Chronic kidney disease is categorized as prerenal, intrarenal, or postrenal. Prerenal causes consist of conditions that lead to decrease blood flow to the kidneys. Such conditions include dehydration (volume depletion) or heart failure with subsequent decreased blood flow to the kidneys. These conditions result in the decrease in filtration of blood by the kidneys. This condition is reversable if flow to the kidneys is improved within a short period of time; however, chronic, persistent low flow can lead to progressive chronic kidney failure.
Intrarenal mechanisms include atherosclerosis (fatty plaque-filled arteries), autoimmune disorders, or chronic inflammatory conditions. These conditions are usually associated with chronic systemic illnesses such as diabetes, hypertension, cardiovascular disease, systemic lupus, or medications that are toxic to the kidneys. If caught early, this form of kidney disease can be reversed if the systemic illness is treated and/or controlled effectively. In the case of toxic medications, reversal of the condition depends on the timely removal of the offending agents.
Postrenal kidney disease is due to obstruction of flow of urine from the kidneys. Tumors, infections, or kidney stones in the structures that drain the kidneys (ureters or urethra) are common disorders of postrenal kidney disease. As discussed before, reversal of kidney dysfunction with post renal disease depends on early reversal of the underlying cause.
The severity of kidney disease is based on its ability to filter the blood. The lower the filtration rate, the higher (or worse) the stage. The different stages of chronic kidney disease is in the diagram below:
MHW Approach to Chronic Kidney Disease
The patients with chronic kidney disease seen at our center frequently have several other chronic illnesses. Our approach to this condition is to initially remove all medications that potentially contribute to kidney disease. Also, many individuals are dehydrated due to their poor diet and diuretic medications. Hence, changes in medications along with improved hydration associated with dietary changes can result in significant improvement in kidney function.
We also assist with the management of patients with end stage kidney disease on dialysis. The nutritional detoxification intervention improves their overall clinical condition, allowing for the reduction of medications and improvement of their overall health.
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