Obesity and Chronic Kidney Disease
Chronic Kidney Disease

What is chronic kidney disease (CKD)?

Chronic kidney disease also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. CKD is a silent disease, since most people with the condition feel well or have minimal symptoms. Complications of CKD include:

  • High blood pressure.
  • Anemia (low blood count).
  • Bone disease.
  • Poor nutritional health.
  • Nerve damage.

Usually only when the kidneys fail do wastes build to high levels in the blood and make one feel sick. Kidney disease also increases the risk of having heart and blood vessel disease.

How is CKD Diagnosed?

Your doctor performs a physical exam, also checking for signs of problems with your heart or blood vessels, and conducts a neurological exam.

For kidney disease diagnosis, you may also need certain tests and procedures, such as:

  • Blood tests: Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood.
  • Urine tests: Analyzing a sample of your urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.
  • Imaging tests: Your doctor may use ultrasound to assess your kidneys' structure and size. Other imaging tests may be used in some cases.
  • Removing a sample of kidney tissue for testing: Your doctor may recommend a kidney biopsy to remove a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that's inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what's causing your kidney problem.

Does obesity cause CKD?

As an indirect cause, obesity increases the risk of the major CKD risk factors – type 2 diabetes and high blood pressure. A direct cause would be when the kidneys have to work harder, filtering above the normal level, called hyper filtration, to meet the metabolic demands of the increased body mass index (BMI) in individuals affected by obesity. This increase in normal function is also associated with a higher risk of developing CKD in the long-term.

How are a person affected by obesity and CKD treated?

The integration of a healthy diet, physical activity and refreshing sleep is the focus of management of the patient with obesity and CKD. These recommendations may be helpful, whether or not you have CKD.

A.    Diet

Extreme diets are not advised and probably not successful in the long-term. The challenge is to modify a person behavior in a way that will change their lifestyle. Using smaller portions, changing from large nine-inch plates to seven-inch plates, is an example of a behavioral technique that might be helpful.

STEP 1: Choose and prepare foods with less salt and sodium.

  • Buy fresh food more often. Sodium (a part of salt) is added to many packaged foods.
  • Use spices, herbs, and sodium-free seasonings in place of salt.
  • Check the Nutrition Facts label on food packages for sodium. A Daily Value of 20% or more means the food is high in sodium.
  • Try lower-sodium versions of frozen dinners and other convenience foods.
  • Rinse canned vegetables, beans, meats, and fish with water before eating.

Look for Food Labels that Say: Sodium free /Salt free /Very low sodium/ Low sodium /Reduced or less sodium / Light in sodium / No salt added /Unsalted / lightly salted.

STEP 2: Eat the right amount and right types of protein.

  • Eat small portions of protein foods.
  • Protein is found in foods from plants and animals. Talk to your dietitian about how to choose the right combination for you.

Animal-protein Foods: Chicken /Fish/Meat/Eggs.
Plant-protein Foods: Beans/ Nuts /Grains.

STEP 3: Choose foods that are healthy for your heart.

  • Grill, broil, bake, roast, or stir-fry foods, instead of deep frying.
  • Cook with nonstick cooking spray or a small amount of olive oil instead of butter.
  • Trim fat from meat and remove skin from poultry before eating.

Heart-healthy Foods: Lean cuts of meat, like loin or round / Poultry without the skin / Fish / Beans / Vegetables / Fruits /Low-fat milk, yogurt, cheese.

STEP 4: Choose foods with less phosphorus.

To help protect your bones and blood vessels.

  • Many packaged foods have added phosphorus. Look for phosphorus , or for words with “PHOS” on ingredient labels.
  • Deli meats and some fresh meat and poultry can have added phosphorus. Ask the butcher to help you pick fresh meats without added phosphorus.

Foods Lower in Phosphorus: Fresh fruits and vegetables / Breads / pasta / rice / Rice milk (not enriched) / Corn and rice cereals / Light-colored sodas / pop.
Foods Higher in Phosphorus: Meat / poultry / fish / Bran cereals and oatmeal / Dairy foods / Beans / lentils / nuts / Colas.

STEP 5: Choose foods that have the right amount of potassium.

To help your nerves and muscles work the right way.

  • Salt substitutes can be very high in potassium. Read the ingredient label. Check with your provider about using salt substitutes.
  • Drain canned fruits and vegetables before eating.

Foods Lower in Potassium: Apples / peaches / Carrots / green beans / White bread and pasta / White rice/ Rice milk (not enriched) / Cooked rice and wheat cereals, grits.
Foods Higher in Potassium: Oranges / bananas / Potatoes / tomatoes / Brown and wild rice / Bran cereals / Dairy foods / Whole wheat bread and pasta / Beans and nuts.

B.    Physical activity

Physical activity is crucial to successful healthy weight reduction. Exercise increases energy expenditure, promotes weight-loss and helps sustain a healthy weight. Inactivity is unhealthy and should be avoided.

The goal to work toward is two hours and 30 minutes of moderate intensity exercise a week. This is usually spread out throughout the week in doable moments of activity, 20-30 minutes at a time, or even shorter intervals. A simple step is to increase daily walking. Using a gradual approach to increase activity is most likely to be successful. You should partner with your healthcare practitioner to determine the best type of exercise program.

C.    Sleep

Adequate sleep promotes maintenance of a healthy weight. Most individuals require about seven hours of sleep each night. Many studies suggest that irregular sleep patterns, eating before sleep and short sleep duration are all linked to obesity. Also, individuals with obesity are more likely to have sleep apnea, which may be found with high blood pressure and CKD. Symptoms of sleep apnea are daytime sleepiness, lack of feeling refreshed after sleep, loud snoring and periods of not breathing during sleep.

Does my Insurance Policy cover test and procedure of CKD?

Yes, According to CCHI unified Policy terms and conditions, health insurance policies in Saudi Arabia cover the test and procedure of CKD.

Please Click Here to access the Unified CCHI Policy Wordings.


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