This routine should take no longer than an hour. Your kidneys and health deserve an hour from you every morning. I understand many of us have hectic lives, but if you are busy, try to go to bed early and wake up one hour earlier the next morning. Trust me, it is worth it. An hour morning routine beats dialysis any time. This could be the first step in how to heal your kidneys naturally.
Start with water
At night the body loses a lot of water due to sweat and breathing. In fact, in a small study presented at an Associated Professional Sleep Societies meeting in 2009, healthy young men were found to lose ¼ lbs. per hour while asleep. That is about 2 lbs. in eight hours of sleep.
This is why you should start your day with water. The rest of the routine can be done according to your judgment and comfort. Start with drinking two glasses of filtered water if you are not on any water restrictions. This is even more important for patients with polycystic kidney disease and kidney stones. If you are wondering how much water to drink in PKD, check out our calculator here.
Exercise
Exercise for about 20 minutes. The type and duration of exercise depend on an individual’s level of functioning, endurance, and preference. Studies on exercise in chronic kidney disease (CKD) have included resistance training and aerobic activities that use large muscle groups continuously such as walking, cycling, and jogging.
High-intensity interval training (HIIT) was shown to offer superior benefits in individuals with metabolic disease. In the few studies of HIIT in CKD, it was found to be a safe and feasible option for individuals with CKD.
If you are new to exercising, start slow and try to gradually get to 20 minutes of strenuous exercise five to six days a week. It is best to alternate between aerobic exercise and resistance training. If you absolutely can’t fit exercise into your morning routine, you can move it to whatever time that works for you. The benefits are all the same. Consistency is the key here.
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Meditation
Meditate for at least 10 minutes. Meditation is a great way to start your day, manage stress, and stimulate your vagus nerve, which connects the brain with many vital organs including the kidneys. There are many ways to meditate and many types of meditations. Mindfulness meditation is the most tested in kidney patients. It has been shown to improve the quality of life, reduce anxiety and depression, reduce sympathetic overactivity, improve sleep, and improve blood pressure.
To practice mindfulness meditation such as Benson’s relaxation technique, sit in a comfortable position or on a meditation cushion, close your eyes, relax your shoulders and muscles, and focus on your breathing. Say a word with every exhalation. Pick a positive word like “gratitude.” As your mind starts racing to distract you from your breath, try to return to the word you chose. Practicing this every day will make you better at it, and you will be able to reap all the benefits with consistency.
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Journaling
Journaling is a great way to write your thoughts and plan your day. It has similar benefits to meditation. In fact, journaling was found to reduce stress and depression, boost the immune system, and improve memory among many other benefits. You can write whatever comes to mind. Think of it as a thought download. This should also not take more than 10 minutes.
Meditation and journaling can also be moved to a different time of the day for busy individuals with similar benefits. If you are very busy, consider meditation in the morning and journaling in the evening.
Cold shower
Taking a cold shower has many benefits for kidney patients. It increases endorphins and fights off depression, and it improves metabolism and circulation. Most importantly, it stimulates the vagus nerve and improves renal circulation. It may also soothe itchy skin, which is common in CKD patients. Cold showers help with post-workout muscle soreness. The benefits of a cold shower begin when the water temperature dips to 60 degrees Fahrenheit. This is 40 degrees lower than the typical steamy shower.
Now, I know it will be hard to turn that shower knob from hot to cold in the morning. The way to do it is to start with your hot shower. Then gradually lower the temperature at the end of the shower every day by turning the knob to cold. Give your body time to adjust. You can start with 30 seconds under the cold and gradually increase it to a maximum of three minutes. A quick shower for kidney health takes 10 minutes.
Plant-based breakfast
A good plant-based breakfast can be a super healthy way to start your day. A plant-based or plant-dominant diet has been linked to better kidney health and to slow the progression of kidney disease. There are many options that you can prepare in less than 10 minutes or plan the day before. You can find a few recipes in this e-book.
The bottom line
Your kidneys and health deserve an hour from you every morning. This morning routine can improve kidney health and help slow the progression of early kidney disease. If you’re wondering how to heal kidneys, this routine could serve as the first step, or it could be all you need for heathier kidneys. You can modify it to fit your schedule so that you’re at least doing some of the suggested morning actions every day. If you’ve been wondering how to improve kidney function, this morning routine is an important step in the right direction.
The post How To Improve Kidney Function with a Morning Routine appeared first on Integrative Kidney.]]>Polycystic kidney disease (PKD) is the most common inherited kidney disease affecting one in 800 people. There have been several advances in our understanding of PKD since our last blog. In a previous blog, we discussed the genetics of PKD and how genetic variants translate into a disease. In this blog, we will discuss recommendations for water, salt, and caffeine intake to reduce cyst growth. You will find out if ketogenic diet or intermittent fasting is the best diet for polycystic kidney disease.
PKD at the Cellular Level
To determine the best PKD diet and lifestyle recommendations, we must understand what is happening at the cellular level. In essence, abnormalities in PC1 or PC2 proteins will activate two pathways inside the cell. First, it activates the cAMP pathway which regulates fluid transport. Second, it changes the way cells make energy from sugar (called glycolysis). When PC1 or PC2 proteins don’t work well, they switch from aerobic (with oxygen) to anaerobic (without oxygen) glycolysis. This is similar to the shift that occurs in cancer cells.
While anaerobic glycolysis produces less energy from glucose, it is faster than aerobic glycolysis. This faster energy production allows the cells to grow faster. However, it also leads to a critical dependence on glucose.1
How Much Water to Drink in PKD
Vasopressin, also called anti-diuretic hormone (ADH), is a hormone that is produced by the brain and excreted by the pituitary gland. It plays an important role in the body’s fluid and sodium balance, blood pressure, and kidney function. ADH was found in several studies to promote cyst growth by stimulating the production of cAMP. Further proving the role of ADH in polycystic kidney disease, cyst growth was inhibited in both forms of PKD by administering ADH receptor blockers (medications that block ADH).
Dehydration can increase ADH and make cysts worse. Drinking large amounts of water leads to a significant decrease in the progression of PKD. The optimal amount of water to drink in PKD patients depends on the amount of salt and food they eat. The simplest way to assess this is by checking a 24-hour urine osmolality. You can use our calculator to assess the amount of water you should drink daily based on your 24-hour urine osmolality. Alternatively, measuring first morning urine osmolality can be used. The target for that is keeping the level less than 280 mOsm/kg.
In addition to dehydration, other factors that lead to the production of ADH include stress, pain, and surgery. These factors, therefore, can indirectly lead to cyst growth and further harm kidney function.
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Polycystic Kidney Disease and Caffeine
In the laboratory, caffeine increased cAMP accumulation in the cells. Yet, in human clinical trials, caffeine intake was not directly associated with kidney size in patients with PKD. An analysis in one clinical trial found no significant association between the consumption of caffeine from coffee and tea on the progression of ADPKD.
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Calorie-restricted and Keto Diets for Polycystic Kidney Disease
Kidney cysts thrive on sugar or glucose, as discussed earlier. Therefore, calorie-restricted and ketogenic diets can be beneficial for patients with PKD. Ketogenic diets induce a state that resembles starvation by providing high fat content and low protein and carbohydrate content. Time-restricted feeding such as intermittent fasting can have similar effects. Studies on animals demonstrated that ketosis could decrease cyst growth in PKD. These effects were thought to be mediated by a strong inhibition of mTOR.2
It is worth mentioning here that metformin can activate AMPK and is currently being studied in PKD.
To our knowledge, there is no published human study to confirm the effect of ketogenic diets and intermittent fasting on PKD. However, given the strong benefit of ketosis on cyst growth, we generally recommend a plant-based ketogenic diet or intermittent fasting in addition to a large water intake for patients with PKD.
Dietary, Lifestyle, and Water Recommendations for PKD
The phrase “our genes are not our destiny” describes how nutrition and lifestyle factors can have a positive impact on genetic expression for certain diseases. Drinking large amounts of filtered water, restricting salt intake, a ketogenic diet, or intermittent fasting can have significant benefits in patients with PKD. So far, limiting caffeine is not necessary to improve PKD, but it has other health benefits. Finally, stress reduction techniques can help to lower ADH and reduce kidney cysts.
Ongoing Studies of Diet and Lifestyle PKD Treatments
- PREVENT-ADPKD trial is looking at water intake and the progression of ADPKD. It should be released in late 2021.
- DRINK trial is investigating water intake in ADPKD. It should also be released in late 2021 or early 2022.
- METROPOLIS trial is comparing Metformin and Tolvaptan for the treatment of ADPKD. It should be completed in early 2022.
- Time-restricted feeding in ADPKD is currently recruiting subjects and is estimated to be completed by end of 2022.
- Keto-ADPKD trial is looking at how the ketogenic diet affects the progression of ADPKD. It should be completed in mid-2022.
- Curcumin Therapy to treat vascular dysfunction in ADPKD was completed in late 2020. It should be released soon.
1 It is noteworthy that glycolysis is inhibited by a cellular messenger called AMP-activated protein kinase (AMPK). It is activated by another messenger called mTOR. Metformin activates AMPK.
2 Activation of AMPK and inhibition of mTOR can theoretically inhibit glycolysis in cells that line the cysts in PKD. However, studies that looked at medications that inhibit mTOR such as sirolimus, did not show any benefit in PKD.
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What is Polycystic Kidney Disease?
PKD is a group of two genetic disorders that affects the kidneys and cause the formation of multiple fluid-filled cysts of various sizes. As these cysts grow, they squeeze and destroy normal kidney tissue, eventually leading to loss of kidney function. PKD is a Mendelian inherited disease, meaning it’s passed down genetically like eye or hair color. It said to be autosomal-dominant, slowly progressive disease affecting 50% of offspring, or autosomal-recessive which affect 25% of offspring of affected individuals but is usually rapidly progressive in childhood.
How does PKD develop?
Cysts that form in PKD usually occur when the cells lining the tubules of the kidney end up proliferating causing outpouchings (bulgings) that eventually separate into cysts. These cysts end up growing, transporting fluid across their lining into their lumen forming a fluid-filled sack or balloon. So, when we think about PKD, we should remember two processes: cell proliferation (cell growth) and fluid secretion into the cysts.
So, when we think about PKD, we should remember two processes: cell proliferation (cell growth) and fluid secretion into the cysts.
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In this blog, we focus on factors that affect fluid secretion into the cysts. This process is mediated by a cellular messenger called cyclic adenosine monophosphate, or cAMP, which is activated by the actions of anti-diuretic hormone (ADH). It should be noted that it can also be activated by other hormones such as the parathyroid hormone, prostaglandin E2, epinephrine, among others, however we will focus on ADH.
What is ADH?
ADH (also known as vasopressin) is a hormone produced by the brain and excreted by the pituitary gland. The purpose of ADH is to tightly regulate water balance and osmotic pressure. The presence of this hormone is crucial for survival, it is what gives humans and other land-dwelling animals the ability to survive out of the water.
When the body’s receptor’s sense that there’s an accumulation of certain solutes such as sodium, a chain of events occurs to preserve water (fluid retention). The chain of events is triggered by an increase in ADH. The kidneys have receptors that respond to ADH by formation of cAMP which leads to increase water retention.
Sodium concentration in the blood is reflective of the amount of water in our body. High sodium (and osmolality) levels stimulate the production of ADH and preservation of water. Low sodium levels inhibit the production of ADH stimulating water release. In fact, at a certain low level of sodium concentration and osmolality ADH excretion will be shut off completely.
Sodium concentration in the blood is reflective of the amount of water in our body. High sodium levels stimulate the production of ADH and preservation of water.
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The role of ADH in PKD
ADH was found in several studies to promote cyst growth by stimulating the production of cAMP. Drinking large amounts of water to a degree that the urine osmolality is lower than serum osmolality leads to a significant decrease in the progression of PKD. Cyst growth was inhibited in both forms of PKD by administering ADH receptor blockers. In addition to dehydration, other factors that lead to the production of ADH include stress, pain, and surgery. These factors, therefore, can indirectly lead to cyst growth and further decline in kidney function.
Researchers found that drinking large amounts of water lead to significant decrease in the progression of PKD.
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What can you do if you have PKD?
The integrative approach to PKD focuses on drinking adequate amounts of filtered water. In general, we recommend that kidney patients who have no significant volume overload problems drink half of their body weight in ounces of water daily. So, for example if you weigh 190 lbs., aim to drink at least 95 oz of water daily. Patients with PKD should aim to have their water intake at the highest end and restrict their salt intake to decrease serum osmolality and ADH excretion.
Yoga and stress reduction techniques, such as meditation or breathing exercises, can also play an important role in inhibiting ADH excretion and other hormones that can activate cAMP such as epinephrine.
In addition, assuring adequate intake of high-quality vitamin D will help inhibit Parathyroid hormone (PTH – another hormone that influences cAMP production) and limit cyst growth.
Finally, there are foods and beverages that can lead to accumulation of cAMP by inhibiting an enzyme called phosphodiesterase (PDE). In certain conditions such as heart disease, some of these same foods may benefit, however they should be avoided by PKD patients to preserve PDE function and minimize cAMP. These include methylxanthines such as caffeine, found in coffee, mate, tea, and cacao. In addition, catechins found in green tea, and flavonoids found in red wine should be avoided. Some recent laboratory studies suggest that extracts of artichoke and ginger might also be contraindicated in PKD, but more research should be done to draw any conclusive outcomes.
As always, we recommend that you discuss these lifestyle recommendations for polycystic kidney disease with your provider or nephrologist since every kidney patient is unique.
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