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The link between Chronic Kidney Disease and Coeliac Disease

https://www.fau.eu/2017/08/07/news/research/important-messenger-substances-in-the-immune-system/

Coeliac Disease might not be one of the first things that comes to mind when we hear the term “Chronic Kidney Disease”, but there are some interesting links between the two diseases, and the increasing incidence of Coeliac Disease globally makes this a topic worth discussing, especially for those of you who have been diagnosed with either disease, or have a family history of them.

 

Coeliac Disease is on the rise…

The estimated rate of Coeliac Disease worldwide is 1%. That’s 1 in every 100 people. The fact that this rate is increasing and that there is a strong genetic link suggest that we can expect this figure to rise. The fact that we do not understand the mechanisms responsible for this increase means there is not a lot we can do at this stage to prevent it.

 

CD vs CKD…

Coeliac Disease is a complex and as yet not well understood autoimmune disease, however the predisposing factors are clear. Sufferers must experience a combination of genetic, immune and environmental factors for the disease to develop. It cannot develop without dietary exposure to the protein gluten, and can only be managed by removing this trigger.

 

Chronic Kidney Disease, although the majority of cases can be attributed to high blood pressure and diabetes, can develop as a result of many different factors, including autoimmune conditions, urinary tract infections, congenital malformations (meaning they are present at birth), physical obstructions of the urinary tract or prostatitis, and many other inflammatory and genetic conditions. Diet and nutrition can be of great benefit in reversing kidney disease as we know, but it is rarely the direct cause of the condition.

 

The conditions do not appear related do they? But a cohort study published by Nephrology Dialysis Transplantation, which investigated the link between any form of glomerulonephritis, dialysis treatment and kidney transplantation and Coeliac Disease, has found statistical significance associating CD with an increased risk of Glomerulonephritis and renal failure.

https://academic.oup.com/ndt/article/21/7/1809/1821933

On the surface, the 2 diseases appear to be completely unrelated, so let’s look below the surface…

 

What are the links between the diseases?

In a nutshell, it appears that immune characteristics are at the core of the connection between these 2 common and very serious diseases.

There is currently a lot of scientific interest in the gut (our gastrointestinal tract), it’s mechanisms of immune regulation and that factors of modern life that present a threat to the delicate balance that it serves to maintain. In the gut resides the gut-associated lymphoid tissue, or GALT. This makes up around 70% of our body’s immune cells – 70%! If this balance is compromised therefore, so is our immune system and its’ ability to protect us from disease. I will not go into too much depth about the role of GALT in this article, and to be honest there is still an awful lot we do not yet know about what goes on in there! But here is what we do know about the gut, and the similarities that have been found between Coeliac Disease and Chronic Kidney Disease sufferers.

 

Activated Immune System 

The mucosal immune system exists in the lining of the gastrointestinal tract and serves as our first line of defence against harmful pathogens, just as our skin does. It is an entire ecosystem made up of a complex network of immune cells and beneficial bacteria. Like any ecosystem, it relies on adequate nutrition, hydration and other factors to thrive and maintain homeostasis, or ‘balance’. When this barrier is compromised, protective mechanisms are initiated, one of which is the production and secretion of Secretory Immunoglobulin A (IgA). Almost 100% of Coeliac Disease patients have these antibodies present, and it appears that this same mucosal immune mechanism is also active in many forms of glomerulonephritis.

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2249.1992.tb07947.x

https://www.frontiersin.org/articles/10.3389/fimmu.2016.00240/full

Gut permeability 

Tight junctions are part of the structural component of the mucosal immune system in the gut wall. They prevent toxins and harmful bacteria from entering the blood stream. Essentially, it’s what separates our internal environment from the outside world, so it’s pretty important! If these tight junctions are damaged, unwanted pathogens enter the systemic circulation and cause inflammation and oxidative stress throughout the body. This has been linked, as both a cause and effect, to generalised autoimmune diseases including Coeliac Disease.

Studies have shown that a loss in kidney function can also reduce the effectiveness of the intestinal barrier, allowing pathogens to enter the bloodstream and potentially increase the decline of kidney function. Conversely, an impaired intestinal barrier can potentially lead to autoimmune kidney diseases in susceptible individuals due to the inflammation and oxidative stress caused by the failure of the body’s first line of defence.

 

Image source: https://uncexchanges.org/2017/04/03/leaky-gut-a-potential-contributor-to-the-brain-gut-microbiota-axis/

https://academic.oup.com/ndt/article/16/3/513/1823041

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071212/

Auto-antibodies 

What are auto-antibodies you ask? These are similar to the antibodies our immune systems produce to fight invading pathogens, but autoantibodies are produced when the immune system mistakenly identifies its’ own tissue as the foreign invader. Auto = Self. This is what happen in autoimmune disease. Being an auto-immune condition, auto-antibodies are raised in Coeliac Disease, and studies have shown the same auto-antibodies to be present in renal disease.

https://www.karger.com/Article/PDF/13497

What are the main threats to our internal environment?

  • Overuse of antibiotics and mediations
  • Stress
  • Chemicals in our food, water and environment
  • Pathogenic bacteria from food water and the environment
  • Poor diet
  • Genetics
  • Methods of birth and infant feeding

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483960/

 

In Conclusion…

As with CD, the incidence of end stage kidney disease is on the increase globally, the underlying causes of which are still largely unknown. Many other chronic, autoimmune and immune related conditions are also on the rise. There are of course theories which speculate on this phenomenon, such as industrialisation, the hygiene hypothesis, overuse of antibiotics, the quality and preparation of the modern diet, stress and infections to name a few, but at the end of the day there are no definitive answers and therefore no definitive solutions.

With the growing body of evidence linking the gut to a myriad of health conditions, looking after our internal ecosystem seems like a pretty logical place to start in preventative health and disease management though. Don’t you agree?

http://www.worldgastroenterology.org/publications/e-wgn/e-wgn-expert-point-of-view-articles-collection/the-global-village-of-celiac-disease-and-its-evolution-over-time

 

 

One Simple Cooking Herb May Reverse Oxidative Kidney Damage

ginger alcohol oxidative kidney damageWe’ve all cooked with it, added it to a veggie juice, or had it as a warming soothing tea. But now the scientists at the Sri Venkateswara University in India (Molecular Biology division) have taken it one step further and started running extensive tests on this humble herb. This humble herb you know as Ginger, and it has been shown to have positive and remarkable effects in the treatment and management of alcohol induced renal oxidative damage. Who would have thunk it?

It is well known that herbal medicines can help protect the kidneys, reverse kidney damage, and assist in the management and reduction of symptoms – there are literally umpteen herbs to choose from. But ginger, before this study, has not really been regarded as one of them (traditional chinese medicine has used ginger to varying degrees for kidney complaints, but in a limited capacity compared to other herbal medicines).

The study led by Shanmugam Ramdudu PhD, together with five other scientists, set out to investigate the renal protective effects of ginger against alcohol-induced oxidative stress and tissue damage. Knowing that alcohol consumption is widespread across the world, causing many diseases, and the over production of oxidative stress, the scientists considered what impact this may have on the kidneys (a major detoxifying organ), and if the herb ginger may lend a solution to this problem.

The scientists decided on ginger as they had recently completed a study proving its benefits for protecting the liver. Not only this, but in recent times ginger has been subject to countless other studies for the treatment and management of diseases, such as: cataracts, stroke, rheumatism, diabetes, neural disorders, and asthma!

The Scientific Method

The scientists used twenty four Wistar rats (aged 6 months) to conduct the study, which were divided up into four distinct groups:
1.    Normal control group (Nc): feed a normal diet
2.    Ginger treated group (Gt): given a ginger extract (equiv. 200mg/kg body weight) everyday for 30 days
3.    Alcohol treated group (At): given 20% alcohol (equiv. 2g/kg body weight) everyday for 30 days
4.    Alcohol plus ginger treated group (At + Gt): alcohol and ginger in the same dosages described above, everyday for 30 days. Alcohol was given first, followed by the ginger extract 5 minutes later.

Immediately after the final dosage, the scientists measured the following parameters: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidise (GPx), and glutathione reductase (GR); all powerful antioxidants enzymes used by the body to quench free radical damage and protect the kidneys.

The Results

The following is a summary of the impressive results attained:

Kidney Disease Diet: Would You Like Kidney Disease With That…?

kidney diet

Fast-food. I know it sure is convenient, and there sure is something satisfying about hoeing into your favourite fast-food. But the fact of the matter is, that fast food is, well, garbage. Shocked? I’m sure.

*Sheepishly* For me, my weakness is fish and chips. Can’t get enough of that golden fried goodness :-). Though I am pleased to tell you I am on a 12 step program and my intake is down to only once a month – for those brave enough, I would love to hear what your vice is in the comment section below.

Of course not all fast-food is evil, but a study undertaken from the good people at The Division of Nephrology at MetroHealth Medical Centre in Cleveland, Ohio have sure made it look so (especially for those suffering from kidney disease).

The scientists wanted to see whether fast-food meals were compatible, at all, to the requirements of a healthy kidney disease diet. The four main nutritional requirements to take into consideration for a kidney disease diet are: potassium, protein, phosphorous and sodium.

They performed quite an intensive investigation, spanning 15 major fast-food chains. Examining ingredient lists and nutritional meal profiles, the scientists were able to accurately assess the levels of potassium, protein, phosphorous and sodium in each of the meals and side-dishes that each of the fast-food chains offer. There were 804 meals and 163 side-dishes in total.

You ready for the scary part (the results)?

Out of the 804 meals only 16% of them were deemed OK on all counts! The side-dishes only slightly better coming in at 17%.

Also, there were no acceptable meals at 3 fast-food chains, and no acceptable side-dishes at 5 fast-food chains.

Kidney Problems: Chickens To The Rescue?

kidney problems

Chicken, the second most consumed ‘meat’ in the world – after goat – and has sparked the interests of the folk from The Ethics Committee at the Hospital de Clínicas de Porto Alegre in Brazil. After running extensive tests (over three years) the scientists have found that this feathered medium sized, relatively flightless bird (fowl), is the animal-protein source of choice for those with diabetic kidney problems (=diabetic nephropathy), and is comparable to its traditional treatment of Enalpril (=ACE inhibitor).

The benefits of low protein diets in chronic renal failure has become well documented, but now this study has shed some light on the fact that not all protein is created equal and a change of diet could prove just as powerful as a western medical drug. Here is how it all came about…

5 scientists in Brazil assembled a group of 28 outpatients with type 2 diabetes and microalbuminuria – Microalbuminuria is where the kidneys leak small amounts of protein (albumin), this is a risk factor for the development of more advanced stages of diabetic nephropathy – the age of the patients were aged between 30 and 75 years of age and being treated with insulin.

Two treatments were randomly selected for each patient:

1.      Experimental chicken diet for 12 months: Patients continued to eat the same amount of protein they were before the test, but replaced all meat with skinless chicken meat.

2.      Enalapril (10mg/day) for 12 months: ACE inhibitors are the traditionally the first line treatment for diabetic nephropathy. Diabetic nephropathy is simply kidney disease as a result of diabetes and can affect up to 40% of patients!

New Hope: Kidney Disease Cure Awaiting Further Studies

kidney disease cure

In a major collaborative study between Harvard Stem Cell Institute, the Centre for Regenerative Medicine, the Brigham and Woman’s Hospital, and the University of Pittsburgh, researchers may have just stumbled across a kidney disease cure while exploring fish!

This amazing news will create much hope for millions of people right across the world suffering from kidney disease, and it is something I will definitely keep a close eye on for you all.

Aside from dialysis and kidney transplants, the medical community have not yet been able to find a cure, or anything that comes close as a ‘real’ treatment (unlike natural therapies that currently leads the way).

So for me this exciting, we may very well be at a point in history where we can blend the very best of western medicine, and natural medicine, to help people right across the world with kidney problems.

So What Is The Research, And What Is It Showing?
Well researchers have identified a cell in Zebrafish that has the ability, once transplanted, to regenerate nephrons from one fish to another (Wow), and therefore increase kidney function.

A fact that many people don’t know, is that many non-mammals (e.g. fish) have the capacity to continually generate new healthy kidney cells (nephrons) right through their life; human beings and other mammals on the other hand do not continually generate new kidney cells.