Dear Pharmacist,

I’ve had diabetes for 12 years and now I have kidney disease.  My doctor just prescribed lisinopril. I’m concerned that there is more I should be doing. What else should I consider? 

--L.V. Los Angeles

Answer:  The kidneys continuously filter your blood to strain out waste products. Without functional kidneys we would die within minutes.  Many people, including non-diabetics, have the beginnings of chronic kidney disease (CKD) and don’t even realize it.  For example, fatigue, itchy skin, ankle swelling, puffy face, back pain, brain fog and any change in urination including frequency, urgency, volume, or color changes could indicate trouble.  You could easily be misdiagnosed, so see a kidney specialist (nephrologist) at least annually, but especially if you have these symptoms.  Here is my top 10 list to protect your precious kidneys:  

1. Bring blood sugar down.  A reduction of “hemoglobin A1c” from 7% to 6.4 % reduces your risk of kidney disease, eye damage and nerve pain by up to 25%. 

2. Eat a low-fat, low-protein diet rich in fresh, organic fruits and vegetables along with healthy nuts and seeds. 

3. Avoid regular table salt and salt substitutes because they may cause water retention or ruin your mineral balance. Sea salt is healthier. 

4. Medications such as ACE inhibitors (lisinopril, enalapril or Altace) can protect the kidneys, lower blood pressure, and reduce protein spillage.  Side effects include dry cough, headache, elevated potassium levels and weird changes in taste.   Newer medications such as Diovan, Cozaar, Avapro or Atacand can achieve similar benefits with fewer side effects. 

5. L-carnitine is an amino acid found in all your cells. Supplements may improve symptoms of heart failure or angina which can occur in people with kidney failure. When your kidneys tire out, supplemental forms may become useful.  Dosage varies and is based on your individual kidney function so ask your doctor.

6. Horsetail or Equisetum arvense:  This ‘diuretic’ herb helps your kidneys filter the blood while providing silica to help strengthen hair, bones and organ tissue.  You can drink tea or take supplements but ask your doctor first because diuretics usually enhance the side effects of medications.

7. Thiamine (vitamin B1)-   It’s not typically considered a kidney-loving vitamin but ‘cutting edge’ is my middle name. This natural nutrient was just shown to have dramatic effects on the body’s ability to excrete albumin and reverse early-stage kidney disease in some type 2 diabetics. 

8. Antioxidants such as resveratrol, astaxanthin, ubiquinol (CoQ10) and vitamin E may protect  kidney cells against free-radical damage.

9. Pau D’Arco – which is an herb from the Amazon rainforest touted for its ability to boost red blood cell production and improve oxygen flow.  Supplements may have a blood-thinning effect. 

10. The sun- it allows you to make vitamin D, which helps diabetics improve blood sugar control, wound healing and kidney function.