Wellness Wednesday: Understanding Polycystic Kidney Disease

March is National Kidney Month, and to start off this HWB social media month, we thought that a brief discussion on kidney health would be a great way to start! The kidneys are an amazing pair of organs that cover a huge scope of key functions in the body. Our kidneys are crucial life sustaining organs which perform many of the main functions to keep our blood clean and chemically balanced.

Some of the more important functions they perform are:
1. They filter the blood to get rid of waste products of metabolism.
2. They keep the electrolytes (sodium and potassium being the most important) and water content of the body constant.
3. They secrete a number of essential hormones such as renin which keeps our blood pressure under control, and also Erythropoeitin another hormone that is secreted by the kidney, and acts on the bone marrow to increase the production of red blood cells.

Unfortunately for many, kidney health can be a chronic challenge. Often times issues with kidney health can also impact other systems as well such as our cardiovascular system (or vice versa) and our endocrine system. In the following article on Polycystic Kidney Disease (PKD), we will review the physiology behind the disease as described by western medicine sources, and also comment on commonly used herbs, supplements, and dietary/lifestyle measures that may potentially support better kidney function for individuals with PKD.

The following information is not meant as a substitute for advice from your medical doctor, nor is it meant to replace any current prescription medications. As with all of our articles, if you are suffering from a current health issue, please speak with an appropriate practitioner. Also, please do not self dose on herbal remedies as not all herbs are appropriate for an individual based off of their current needs.

We hope you enjoy this article on Polycystic Kidney Disease.

Understanding Polycystic Kidney Disease

 The above image is anatomy of a kidney with Polycystic Kidney Disease

According to Taber’s Cyclopedic Medical Dictionary, Polycystic Kidney Disease, or PKD is “any of several hereditary disorders in which cysts form in the kidneys and other organs, eventually damaging kidney tissue and function”. PKD is considered a hereditary disorder with two types. The first is considered autosomal recessive when the disease appears in childhood, and the second is considered autosomal dominant when it appears in adulthood (commonly over the age of 30). In both cases, this systemic hereditary disorder is characterized by the formation of cysts in the cortex and medulla of both kidneys. Small cysts lined by tubular epithelium (which play an active role in renal inflammation) form and the surrounding normal kidney tissue is compressed and progressively damaged which leads to the eventual damaged/destruction of the tissue. In the case of PKD, the damaged tissue stimulates the body’s protective inflammatory response due to the renal injury, thus beginning the chronic inflammatory cycle.

Individuals with early PKD are often without symptoms until later in life but generally show evidence of high or elevated blood pressure from the approx. age of 20 and onward. 

In adults, this hereditary disorder has a prevalence of approximately 1 in 1000 individuals.

Causes:
This is a hereditary genetic disorder most often passed down in families. Rarely, a genetic mutation can occur spontaneously so that neither parent has a copy of the mutated gene. 

Individuals with a strong positive family history of ADPKD and no cysts detected by imaging studies can undergo genetic linkage analysis for additional evaluation.

When your Doctor diagnosis PKD:
“A person is considered to have PKD if three or more cysts are noted in both kidneys and there is a positive family member with autosomal dominant polycystic disease (ADPKD)” – Ferri’s Atlas and Text of Clinical Medicine

The diagnosis is usually based on family history, clinical and laboratory findings, and ultrasound examination, only your MD can diagnose PKD.

Symptoms of PKD:

• Usually presents in the 30’s and 40’s
• Pain (Abdominal, flank, or back)
• Vague discomfort in loin or abdomen due to increasing mass of renal tissue
• Renal colic
• High or elevated blood pressure
• Headache
• Excessive urination at night (Nocturia)
• Urinary tract infections
• Presence of blood in urine when urinalysis takes place (Hematuria)
• Kidney Stones (only in 20% of cases), also known as Nephrolithiasis

Laboratory Findings in PKD:

• Hemoglobin and hematocrit are elevated in blood because of increased secretion of erythropoietin (a hormone secreted by the kidneys that increases the rate of production of red blood cells in response to falling levels of oxygen in tissues) from functioning renal cysts.
• Relatively mild anemia often found (lowered iron levels).
• Electrolyte abnormalities may be present in blood.
• BUN (Blood, Urea, Nitrogen) and Creatinine (a compound that is produced by metabolism of creatine and excreted in the urine) may be elevated.

Complications of PKD:

• High blood pressure
• Reduction or eventual loss of kidney function (progressive)
• In women, may lead to complications in pregnancy
• Cysts may develop on the liver
• Brain aneurysm
• Heart valve abnormalities, cardiac regurgitation
• Colon problems
• Chronic pain

Dietary and Lifestyle Suggestions for PKD:
Always consult an appropriate practitioner before starting new dietary changes, dietary needs will differ with each individual. This list is not a complete dietary needs list, this is not a treatment plan.

• Remove all processed foods from your diet.
• Remove all processed and refined sugars from your diet.
• Greatly reduce salt intake.
• Remove all caffeine and soft drinks.
• Remove gluten from your diet.
• Remove or greatly reduce alcohol intake
• Implement the anti-inflammatory diet.
• Increase water intake, 6 glasses daily – steam distilled is greatly helpful, high quality water is important.
• Take caution in contact sports.
• Reduce your intake of potassium and phosphates if your levels are elevated
• Consume a diet composed of 75% raw foods. 
• Include in your diet legumes, seeds, and organic soy beans. These foods contain the amino acid arginine, which is beneficial for the kidneys.
• Reduce your intake of animal protein, or eliminate it altogether. A diet high in animal protein puts stress on the kidneys. Excessive accumulation of protein can result in uremia. Protein is easiest to utilize if it has been broken down into free form amino acids. Other good protein sources include beans, lentils, millet, peas, organic soy beans, and whole ancient grains.

Supplement Suggestions for PKD:
Always consult an appropriate practitioner before taking new supplements, do not self-dose. This list is not a complete supplementation list, this is not a treatment plan.

• Probiotics – Especially important if taking antibiotics for chronic urinary tract infections
• Coenzyme A – Acts as an antioxidant and removes harmful substances from the body
• Vitamin B Complex, especially B6 – To reduce fluid retention in later or advanced PKD
• Vitamin C with Bioflavonoids – Acidifies the urine, boosts immune function, and aids healing
• Calcium and magnesium - For proper mineral balancing
• Amino acids L-arginine and L-methionine – For kidney disease and for improved kidney circulation
• Vitamin A with Carotenoids – Important in healing or urinary tract lining and immune function. Use emulsion form for easier assimilation.
• Vitamin E – Promotes immune function, important free radical destroyer, use d-alpha-tocopherol form.
• Zinc – An immunostimulant necessary for healing and an important inhibitor of crystallization and crystal growth. Take with copper to balance.

 
Herbal Suggestions for PKD:
Always consult an appropriate practitioner before taking herbs, do not self-dose. This is not a complete herbal list, this is not a treatment plan.

• Nettle Seed (Urtica dioica semen) – Traditionally, nettle is considered to be blood tonic in action and is often used for its mild diuretic properties. However, nettle, and specifically nettle seed has many other helpful uses. These include its blood pressure lowering actions, and its ability to assist in eliminating uric acid build up in the body. It is considered to by hypoglycemic, anti-inflammatory, mineralizing, detoxifying, nutritive, vasodilating, circulatory stimulant, and anti-hemorrhagic. When it comes to issues with PKD, the seed has been shown to increase overall kidney function without straining the kidney or making it work harder to help maintain balance.
  
  
• Couch Grass (Agropyron repens) – Also known as quack grass, dog grass, and cooch grass. It is the Rhizome of the herb that is used and is demulcent, anti-inflammatory, and tonic to the urinary tract. Most importantly, it is mucilage rich which allows it so sooth inflamed tissue and mucosal membranes within the body. In issues specific to PKD it is specific to renal colic, irritation to the urinary tract as a whole, tonic to general kidney and bladder health as a whole, and like nettle seed, helps maintain function without causing the kidneys to work harder.

 

• Schisandra/Wu Wei Zi  (Schisandra chinensis) – Schisandra berry is a traditional Chinese medicine herb (TCM), but in cases of PKD, one that I would consider as an excellent secondary support herb. It is considered to be adaptogenic (meaning it helps the body to adapt as a whole and assists in bringing about homeostasis more regularly or to adjust to stressors). It is also considered to be a general tonic and restoring stimulant (It may not be appropriate for all individuals, and may prove too stimulating, but in small doses I think it is an excellent formulation partner). It is tonic to the nervous system, helps with stress and fatigue, regulates blood glucose and body secretions, is considered to be antioxidant, helps regulate blood pressure, and is tonic to the kidneys. In cases with PKD, I would consider it as a critical helper for its ability to assist in strengthening kidney function and to balance all body fluids.

 

• Cleavers (Galium aparine) – Cleavers holds a long tradition in western clinical herbalism. It is considered to be a slow, deeply healing herb and is often used for its lymphatic and anti-tumor properties. However, there is so much more to cleavers than these two common actions. It is considered to be tonic and adaptogenic (by some), to be anti-inflammatory, detoxifying, cooling to inflamed tissues, and hypotensive. It is considered to be an herb that is specific for cysts both internally and externally. In urinary health it is specific for kidney obstructions, inflammation, and general agitation of the urinary system as a whole. Commonly it is the aerial parts that are used when dried, but it can also be used as a fresh juice which is exceedingly helpful.

 

• Milk Thistle Seed (Silybum marianum) -   When it comes to chronic health issues, Milk thistle holds a specific action which is exceedingly helpful. Unlike many liver herbs which act upon the bitter principle to activate the liver, milk thistle is hepatoprotective, meaning it helps protect the structure and cellular integrity of the liver. Often in issues of chronic health challenges, other body systems may be impacted. In the case of PKD these systems are commonly the liver and the cardiovascular/circulatory system. Milk thistle assists in protecting the liver, its key actions, and in helping to maintain cellular regeneration. Also, depending on the situation or the individual, I would most likely include Dandelion Root (Taraxacum officinale radix) with the herb to assist with consistent detoxification to ensure that channels of elimination are working properly.

 

• Hawthorn (Crataegus monogyna) – As mentioned above, when it comes to issues with PKD, it is common for other systems to be involved. One of the more common organ systems that are impacted by PKD is the cardiovascular/circulatory system. Traditionally, Hawthorn is used for its adaptogenic actions, it is also known to be cardio trophorestorative (restorative to the cardiac muscle), cardiotonic, regulatory of blood pressure, coronary and peripheral vasodilator, and also a gentle relaxant. It is said that hawthorn helps the heart to beat more actively without having it work harder. It is also used traditionally in kidney diseases.

 

References:

• Prescription for Nutritional Healing Fifth Edition by Phyllis A. Blach CNC – Avery Press NY 2010
• Tabers Cyclopedic Medical Dictionary Edition 21 by F.A. Davis – F.A. Davis Company 2009
• Ferri’s Color Atlas and Text of Clinical Medicine by Fred F. Ferri, MD – Saunders Elsevier Publishing Philadelphia PA 2009
• Davidson’s Principles and Practice of Medicine 22nd Edition by Brian R. Walker, Nicki R. Colledge, Stuart H. Ralston, and Ian D. Penman – Churchill Livingstone Elsevier Toronto Canada 2014
• Current Medical Diagnosis and Treatment 2015 By Maxine A Papadakis and Stephen J McPhee – Lange Mc Graw Hill Educational Publishing Medical NY NY 2015
• Principles of Anatomy and Physiology 14th Edition by Gerard Tortora and Bryan Derrickson – Wiley Publishing Hoboken NJ 2014
• Medicinal Herbs Quick Reference Revision 7 by Julieta Criollo DNM, CHT – Self Published 2017

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About the Contributor

Petra Sovcov holds a Doctorate of Natural Medicine (DNM) with a focus on Herbal Medicine (CHT) and is a current faculty member at the Institute of Holistic Nutrition Nutrition. She is a new member on the HWB Board of Directors,  and has been a member of HWB since 2014. She currently runs the HWB Mahonia Chapter for the greater Vancouver BC area and coordinates the community free clinic. She is also the owner of Healing House Natural Wellness Centre, a multi-modality center located in BC Canada. For more info please visit the site, or follow her on Instagram @healinghouseherbal 
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