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Chronic Kidney Disease

Overcoming CKD-Related Fatique

L-carnitine, an amino acid-derived nutrient crucial to cellular energy management, may play a vital role in kidney disease prevention and management (Kendler 1986; Matera 2003). Carnitine deficiency is itself a known causative factor in the development of kidney disease. Conversely, patients with kidney disease frequently develop carnitine deficiency, especially those on dialysis. Carnitine therapy is known to lead to improvements in many kidney disease-related complications including cardiovascular disease, anemia, decreased exercise tolerance, weakness, and fatigue (Matera 2003).

As noted earlier, CKD sufferers are at very high risk for developing cardiovascular complications, including heart attacks and heart failure. This is thought to be related in part to the massive oxidative stress induced by kidney disease and in part to inadequate energy management in cardiac tissues induced by carnitine deficiency (Calo 2006). The frequent result of these interrelated factors is a massive deterioration in energy, exercise tolerance, quality of life—and perhaps, longevity (Schreiber 2006).

Based on patient reported outcomes, scientists in Kentucky discovered that supplementation with L-carnitine could improve general health, vitality, and physical function in people on dialysis (Sloan 1998). In 2001, research by clinicians at Los Angeles Medical Center showed that L-carnitine given intravenously to dialysis patients could reduce fatigue and preserve exercise capacity (Brass 2001). A literature review by nephrologists at Vanderbilt University indicated that L-carnitine supplementation should be used to improve red blood cell count in dialysis patients whose anemia doesn’t respond to therapy with the hormone erythropoietin (Golper 2003). Finally, data from Italy demonstrated that L-carnitine supplements could help suppress levels of the inflammatory marker C-reactive protein, potentially reducing cardiovascular risk in dialysis patients (Savica 2005).

Additional Nutrients that May Benefit CKD

Folic acid is well known for its capacity to reduce levels of the metabolite homocysteine, which is strongly associated with cardiovascular disease and dramatically elevated in individuals with kidney disease or kidney failure (Alvares Delfino 2007; Bostom 2006; Menon 2005; Nanayakkara 2007).

Omega-3 fatty acids have been shown to help improve cardiovascular risk factors (Farmer 2001; Hartweg 2009; Moreira 2007) and kidney function in patients with established kidney disease (Miller 2009; Parinyasiri 2004). Research published in 2009 suggests that diets rich in omega-3s may actually prevent kidney disease (Bell 2009; Garman 2009).

Through its powerful antioxidant effects, vitamin E may help prevent the onset of CKD. Vitamins E and C may mitigate the development of cardiovascular and other complications in patients with chronic kidney disease (Abdel-Naim 1999; Boaz 2000; Khajehdehi 2001; Mune 1999; Ramos 2005; Tain 2007).

Summary

Chronic kidney disease (CKD) is rapidly approaching epidemic proportions, with up to 26 million Americans suffering from some form of kidney disease. Kidneys filter 200 quarts of blood daily. The high-pressure and toxin-rich environment surrounding kidneys renders these delicate, highly complex organs especially vulnerable to damage, dysfunction, and disease.

High blood pressure, elevated blood sugar, NSAIDs (such as ibuprofen), certain medications, and high-protein diets are the most common threats to kidney health. The potentially lethal insults they inflict include oxidative stress, production of advanced glycation and lipoxidation end-products (AGE's and ALE's), inflammation, and an excessive filtration burden that taxes renal function over time.

Nutrients such as pyridoxal-5-phosphate (P5P) fight AGE's and ALE's. CoQ10, silymarin, resveratrol, and lipoic acid are also clinically supported, potent interventions. Omega-3 fatty acids help quell inflammation, contributing to enhanced kidney health. A host of additional nutrients complement these actions, including folic acid (folate) and vitamins C and E.

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