaviours, beliefs and habits that were contributing to my

illness. Was I prepared to do what it would take to regain my health and empower myself enough to step

out of my role of being a victim? I decided to give myself a chance by committing to doing whatever it

takes to heal.

Every time you feel resistance to taking a medicine, getting out of bed, or saying no to a sugary ‘treat’ just

ask yourself ‘Is this more important to me than healing?’ It never is!

The great news is that the journey gets easier and easier as you get stronger … all you have to do is take

the second step … you already took the first step when you started reading this book!

In the next section we will be very practical … it’s the actual nitty gritty level of what will help you and

what you need to avoid – its all laid out step by step to empower you to find your way back home …


Appendix 05

The Best Foods for CKD

The following foods, beverages and suggestions are exactly what you need to combat CKD. This

information empowers you to get creative with the Rainbow Renal Diet. It’s your chance to be the

architect of your own health future, starting now…

All berries, blueberries, tart cherries, cranberries, and strawberries – think resveratrol and

polyphenols – and delicious too!

Lemon or lime juice is also helpful for its alkalinizing effects – dilute with water

Dark grapes with skins and seeds intact are packed with Resveratrol – a perfect snack

Celery smoothies – Keep your microbiome ‘inner tribe’ happy and healthy!

Coconut or Olive oil for cooking - these oils are healthy lipid sources that don’t contribute to

chronic inflammation; grass-fed butter and ghee are also acceptable too

Flaxseed oil added to salads or smoothies is really therapeutic

Chia seeds are rich in omega-3’s to combat inflammation and are rich in protein whilst being a

super prebiotic food – have 2 tablespoons daily. Note: drink enough liquid in the day to prevent

constipation

Raw unsalted nuts – Enjoy a handful now and again of raw pistachios, walnuts, macadamias, and

almond nuts up to 4 handful servings per week

White mulberries – exotic natural superfood

Turmeric - think “curcumin” and combine with ground black pepper

Ginger either in food or as a tea is fabulous to reduce inflammation and nausea

Garlic and olive oil are a great way to flavor your steamed vegetables – use a clove 3 – 4 times

weekly

Green Tea - Make this your main drink throughout the day until 16h00 – you’ll be surprised how

good it makes you feel

Basil Tulsi Tea (Stress), Chamomile Tea (Sleep), Hibiscus Tea is a good diuretic for those

swollen days

Pure ground filter coffee (as opposed to granulated freeze-dried types) in Phase 3 only

1 cup in the morning without sugar (Stevia or honey can be used to sweeten)

Fiber-rich prebiotic foods such as those discussed in the microbiome section A minimum of 30

grams daily fiber is ideal – remember to drink plenty of mineral-rich water daily to avoid

constipation

Magnesium-rich foods, such as pumpkin seeds, raw unsalted almonds, and cultured organic

yogurt

Low-glycemic foods (Refer to Appendix 2) such as stone fruits, all berries, avocados, non-starchy

vegetables, coconut, and free-range eggs

Drink 4 – 6 glasses filtered mineral-rich water daily – consider adding half a squeezed lemon to

alkalinize your body at the start of each day

APPENDIX 05 – The Best Foods for CKD


Pineapple – full of digestive enzyme Bromelain

Papaya is another wonderful enzyme rich fruit to enjoy - add berries for pleasure and health

Honey or non-GMO natural Stevia instead of other sugars

Prebiotic, fruit & vegetable smoothies – make sure to invest in a good glass blender and enjoy

simple, easy healthy food. It’s a good way to make sure that you eat more fresh uncooked food

packed full of vital nutrients to boost energy levels …

Increase raw whole foods into your diet by eating fruit and vegetable salads and smoothies

Steaming vegetables for 10 minutes removes oxalic acids and is the healthiest way to eat food

after raw foods of course – you get to enjoy nature’s sophisticated pharmacy without losing vital

nutrients

Basil, origanum, rosemary, coriander, thyme, cinnamon, parsley and peppermint … fresh is best -

go wild!

Grass-fed poultry, and deep-sea fish. Collagen protein powder or bone broth protein powder are

highly nutritious too; avoid Salmon it contains high levels of phosphorous

100% whole grains grown organically without harmful pesticides – avoid fortified grains and

keep these limited to a maximum of three servings weekly until you are in Phase 3 Wild brown

rice with husks, quinoa and cous cous are good options

Organic milk and dairy products, including yogurt and kefir - aged cheeses in Phase 3

Free range Eggs – Boiled or poached is best – try to limit to a maximum of 3 per week

Grass-fed poultry, and deep-sea fish. Collagen protein powder or bone broth protein powder are

highly nutritious too.

Vegetables – if they are not on your restricted list then feel free to have as much goodness as you

can manage! Below are some examples …

• Steamed leafy greens – the darker the leaves the better (eg: Spinach, celery, dandelion greens,

beet leaves and carrot tops)

• Seaweeds are excellent

• Carrots

• Artichokes in olive oil for a special treat

• Asparagus – better boiled for 10 minutes than eaten raw

• Red organic potatoes

• Red cabbage

• Orange flesh sweet potatoes

• Pumpkin

• Leeks

• Fennel

• Turnips

• Heirloom cauliflower

• Okra

• Cucumber

• Reishi mushrooms now and then

• Peas

• Mung beans

• Onions

APPENDIX 05 – The Best Foods for CKD


• Purple spring onions

• Beetroot in moderation

• Avocado can be taken occasionally until phase 3


Appendix 06

The Big No-No’s – Avoid These

• All Red Meats – consider going green altogether until you are healed

• Acidic Foods – (Appendix 7)

• Foods containing high levels of phosphates (Appendix 4)

• High Glycemic foods (Appendix 8) - Especially sugar as it increases uric acid, blood glucose levels,

premature aging and inflammation

• Artificial sweeteners - Although they aren’t sugar, they are pure poison for our body even without

kidney problems (Appendix 9)

• No High Fructose Corn Syrup (HFCS)

• Eliminate all commercial fruit juice and sodas

• Additives, food colorants, heavy metals, pesticides - these compounds generate inflammation,

promote digestive stress, interfere with your hormones and generally causes havoc in the body

• Refined or Processed foods – These have poor nutrient value, escalate inflammation, are highly acidic

and cause erratic spikes in blood sugar levels because they quickly digested

• Pulp Free sweetened (or artificially sweetened) Fruit juice – not even now and then!

• Smoking is dangerous for CKD, diabetes, atherosclerosis and cardiovascular disease

• Alcohol - extremely toxic for the body – be cautious of mouthwashes and tinctures

• Trans fatty acids and hydrogenated rancid cooking oils, such as sunflower seed oil, soybean,

cottonseed, and canola oil that are to very high temperatures - they cause inflammation and many

other harmful effects

• Avoid lectins - including grains (especially the ones containing gluten, such as wheat), potatoes,

tomatoes and aubergines (eggplant), cashew nuts, peanuts and legumes that are not sprouted or

properly fermented

• Frying, baking, grilling, and barbecues - create AGEs and need to be specifically avoided, along with

smoked products as they increase gut permeability causing havoc in our GIT and cardiovascular

system

• Avoid using aluminum cooking pots – Stainless steel is far better for your health

• Avoid barbecues, frying, roasting and grilling food

• GMO foods such as corn, soy, and canola - multiple studies have proven that these foods directly

relate to liver and kidney diseases and increase risks for all chronic lifestyle disorders

• Avoid all salt, table salt with anti-caking agents, sea salt, health salts, seasoned salts like garlic and

celery salt


Appendix 07

Acid & Alkaline Foods

Alkaline Foods – (Good Options)1

(Information Adapted from source)

Vegetables:

- Carrots

- Celery

- Chards

- Beet Roots (Including Tops)

- Lettuce

- Kohlrabi

- Cucumber

- Pickled Vegetables – Prebiotic Foods

- Garlic

- Onion

- Mushrooms

- Pumpkin

- Turnip

- Spinach

- Asparagus

- Brussels Sprouts

- Bell Pepper

- Horseradish

Fruit:

- Apples

- Tangerines

- Peach

- Pears

- Watermelons

- Raspberries

- Wild Strawberries

- Strawberries

- Blackberries

- Sweet Cherries

- Grapes

APPENDIX 07 – Acid & Alkaline Foods


- Avocados

- Bananas

- Dried Apricots

- Kiwi-fruits

- Mango

- Figs / Dates – in moderation because they can shoot up blood sugar levels due to a high glycemic

index

- Currants

- Grapefruits

- Lemons

- Limes

- Oranges

- Pineapple

- Papaya (papino or paw-paw)

- Tangerines

- Freshly squeezed fruit and vegetables with pulp included are powerful energy boosters

Protein:

- Eggs

- Yogurt

- Chicken Breast

- Flaxseeds

- Pumpkin Seeds

- Squash Seeds

- Summer Squash Seeds

- Sunflower Seeds

- Sprouts

- Millet

Spices / Condiments:

- Curry

- Turmeric / Curcumin with Black Pepper

- Rosemary

- Cinnamon

- Ginger

- Apple Cider Vinegar

- Himalayan Pink Salt

Other:

- Bee Pollen

- Mineral Waters

- Molasses



- Green and Herbal Teas

Acidic Foods – (Bad Options)2

- Avoid These Foods Unless Indicated

Vegetables:

- Lentils

- Olives

- Potatoes

- Black, Red & White Beans

- Chickpea

- Soybeans

Fruit:

- Blueberry – High source of resveratrol

- Cranberry – Very good for urinary tract infections

- Plums

Protein:

- Bacon

- Veal

- Turkey

- Game Meat

- Pork

- Rabbit

- Smoked Sausage

- Carp

- Cod

- Salmon

- Tuna

- Haddock

- Lobster

- Oysters

- Shrimps

- Shellfish

- Pike

- Sardines

- Cheese – especially processed cheeses that undergo bleaching, and have dyes (colorants) added along with

many other chemical additives

Spices / Condiments:

- Sugar – all refined and artificial sweeteners

- Mustard



- Vinegar

- Ketchup

- Most store-prepared commercial condiments

- Cacao – May be used moderately if a top-quality cacao product is sourced

Cereals:

- Barley

- Rye

- Wheat

- Spelt

- Oat Bran

- Flour

- Bread

- Pasta

- Rice

- Rice Cookies

Fats:

- Sesame Oil

- Sunflower Oil

- Avocado Oil– Accepted in moderation

- Hempseed Oil

- Olive Oil – Accepted in moderation

- Butter – Accepted in moderation

- Lard

- Hazelnuts – Accepted in moderation

- Walnuts – Accepted in moderation

- Peanuts

Alcohols:

- Beer

- Wine – Red wine on rare occasions appears to be less damaging than other alcohols

- Spirit

- Liqueurs

Drugs:

- Aspirin

Other:

- Sweetened non-alcoholic beverage consumption (i.e. Sodas)

- High fructose content in food or beverages

- High Fructose Corn Syrup

- Commercial artificial sweeteners – all of them

- Refined sugar


Appendix 08 - The Glycemic Index

The glycemic index (GI) is a list or index of foods that have been given an index number that shows the

degree to which blood sugar spikes in response to eating them. The GI is an important and useful resource

for people who specifically suffer from diabetes, obesity, gout, and of course CKD – although eating

‘low-GI’ will always benefit anyone’s health because preventing crazy blood sugar spikes will prevent

fatigue and promote sustained energy levels throughout the day; this in addition to preventing much of the

damage that can arise from high blood sugar spikes. This means that understanding how it works can only

be of benefit.1

Only foods that contain carbohydrates are rated with the GI system. The smaller the index number a food

has on the GI the lower the blood spike will be after eating it.

Low GI foods are classified as having a GI of 55 or less, and the foods that populate this end of the GI

spectrum tend to be packed with nutrient-rich fruits, vegetables, beans, and some grains.

Medium GI foods range between 56 and 69 on the GI index, whilst High GI foods cause rather large

blood glucose spikes and occupy GI index values of 70 or more.

Typically, foods in the high GI category tend to be highly processed or extremely refined, sweet and

sugary foods like table sugar, dates or ice cream.

Please refer to the GI table beginning on the next page for a nice GI list of foods categorized into Low,

medium, and high GI index scores. 2

APPENDIX 08 – Glycemic Index Foods


LOW GLYCEMIC INDEX (< 55)

Fruits

Apples 38

Apple juice 40

Apricots, dried 31

Bananas 54

Blueberries 25

Cherries 22

Coconut 45

Cranberries 45

Cranberry juice 50

Figs, dried 40

Grapefruit 25

Grapes 46

Orange juice 53

Oranges 44

Peaches 42

Pears, fresh 53

Plantains, raw 45

Plums 55

Strawberries 41



Vegetables

Artichokes 20

Asparagus 15

Bamboo shoots, raw 20

Beet greens 20

Broccoli 15

Broccoli rabe 10

Brussel sprouts 15

Butternut squash, baked 50

Cabbage, Chinese 10

Cabbage, savoy, boiled 15

Carrot juice 45

Carrots, raw 47

Cauliflower 15

Celery 15

Collard greens 20

Corn, sweet 54

Cucumber 15

Eggplant 15

Garlic 30

Green beans 15

Hubbard squash, baked 50

Kale 15

Leeks 15

Lettuce 15

Lima beans, baby, frozen 46

Okra, raw 15

Olives 15

Onions 15

Peppers 15

Pickles, dill 15

Turnip greens, boiled 10

Turnips, boiled 30

Snow peas 15

Summer squash 15

Tomato soup 54



Tomatoes 15

Spinach 15

Summer squash 15

Tomato soup 54

Tomatoes 15

Watercress 10

Grains, Breads & Cereals

Banana bread 47

Barley 25

Basmati rice 50

Bran cereal 42

Brown rice 50

Bulgur wheat, whole, cooked 45

Chickpeas 33

Fettuccine 32

Matzo bread 40

Quinoa 53

Ravioli, meat 39

Rice bran 27

Rice, parboiled 47

Spaghetti, protein-enriched 38

Spaghetti, wholemeal 53

Spaghetti, whole wheat 37

Tortellini, cheese 50

Vermicelli 35

Dairy and Dairy Alternatives

Chocolate milk 32

Skim milk 32

Soy milk 43

Yogurt, low fat, artificially sweetened 15

Yogurt, low fat, fruit, sugar-sweetened 46

Yogurt, plain 14



Nuts and Legumes

Almonds 15

Black Beans 30

Broad beans 40

Butter beans 43

Cashews 23

Chickpeas 33

Fava beans 40

Horse beans 40

Kidney beans 41

Navy beans 54

Peanuts 14

Pinto bean 39

Soybeans, boiled 16

Split peas, yellow, boiled 45

Snacks & Sweets

Honey 55

Hummus 6

Power Bar 53

Snickers 41

Strawberry jam 51



MEDIUM GLYCEMIC INDEX (From 56 to 69)

Fruits

Apricots, canned with light syrup 64

Apricots, fresh 57

Cantaloupe 65

Fruit cocktail 55

Grapes 66

Mango juice, unsweetened 55

Mangoes 56

Oranges 63

Orange juice 55

Papaya, fresh 55

Peaches, fresh 60

Peaches, canned 67

Pineapple 59

Raisins 64

Vegetables

Marrowfat peas, dried 56

Peas, green 68

Sweet potato 61


All-Bran 60

Bulgur 68

Couscous 65

Hamburger bun 61

Instant noodles 67

Instant porridge 66

Lasagna 60

Linguine 65

Macaroni and cheese 64

Mixed grain bread 69

Oat bran bread 68



Oatmeal, plain 58

Pancakes 60

Pita bread 57

Quick-cooking porridge 65

Rye crispbread 65

Rye kernel bread 66

Spaghetti, white 59

Taco shells 68

Wheat kernels 59

Whole-white bread 67

Wild rice 57


Mayonnaise 60

Nuts and Legumes

Black-eyed peas 59

Chestnuts 60

Lentil soup, canned 63

Pinto beans, canned 64

Snacks & Sweets

Blueberry muffin 59

Bran muffin 60

Coca-Cola 63

Ketchup 55

Mustard 55

Nutella 55

Pizza, cheese 63

Sponge cake 66

Sushi 55

HIGH GLYCEMIC INDEX (≥ 70)

Fruits

Dates 103



Kiwifruit 75

Watermelon 72

Vegetables

Parsnips 139

Pumpkin 107

Rutabaga 103

Potato, instant 121

Potato, mashed 100

Potato, microwaved 117

Potato, white, baked 85


Bagel 72

Bagel, white 103

Barley flour bread 95

Bran buds 77

Bran Chex 83

Bread stuffing 106

Cheerios 106

Cocoa Pops 79

Corn Flakes 81

French baguette 136

French bread 95

Gluten-free bread 90

Gnocchi 95

Golden Grahams 102

Grape Nuts 75

Hamburger bun 87

Kaiser roll 104

Life cereal 94

Muesli 80

Muesli bars 87

Oat kernel bread 93

Oatmeal 87

Pita bread, white 82



Pumpernickel bread 71

Rice cakes 82

Rice Chex 127

Rice Krispies 117

Rice, brown 79

Rice, instant 128

Rice, white 83

Rye flour bread 92

Shredded Wheat 75

Special K 77

Tapioca, boiled with milk 115

Water crackers 102

Waffles 109

Wheat bread 97

White bread 70


Ice cream, full-fat 87

Ice cream, low-fat 71

Tofu, frozen dessert, non-dairy 164

Nuts and Legumes

Black bean soup 92

Green pea soup, canned 94

Kidney beans, canned 74

Lentils, canned 74

Split pea soup 86

Snacks & Sweets

Cake, angel food 95

Cake, pound 77

Corn chips 105

Corn syrup 90

Croissant 96

Doughnuts 108

French fries 75

Gatorade 78



Glucose 138

Graham crackers 74

Jelly beans 80

Life Savers 70

Maltodextrin 95

Maltose 152

Nutri-Grain bar 94

Oatmeal cookies 79

Pastry 84

Popcorn 72

Pretzels 83

Shortbread 91

Stoned Wheat Thins 96

Sugar, table 89


Appendix 09

A Seven Day Example Meal Plan for Renal Rainbow Diet

Day 1

Breakfast

Paw-paw, squeezed lemon

honey - optional

Green tea

10h00

Fruit snack

Hibiscus Tea

Lunch

Celery & Apple Smoothie Salad – ¼ Avocado, finely grated

cabbage & carrots, boiled egg

Honey, lemon, garlic dressing

Green Tea

15h30

Lemon water & fruit snack

Dinner

Steamed wild brown rice with chopped steamed vegetables added Garlic, black pepper, olive oil & Teaspoon tahini for dressing

Bedtime

Camomile or Rooibos Tea or combination

APPENDIX 9 – A Seven Day Example Meal Plan For Renal Rainbow Diet


Day 2

Water with lemon

Breakfast Fruit Salad & Probiotic Yoghurt

honey - optional

Green tea

10h00 Blueberry & Cranberry snack

Green Tea

Lunch Quinoa Salad - Avocado,

spring onions, chopped walnuts,

grated carrots, sliced turnips with humus dressing

15h30 Celery & Apple Smoothie

Dinner

Wild fish with a green salad & steamed vegetable – tossed in garlic and olive oil dressing

Bedtime Camomile & Rooibos Tea

Day 3

Water with lime slices

Breakfast Stewed apple, pear, cinnamon

honey - served with yoghurt

Cold hibiscus tea with peppermint leaf

10h00 Celery and apple Smoothie

Green Tea & Spearmint

Lunch

Baked skinless chicken breast & variety of steamed vegetables with handful of sesame seeds, garlic & olive oil dressing

15h30 Carrot & pineapple smoothie

Dinner

Omelette with garlic, spring onion finely grated baby spinach

& Tablespoon of Organic cottage cheese

Bedtime

Camomile & Rooibos Tea



Day 4

Breakfast Red Grapefruit

Boiled Egg

Hibiscus tea

10h00 Pomegranate juice & nut snack

Minty Green Tea

Lunch

Cous cous salad with sliced veg of choice, artichokes, spring onions,

Tahini and humus dressing

15h30 Celery & Strawberry Smoothie

Dinner

Vegetable stew with, red potato (medium), Okra, red cabbage, leeks, turnips, golden beet, cauliflower, carrots and peas turmeric, black pepper, teaspoon garlic and herb spicing

Bedtime Tulsi Tea

Day 5

Lemon Mint Water

Breakfast

Cubed Paw paw, Kiwi, Dragonfruit, Blueberries & Pomegranates

Honey (optional)

Green tea

10h00 Celery, Apple, Green leafy smoothie

Cold iced Minty Hibiscus Tea

Lunch

Salad – ½ Avocado, mixed lettuce, finely grated cabbage, boiled egg,

asparagus, cottage cheese, black pepper, Honey & lemon dressing

15h30 Cranberry & walnut snack

Dinner

Stir-fried Fish with steamed vegetables on the side

Lemon Sorbet

Bedtime

Camomile & Rooibos Tea



Day 6

Lemon Mint Water

Breakfast

Poached Eggs & Boiled Asparagus served with white garlic sauce

Kombucha

10h00 Celery & Apple Smoothie

Minty Green Tea

Lunch

Falafels with Tzatziki served with Baked potatoes & Salad with cabbage, dandelion greens, grated carrots and apple, walnuts

vegetables, garlic lemon & olive oil

dressing

15h30

Pomegranate juice & Berry Smoothie

Dinner Vegetable soup

Carob Mousse

Bedtime Tulsi Tea

Day 7

Minty Lemon Water

Breakfast Stewed apple, pear, cinnamon

honey - served with cultured probiotic yoghurt

10h00 Chia Seed Berry Delight

Hibiscus Tea

Lunch

Wild brown rice, Light grilled skinless chicken breast served with

garlic white sauce & green salad

15h30 Beetroot, Pineapple, Celery & Apple

Smoothie Treat

Dinner Vegetable Stew

Mango sorbet

Bedtime Camomile & Rooibos Tea



Shopping List Ideas

• Apples

• All berries - especially the blue, black and dark red ones

• Cranberries

• Cherries

• Grapefruit

• Pineapples

• Pomegranates

• Papaya

• Leafy greens

• Sprouts

• Leeks

• Celery

• Endives

• Parsley

• Chives

• Carrots

• Onions

• Radishes

• Turnips

• Garlic

• Ginger

• Curcumin and turmeric

• Bell peppers

• Mushrooms – Phase 2

• Cauliflower

• Spaghetti squash, summer squash and zucchini - Phase 2

• Tortillas – Phase 3

• Olive oil

• Coconut Oil

• Coconut Cream – Phase 3

• Most spices – from a health store so they are GMO-free, non-irradiated, and free from additives

like TBHQ and MSG

• Chia seeds

• Hemp seeds

• Stevia – make sure it is GMO free

• Pure wild bee honey

• Quinoa

• Cous cous

• Kefir

• Cultured yoghurt

• Free range poultry – skinned

• Deep sea fish, fish oil, krill oil, hemp seed oil and flaxseed oil



• 100 % pure pomegranate juice

• Lemons and limes

• Olive oil - cold pressed

• Virgin coconut oil – odorless may suit better

• Free range eggs


Appendix 10 - Prebiotic Guidance

We have explored powerful evidence from multiple studies showing that many species of bacteria

contribute to a broad spectrum of healing functions in your gut microbiome. These healing functions

provide massive benefits to your entire body, bringing multiple areas and systems of the body into a

harmonious balance.

You need to learn to be a 5-star host, providing gourmet prebiotic foods to promote the type of healthy

bacteria that will work to truly benefit your health.

A quick recap …

Prebiotics are non-digestible foods

• Dietary fibers

• Oligosaccharides and polysaccharides (See Below)

• Resistant starches that beneficially change the composition or activity of our gut microbiota.1

Prebiotics are found naturally in many foods2

• Fruits

• Vegetables – for example asparagus, sugar beet, garlic, chicory, onion, banana

• Honey

• Breast milk

Why are Prebiotics Beneficial?

Prebiotic fermentation stimulates the growth of healthy bacteria in our guts, especially Bifidobacteria and

Lactobacilli species and prevent other harmful bacteria, like Bacteroides, Clostridia and Enterobacteria

from thriving.3

These enterprising ‘good guys’ ferment prebiotic food into health promoting short chain fatty acids

(SCFA) like butyrate. Some of these extraordinary benefits from taking prebiotics are listed below:4

1. Improves glycemia and insulin resistance

2. Improves abnormal fat metabolism (dyslipidemia)5

3. Reduces hunger;

4. Decreases pH in the colon

5. Positively modulates our immune system

6. Restores gut barrier integrity

7. Reduce exposure to harmful lipopolysaccharides (LPS) and uremic toxins

8. Reduces damaging oxidative stress and inflammation6

APPENDIX 10 – Prebiotic Guidance


There are two main prebiotic groups listed below:

Prebiotic group 1: Fructo-oligosaccharide (FOS)

• Chicory root

• Onions

• Jerusalem artichoke

• Garlic

• Leeks

• Bananas – restricted in CKD

• Wheat – restricted in CKD

• Barley

Prebiotic group 2: Galacto-oligosaccharides (GOS)

GOS are wonderful foods to promote happy colonies of lactobacilli and bifidobacteria.

GOS rich foods include:

• Green peas

• Hummus – made from chickpeas

• Kidney beans – use sparingly

• Lentils, and Lima beans – restricted in CKD

Just a handful of these foods daily included in your diet will optimize your health and keep your

microbiota in an optimal state.7

Prebiotic high fiber foods support bacterial production of beneficial Butyrate8

By now you should be familiar with butyrate, a potent SCFA (short chain fatty acid) that’s produced by

our healthy gut bacteria. There are two ways that you can get more butyrate to boost your healing and

well-being.

The first way we already learnt about - eating plenty of fiber-rich prebiotic foods that feeds our bacteria

and helps them manufacture butyrate and other great fatty acids for us.

The second way is to eat foods that contain butyrate, the best source being organic butter. In fact, butyrate

was initially named after butter because it is the richest food source of butyrate that is known. Butter

contains 3 – 4 % butyrate and is therefore a very beneficial addition to our CKD diet but to be used

sparingly and definitely not for cooking at high heats!

Butyrate is known to prevent and reverse damage caused by unhealthy high fat diets commonly seen in

the western world today.



A quick review of some of the medicinal benefits of this SCFA are listed below:9

• Potent anti-inflammatory effects in the gut and immune system cells

• Anti-carcinogenic effects

• Reduces intestinal permeability

• Strengthens immune system responses

• Reduces risks for heart attack

• Decreases progression of atherosclerosis

• Helps to regulate body temperature – e.g. it reduces resistance to cold conditions

What other kinds of foods are beneficial prebiotics in CKD?

• Yogurt

• Kefir

• Sauerkraut

• Tempeh

• Kimchi

• Miso

• Kombucha

Remember if you take probiotics they will not survive unless you feed them with prebiotics too!

Helpful recipes and tips to get started …

Below are some ideas that are helpful to get you started.

Kombucha Tips

• Build up slowly in the beginning and gradually increase your intake over time

• Start with drink ¼ glass Kombucha mid-afternoon to energize and support the ‘Inner tribe’

Celery and Apple Prebiotic Smoothie

Ingredients

• 1 fresh celery stalk (with leaves)

• 1 medium red organic apple

Method

• Soak ingredients for 10 minutes in a bowl with water and 1 teaspoon of organic apple cider

vinegar to clean

• Place in glass blender with a cup of water or a cold cup of prepared green tea and pulse until

smooth



Notes:

• This superior prebiotic blend is ideal taken half an hour before lunch

• I found that the more I had this smoothie the more I appreciated it and could feel its positive

effects on my body

Living Yoghurt & Berry Breakfast Bowl

• Add a capsule of Bifidobacteria to organic natural yoghurt

Make sure the yoghurt is free from gelatine & additives

Leave overnight to culture

• Add a handful of berries and a tablespoon of honey to a cup of cultured yoghurt and serve for

breakfast or as a tasty treat during the day

Note: Use one capsule probiotic supplement that contains one or more of the following bacteria

o Bifidobacteria

o Acidophillus

o Lactobacillus

Chia Seed Berry Pudding Recipe

Ingredients

• 2 tablespoons Chia Seeds

• 1/2 cup water

• 1 tablespoons Honey (adjust for personal taste preferences)

• 1/2 cup Mixed Berries

• Cinnamon

• Ginger

Method

1. Place the chia seeds, spices and honey in a bowl and pour the water over.

2. Stir until the honey is dissolved.

3. Leave in fridge overnight.

4. Add berries on top and extra honey to taste, as desired.

5. Enjoy!

Notes:

If you prefer, you can also add the berries in step 1, leaving them overnight to steep and letting them both

color the pudding and diffuse their flavor evenly.

For those of you who lead a busy life and are constrained for time, try preparing the pudding in a portable

jar with a lid. That way, you can easily take the pudding with you to work or anywhere on the go the

following morning.


Appendix 11

A List of Sugars Added to Foods That Should Be Avoided

DIFFERENT SOURCES OF NATURALLY DERIVED SUGARS COMMONLY ADDED TO FOOD

PRODUCTS

(Listed Alphabetically)

Agave nectar Barbados sugar Barley malt Barley malt syrup

Beet sugar Brown sugar Buttered syrup Cane juice

Cane juice crystals Cane sugar Caramel Carob syrup

Castor sugar Coconut palm sugar Coconut sugar Confectioner's sugar

Corn sweetener Corn syrup Corn syrup (solid) Date sugar

Dehydrated cane juice Demerara sugar Dextrin Dextrose

Evaporated cane juice Fructose Fruit juice Fruit juice concentrate

Glucose Glucose solids Golden sugar Golden syrup

Grape sugar Honey Icing sugar Invert sugar

Malt syrup Maltodextrin Maltol Maltose

Mannose Maple syrup Molasses Muscovado

Palm sugar Panocha Powdered sugar Raw sugar

Refiner's syrup Rice syrup Saccharose Sorghum Syrup

Sucrose Sugar (granulated) Sweet Sorghum Syrup

Treacle Turbinado sugar Yellow sugar HFCS*

* HFCS = High Fructose Corn Syrup

The above substances are all different types of naturally sourced sugars. You should avoid them to keep

your sugar intake down overall. Many of the above listed sugars are extremely toxic to the body, even in

modest amounts, especially if eaten with regularity over many years.


Appendix 12

Supplementation Safety Guide1

Nutritional Supplementation

A supplement is a product intended to supplement the diet, not to be use as a food or as a sole item of a

meal or the diet. Nutritional supplementation may include vitamins, minerals, essential nutrients,

accessory nutrients or nutraceuticals.

Recommended Dietary Allowance (RDA)

RDAs have been set since 1940s by various Food and Nutrition Boards; they were originally intended to

reduce severe states of nutritional deficiency e.g. Scurvy, rickets and beriberi. RDAs were designed to

assess diets in groups of people not individuals, because individual RDAs vary depending on diet and

lifestyle. “Individuals with special nutritional needs are not covered by the RDAs.” (National Research

Council, Recommended Dietary Allowances, National Academy Press, DC, 1989)

Recommended Daily Intake (RDI)

RDI are “the levels of intake of essential nutrients considered, on the basis of available scientific

knowledge, to be adequate to meet the needs of practically all healthy people.” Based on preventing

nutrient deficiency signs in healthy people, they do not take individual requirements into account. E.g.

tannin/phytates and iron. Often known to change when new evidence emerges and can vary from country

to country, so not a definitive guide. They have limited clinical use. RDAs and RDIs do not reduce the

risk of developmental or degenerative diseases such as CVD or neural tube defects.

Daily Value (DV)

Food product labeling. Two sets of references: Daily Reference Values (DRV) and RDI. DRVs are a set

of dietary references that apply to fat, saturated fat, cholesterol, carbohydrate, protein, fiber, sodium and

potassium.

Optimum Daily Intake (ODI)

The amount of nutrients needed for vibrant health. Higher amounts than RDA. This is generally where

nutritionists/naturopaths prescribe. Scientific research shows the optimal level for nutrients are much

higher than RDAs.

1 Segala, M. (2003). The Life Extension Foundation’s Disease Prevention & Treatment. 4th Edition. Life Extension Media: Florida (pp. 605 – 609)

APPENDIX 12 – Supplementation Safety Guide


Supplement Safety Guidelines

Several of the nutrients suggested in this Book may have adverse effects. We have listed some of these

but wish to stress that this is not a full list and every supplement that is taken needs to be checked for side

effects and cross reactivity to other medications and some medical conditions such as Phenylketonuria

(PKU).

Some adverse effects for selected compounds are listed below:

Curcumin

Do not take curcumin if you have a bile duct obstruction or a history of gallstones. Taking curcumin can

stimulate bile production.

Consult your doctor before taking curcumin if you:

• have gastro-esophageal reflux disease (GORD)

• a history of peptic ulcer disease

• if you take warfarin or antiplatelet drugs

• Curcumin can exert anti-thrombotic activity.

Always take curcumin with food since it may cause gastric irritation, ulceration, gastritis, and peptic ulcer

disease if taken on an empty stomach.

Curcumin can cause gastrointestinal symptoms such as nausea and diarrhea.

DHEA

Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or

ovarian cancer. DHEA can cause androgenic effects in woman such as acne, deepening of the voice,

facial hair growth and hair loss.

EPA/DHA

Consult your doctor before taking EPA / DHA if you take warfarin (Coumadin). Taking EPA/DHA with

warfarin may increase the risk of bleeding. Discontinue using EPA/DHA 2 weeks before any surgical

procedure.

Ginger

Do not take ginger if you have a bile duct obstruction or gallstones. Ginger may stimulate bile production.

High doses of ginger (6 grams or more) can cause damage to the stomach lining and ulcers. Ginger can

cause allergic skin reactions. Consult your doctor before taking ginger if you take blood thinners such as

warfarin (Coumadin). Ginger can increase the risk of bleeding.

GLA

Consult your doctor before taking GLA if you take warfarin (Coumadin). Taking GLA with warfarin may

increase the risk of bleeding. Discontinue using GLA 2 weeks before any surgical procedure. GLA can

cause gastrointestinal symptoms such as nausea and diarrhea.



Glucosamine

Consult your doctor before taking glucosamine if you have diabetes. It is unknown if glucosamine will

increase insulin resistance in humans but glucosamine has been shown to increase insulin resistance in

healthy animals and in animals with diabetes. Animals given intravenous glucosamine were found to have

a significantly decreased rate of glucose uptake in their skeletal muscle (this effect was not observed,

however, in animals given oral glucosamine).

If you have diabetes, are overweight, or have difficulty with glucose tolerance and take glucosamine

under medical advisement, monitor your blood glucose level frequently. Your doctor will need to adjust

your medication levels accordingly.

Glucosamine can cause gastrointestinal symptoms such as nausea and diarrhea.

Green Tea

Consult your doctor before taking green tea extract if you take aspirin or warfarin (Coumadin). Taking

green tea extract and aspirin or warfarin increases the risk of bleeding. Green tea extract may decrease

platelet aggregation. Discontinue using green tea extract 2 weeks before any surgical procedure. Green tea

extract contains caffeine, which may produce a variety of symptoms including restlessness, nausea,

headache, muscle tension, sleep disturbances, and rapid heartbeat.

NAC

NAC clearance is reduced in people who have chronic liver disease.

Do not take NAC if you have a history of kidney stones

NAC can produce a false-positive result in the nitroprusside test for ketone bodies used to Consult your

doctor before taking NAC if you have a history of peptic ulcer disease. Mucolytic agents may disrupt the

gastric mucosal barrier.

NAC can cause headache (especially when used along with nitrates) and gastrointestinal symptoms such

as nausea and diarrhea.

SAMe

Consult your doctor before taking SAMe if you have bipolar disorder or on antidepressants.

Consult your doctor before taking SAMe if you have cancer. Methylation patterns may change in people

who have cancer and take SAMe.

Do not take SAMe if you are undergoing gene therapy.

SAMe can cause anxiety, hyperactive muscle movement, insomnia, hypomania, and gastrointestinal

symptoms such as nausea and diarrhea.



Vitamin C

Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having

a serum creatine level greater than 2 mg / dl and/or a creatinine clearance less than 30 ml / minute).

Consult your doctor before taking large amounts of vitamin C if you have haemochromatosis,

thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase

(G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large

amounts of vitamin C.

Vitamin E

Consult your doctor before taking vitamin E if you take warfarin (Coumadin).

Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history

of liver failure. Consult your doctor before taking vitamin E if you have a history of any bleeding disorder

such as peptic ulcers, hemorrhagic stroke, or haemophilia.

Taking too much selenium and vitamin E may increase the risk for prostate cancer.

Discontinue using vitamin E 1 month before any surgical procedure.

Ginkgo biloba

Avoid taking if you have a bleeding disorder or are taking warfarin or other pharmaceuticals that thin the

blood such as aspirin, ticlopidine (brand name: Ticlid), clopidogrel (brand name: Plavix) or dipyridamole

(brand name: Persantine).

Beta-carotene

Taking more than the amount included in a daily multi-vitamin may increase the risk of lung cancer in

smokers according to the research.

Common negative interactions can occur when taking these supplements:

• Calcium can interact with heart medicine, certain diuretics, aluminum and magnesium-containing

antacids

• Magnesium can interact with certain diuretics, some cancer drugs, and magnesium-containing

antacids.

• Vitamin K can interact with blood thinners like Coumadin.

• St. John's Wort is known to adversely affect selective serotonin reuptake inhibitor (SSRI) drugs

(i.e., anti-depressant drugs), blood pressure medication, and birth control pills.

• Coenzyme Q-10 can interact with anticoagulants, blood pressure medication, and chemotherapy

drugs.

• Ginkgo biloba and vitamin E can increase the risk for internal bleeding when taken with aspirin

or anticoagulants such as warfarin.

• Ginseng can also increase the risk for internal bleeding when taken with anticoagulants or

NSAIDs, and may cause side effects when taken with MAOI antidepressants.



• Echinacea can change how the body breaks down certain medications in the liver.

• Saw palmetto can interact with anticoagulants and NSAID pain relievers

The Following Supplements are Toxic:

• Aristolochia (linked to kidney failure)

• Yohimbe (sexual stimulant linked to heart and respiratory problems)

• Bitter orange (has effects similar to the banned stimulant ephedra);

• Chaparral (linked to liver damage).


References

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