When you are first diagnosed with kidney failure (eGFR of 15 ml/min or below), many emotions may arise: anger, shock, panic, despair, and a feeling of complete hopelessness. You try to hold your composure and recount the past days, weeks, and months that lead up to this event to see if there were any signs or past actions that may have caused this.
You draw a blank and the only thing you are left wondering is “how do we fix this?”
This is when disbelief really sets in. The only form of treatment that your doctor provides you is either kidney dialysis or kidney transplantation. Both of which are highly invasive and complicated.
For the purposes of this article we will be discussing kidney dialysis as a treatment option, as this is the most common treatment choice for most sufferers of kidney failure.
The life changing effects that these treatments have on your life are both profound, but unfortunately even these drastic measures do not offer healthy increases to life expectancy for the “average” person once they are diagnosed with kidney failure.
Kidney Failure Life Expectancy
Kidney failure life expectancy, like anything depends on many variables, some of which you can control, and others that you cannot control: age, gender, genes, race, diet, lifestyle choices, what caused your condition (etiology), the type of treatment you choose, etc.
It is therefore prudent to exercise your will to give yourself the best chance of being the “lucky*” ones that live for 20+ years on dialysis. (*luck definition = where preparation and action meet)
Once again it should be noted that we are discussing life expectancy in relationship to kidney failure. This means that the kidneys are now functioning at or below 15% – also termed as End-Stage-Kidney-Failure or Stage 5 Kidney Failure. It is important to make this distinction, because the life expectancy severely drops once at this level.
Let’s take a look at some of the stats…
• The life expectancy of a kidney failure patient with an eGFR of 10ml/min or less, ranges from 1 to 12 months without treatment of any kind (e.g. dialysis, transplant, natural medicine). The average is 6 months.
(Szeto CC, et el. Nephrology (Carlton). 2011 Nov;16(8):715-9. doi: 10.1111/j.1440-1797.2011.01504.x.)
• The average life expectancy of someone receiving kidney dialysis is 4.25 years.
• The 10 year kidney dialysis life expectancy is 23%.
(Mailloux LU,et el. Clin Nephrol. 1994 Aug;42(2):127-35.)
Kidney Dialysis Life Expectancy
It might be hard to read such statistics, but I believe knowing such statistics can give you a chance to change your life.
How? Well it gives us a clue that dialysis is not your winning ticket home to health. That although dialysis is helpful in severe cases of kidney failure, it is not a complete solution and therefore begs the questions “why is this the case?”, and “how can I change my outcome?”
There are many reasons why this is the case, among them are:
Complications Caused by Kidney Failure
• Bleeding from the stomach or intestines
• Bone, joint, and muscle pain
• Congestive heart failure
• Coronary artery disease
• Fluid buildup around the lungs (pleural effusion)
• High blood pressure
• Increased risk of infections
• Liver damage or failure
• Miscarriages and infertility
• Weakening of the bones and increased risk of fractures
Complications Caused by Dialysis
• Bleeding, from the access point
• Loss of nutrition
• Low blood pressure
• Muscle cramps
• Rare: diseases like Hepatitis B and Hepatitis C
• Weight gain
Other Common Health Influences Found In Dialysis Patients:
• Poor dietary choices
• Patients often “give up”. Due to loss of freedom; dialysis schedules can be mentally, emotionally and physically taxing; feelings of alienation, and separateness from loved ones; etc.
• Lack of exercise
• Plus many, many more.
It is easy to see why then that the mortality rate for dialysis patients reduces quite substantially. And truth be told, kidney failure sufferers are more likely to pass away from cardiovascular disease, than from the actual kidneys completely shutting down.
Therefore we come two question number two “how can I change my outcome?”.
Top 5 Tips to Extend Your Kidney Dialysis Life Expectancy
During the dialysis process a large amount of protein is lost. Protein is one of the building blocks of the body, and therefore it is critical to get ample quantities through the diet to re-stock on what has been lost to allow the body to repair itself. This is usually a joy for dialysis patients as the lead up to dialysis requires heavy dietary protein restriction.
Daily Protein Intake Recommendation:
• Hemodialysis: 1.2 to 1.5 grams per kilo of body weight (e.g. 72 to 90 grams for a 60 kg (130 lb) individual)
• Peritoneal Dialysis: 1.5 to 2.0 grams per kilo of body weight (e.g. 90 to 120 grams for a 60 kg (130 lb) individual)
Please note: that these figures are a “general rule”, and therefore subject to change depending on your requirements and blood work. This means that you may need to consume more or need to consume less depending on your current situation and blood test results. I recommend having your renal dietician personally tailor your dietary requirements for this and the below dietary nutrients.
Protein ‘type’ recommendation:
50 % of your protein intake for the day must be from animal protein, the best sources include: chicken, fish, eggs, and turkey. 50% must be from animal protein because animal protein contains all the essential amino acids required for health. However that is not to say plant proteins (grains, legumes, nuts, seeds, vegetables) are not recommended, far from it. It is important to get a variety of sources as plants contain essential vitamins, minerals and phytonutrients that animal sources do not. Simply eat a 50/50 split, and you can’t go wrong!
To monitor if you are eating enough protein throughout the day, you need to monitor your Albumin levels in your blood work. Albumin is you body’s storage protein. Blood levels should be 4.0 or higher. Though please be aware that Albumin levels can take 1 – 2 months to show a change in your blood results.
Phosphorus, Potassium and Sodium
The minerals phosphorus, potassium and sodium all need to be closely monitored during dialysis. This is because each of these minerals has the potential to rise to dangerous levels (though in some people they can get too low) and cause a myriad of health problems. Cardiovascular disease is the most common side-effect of these.
Unfortunately very little phosphorus is removed during dialysis. Dialysis is an excellent treatment to remove toxins from the body, but there are some things that it cannot remove, and phosphorus is one of them.
Daily Phosphorus Intake Recommendation: up to 7mg per kg of body weight (e.g. up to 420mg for a 60 kg (130 lb) individual)
Hidden Phosphorus: phosphorus is used widely in food manufacturing, because it lends itself in so many ways, from preserving foods all the way to improving the consistency of foods. Please keep a look out for these food additives on your next supermarket shop:
• Dicalcium phosphate
• Monocalcium phosphate
• Phosphoric acid
• Sodium phosphate
Side-effects of high blood phosphorus levels: bone and teeth problems, abnormal bone and tissue calcification, hardening of the arteries, hyperparathyroidism, low calcium levels, bone pain, and itching.
Unlike phosphorus, potassium is easily removed via dialysis, so it can be managed a great deal easier than phosphorus. However between dialysis visits, it is easy for potassium levels to spike to high levels and cause unnecessary problems for your health. Therefore limiting you daily intake will help prevent this.
Daily Potassium Intake Recommendation:
• Hemodialysis: 1500mg to 2000mg a day
• Peritoneal dialysis: 2000mg to 4000mg a day
Side-effects of high blood potassium levels: nausea, weakness, numbness or tingling, slow pulse, irregular heartbeat, heart failure, sudden death
Sodium is only removed in low to moderate amounts by dialysis, so it too needs to be monitored.
Daily Sodium Intake Recommendation:
• Hemodialysis: 1500mg to 2500mg a day
• Peritoneal dialysis: 2500mg to 4000mg a day
Side-effects of high blood sodium levels: high blood pressure, edema, cardiovascular disease, nausea, vomiting, weakness, fatigue, insomnia, irritability, confusion, seizures, coma.
There are MANY nutrients that I could recommend to improve the life-span and life quality of someone of dialysis, but in many cases it is not wise to overload the body with too many substances, plus it would also overload your bank account! Please see below for what I believe are the key nutrients for dialysis patients – based on the complications listed earlier:
• CoQ10: improves heart and cardiovascular function, helps improve energy levels and fight fatigue
• Iron: treats anemia and low haemoglobin levels
• Multivitamin and mineral supplement: improves the overall nutrient status of the body (dialysis depletes the body of many vital nutrients); contains B6, B12, and folate to improve hemoglobin levels and reduce anemia
• Magnesium: alleviates headaches, cramps, muscle pain and tension, helps improve energy levels, balances blood sugar levels, and improves cardiovascular health
#3 Herbal Medicine
Like the nutrient section above, I have tried to be very conservative here, and try to list only the key herbal medicines that will treat the common problems associated with dialysis, and also extend the kidney dialysis life expectancy. I have come up with three:
• Hawthorn: best herbal cardiovascular tonic, improves heart function, reduces cholesterol, helps treat arterial plaque, increases circulation, treats high or low blood pressure
• Olive Leaf: helps fight infections of all kinds (bacteria, parasites, fungus, viruses), useful for treating dialysis access point infections, cardiovascular tonic, lowers cholesterol
• St Mary’s Thistle (aka Milk Thistle): Protects liver from liver damage and associated conditions, anti-nausea/anti-vomiting action, improves hunger levels for those with low to no appetite, and balances blood sugar levels
Even on dialysis it is still very much important to exercise. Movement is the definition of being alive, without movement we die a small death every day. The key component here is knowing what type of exercise is best for you, and what intensity is best for you. You don’t have to be entering strongman competitions, but as long as you are regularly moving that body of yours at a moderate intensity 5 times a week, then you are doing the very best for you health. I have put together a list of activities to help you get an idea of what constitutes “moderate” exercise” below, but another way of saying moderate intensity is: you are lightly huffing and puffing, but can talk without difficulty.
• Bicycling 5 miles in 30 minutes
• Climbing stairs for 15 minutes
• Gardening for 30 to 45 minutes
• Swimming laps for 25 minutes
• Walking 1.75 miles in 35 minutes
• Water aerobics for 30 minutes
For information on exercising, please see my stellar article here (scroll down to the “exercise” section).
#5 Optimal Dialysis
This may sound obvious, but having your blood work frequently assessed to evaluate the effectiveness of your dialysis treatments is crucial. By calculating the reductions of toxins removed from your blood stream, your doctor can determine if the time you are on dialysis is adequate to keep you healthy.
Not only that, but the growing consensus is that the more frequently one has dialysis, the better patients will feel and the longer they will live. Though this of course has a play-off with your spare time. Studies have found those receiving inadequate dialysis, experience higher than normal death rate, reduced appetite, and counter-intuitive, increased number of days per year spent in the hospital. Make sure you hold yourself and your doctor accountable to get your dialysis times right.
People can get bogged down with all the statistics out there; in fact you may have found yourself searching the web endlessly for statistics on dialysis and kidney dialysis life expectancy trying to get a gauge on your life expectancy. But what is that really going to tell you about you and your health? I am here to tell you, nothing. Statistics do not apply to you. It is how you live each day that determines your life and health.
A famous line from the financial author and radio host Dave Ramsey says “If you live like no one else, you will live like no one else”, meaning if you do the things that the “average” person does you will get average results, but if you do things that most do not do (eating a healthy renal diet, exercising, taking supplements, etc.), then you will be the one of the “lucky” exceptions, and not the rule. People can and do live for decades with kidney failure, but it doesn’t happen by accident.
So please do not spend your time worrying about how you may die sooner because of kidney failure, any of us could encounter an accident tomorrow. Instead, why not focus your energy on how you can best enhance your life through natural treatments and healthy a lifestyle, but most importantly, focus on living.
To your optimum health!
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