Pro on Probiotics?

probioticsMy husband takes probiotics and they work for him. This is why he takes them, as explained by http://www.theralac.com/why-take-probiotics.aspx:

“For healthy people, probiotics can help boost the immune system and increase the absorption of important minerals and nutrients. For people with digestive problems, probiotics can be taken in higher doses to help regain digestive balance.”

I thought they might be worth a try, but my nephrologist disagreed.  We had our discussion about this right after I’d been a guest on a radio show during which the pros and cons of using probiotics for chronic kidney disease were discussed. This was just about the same time the information I’d requested from Kibow arrived.  This is from their website at www.Kibow.com:

“Certain probiotic microorganisms can utilize urea, uric acid and creatinine and other toxins as its nutrients for growth. Overloaded and impaired kidneys have a buildup of these poisonous wastes in the bloodstream. Probiotic microorganisms multiply, thereby creating a greater diffusion of these uremic toxins from the circulating blood across the lining of the intestinal walls into the bowel. This increased microbial growth is excreted along with the feces (which is normally 50% microbes by weight).

Enteric toxin reduction technology uses probiotic organisms to transform the colon into a blood cleansing agent, which, with the aid of microbes, indirectly removes toxic wastes and helps eliminate them as fecal matter. Consequently, a natural treatment for kidney failure is possible to maintain a healthy kidney function with the oral use of Renadyl™. The patented, proprietary probiotics in Renadyl™ have been clinically tested and shown to be safe, free of serious side effects, and effective in helping the body rid itself of harmful toxins when taken for as long as 6 months.”

Let’s slow down a bit.  We’ll need some definitions, so I turned to my favorite user friendly online medical dictionary, www.merriam-webster.com for the following:

CREATININE: (I know you know this one; this is just a reminder) a white crystalline strongly basic compound C4H7N3O formed from creatine and found especially in muscle, blood, and urine

ENTERIC: of, relating to or affecting the intestines; broadly:  alimentary

PROBIOTIC: a preparation (as a dietary supplement) containing a live bacterium (as lactobacilli) that is taken orally to restore beneficial bacteria to the body; also:  a bacterium of such a preparation

UREA: a substance that contains nitrogen, is found in the urine of mammals and some fish, and is used in some kinds of fertilizerdictionary

URIC ACID: a white odorless and tasteless nearly insoluble acid C5H4N4O3 that is the chief nitrogenous waste present in the urine especially of lower vertebrates (as birds and reptiles), is present in small quantity in human urine, and occurs pathologically in renal calculi {a little help here, this means a concretion usually of mineral salts around organic material found especially in hollow organs or ducts} and the tophi of gout

What I found on Kibow is a mouthful… and an advertisement.  I am not endorsing Renadyl.  However, there is an animation at http://www.renadyl.com/How-Renadyl-works which visually clarifies the information above. While I understood the process better after watching the animation, I’m still leery of that six month warning, especially after I found this at the bottom of one of their pages:

“* These statements have not been approved by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent disease. Results may vary.”

In addition, this product contains psyllium seed husk, something I was cautioned to avoid. It seems my nephrologist is not the only one who feels this way. http://www.metamuciladvisor.com/avoid-psyllium-and-metamucil-in-kidney-disease/ is the webpage of Metamucil, a product whose main ingredient is psyllium.  However, this conscientious company also posts this information on their website:

Psyllium Products and Their Minerals

There are certain psyllium products that contain a large amount of minerals that individuals with kidney disease cannot process. Some psyllium products contain high volumes of psyllium seed huskspotassium, sodium and magnesium, which if a person with kidney disease consumes can cause a lot of problems. If an individual’s physician gives permission on taking psyllium then they need to make sure the psyllium product follows their restricted diet.

Fluids Required With Psyllium

When consuming psyllium six to eight glasses of water must be consumed to keep from having any uncomfortable side effects. This can be a problem for an individual with kidney disease since the kidneys cannot effectively filter the fluid. Since the proper amount of fluid cannot be consumed this can cause side effects and make the natural fiber less effective.

Things to Consider

One of the number one complaints in individuals with kidney disease is constipation due to the fact fluid restrictions, vegetables and more. Since there are many restrictions an individual has with kidney disease with their diet there are other safe options to choose from. Discuss these other safe options with your physician to relieve constipation.

Maybe it’s just me, but I don’t understand why someone with kidney disease would want to take a product that will harm them.  As a matter of fact, I don’t understand why Kibow, the makers of Renadyl, don’t post such a warning on their site. Hmmm, I wonder if the  “…safe, free of serious side effects, and effective in helping the body rid itself of harmful toxins when taken for as long as 6 months” statement included in their material IS their warning.  And just how many people catch that one sentence anyway?

At http://clinicaltrials.gov/show/NCT00760162, I did find the record of a study filed by Kibow in 2009, but not the results of the six month trial.  The record was processed on November 9, 2014 which is very recent.  Either I don’t know how to find the outcomes of the trial or they are simply not there. I suspect the latter.

I have no intention of vilifying Kibow, but do find this to be another case of be careful what you choose to take, very careful.  Watch the small print, talk to your nephrologist before making any decisions, and make sure you guard whatever you have left of your kidney function.

Book CoverThank you for your continued interest in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease. Keep in mind what a terrific holiday gift this is… and that next year, you’ll be able to gift the same person with What Is It and How Did I Get It? Early Stage Chronic Kidney Disease’s little sister: The Book of Blogs.

Until next week,

Keep living your life.

Dr. Rich Synder DO – Guest Blog

Nothing like being post blood draw for feeling relieved and ready to work.  By the way, that picture frame on the right side of the table contains a list of my numbers.  Make sure you know your own so you can deal intelligently with your body and your doctors.

I keep my eye out for any Chronic Kidney Disease publications after the release date of my own book.  One day, to my surprise since it had been a futile attempt until then, I discovered What You Must Know About Kidney Disease. I figured it was going to be about another kind of kidney disease just like all the others I’d looked at since last May, but it wasn’t. I bought it, read it, and is my wont, contacted the author to both congratulate him on an informative book and ask him whatever questions I had.  It turned out Dr. Synder reads the blog and to quote him, “Concerning your blog, I love your blog!”  Where’s that feather that keeps knocking me over?

You’ll find his blog on my blogroll to the right below the calendar after the categories.  I should be on his blogroll, too, by now or will be soon.  This is one busy person.

Below are the answers to some of the questions I asked him:

Let me a clarify: probiotics and alkalinized water are for everyone.

My approach: I am looking at the kidney as part of and working with your total body. It is a different approach than the way I was taught in fellowship. If the heart and the blood vessels and the cells are not working well, your kidneys are not going to work well.I am using a more holistic approach.

Probiotics in general: While decreasing total body inflammation, they help to normalize the immune system as well as help bowel irregularity. The kidney based probiotic is still a probiotic; it just also helps to also clear the intestine of the uremic toxins that can build up in advanced CKD. They have the lactobacillus and bifidobacterium species present in other probiotics.

Concerning water: Do you know how many people I see with early stage CKD who have a benign urine and no proteinuria? Why do they have early CKD ? Maybe part of it is what we ingest and what we are exposed to every day. An article in The New England Journal of Medicine talked about water and low level lead exposure and how it can be a cause of CKD over the years. This encompasses the pesticides in the water, not to mention the cellular effect of an acidic Western diet. I did a show entitled “Are Colas Killing Your Kidneys?” in which I talked about the fact that twenty years of phosphoric acid are likely to have an effect on your kidneys.

Ongoing studies of how to treat glomerular disease and proteinuria: These look at protocols: what can I give – steroids or chemo or both? I am not going to say I have  not used them or medications when necessary. I would be a hypocrite if I did. But….why, why, why do my patients have kidney disease and what can one do about it? The prevention is what we do each and every day of our lives.

Here are some suggestions:
1) Alkaline/anti-inflammatory based diet: Some say,”Eat for your blood type.” But, what is the DASH diet for hypertension? It is not just a low salt diet. It is also full of anti-oxidants and anti-inflammatory.

2) Water: I have taken alkaline water myself and I notice a difference in how I feel. Our bodies are sixty percent water. Why would I not want to put the best type of water into it? Mineralized water helps with bone health.  In alkalinized water, the hydroxyl ions produced from the reaction of the bicarbonate and the gastric acid with a low pH produce more hydroxyl ions which help buffer the acidity we produce on a daily basis. Where are these buffers? In the bones and in the cells, as well as some extracellular buffers. You are helping lower the total body acidity and decreasing the inflammation brought on by it. You do this early on so that you don’t have a problem with advanced acidosis later. Why wait until you are acidotic before doing something?

3) Decreasing total body inflammation and raising anti-oxidant support:  Why is the heart the most common organ affected by kidney disease and dialysis? It’s due to inflammation and vascular calcification. If a person is diabetic and obese, they may also have a fatty liver. Altered liver hemodynamics are also going to play  a role in kidney function. I see the end aspect of this everyday in the hospital. I look at these things too.

4) Standard care for someone with diabetes and kidney disease: This is the use of an ACE inhibitor. This is right and I use it with anyone I can. What happens if the person is on the ACE inhibitor and is still spilling tons of protein? What happens if they can’t take the ACE inhibitor because of high potassium problems?  I look for other answers.

Your kidney doctors are not wrong  at all in what they are telling you. I  just look at things from an additional perspective. Do I bat 1,000? No way. Have I had better results than before? Absolutely, yes. Do I need to learn a lot more? Heck, yes….I keep looking at things from a different perspective and asking why.

Many thanks to Dr. Synder for guest blogging to answer my questions today. Listen in at 8pm EST (that’s 6pm in Az.) to hear him interview me on Improve Your Kidney Health tonight: www.voiceamerica/show/1843/improve-your-kidney-health.

Until next week,

Keep living your life!