Nutritional and Lifestyle Interventions in Polycystic Kidney Disease

While there is no cure for polycystic kidney disease (PKD), patients can play a major role in controlling certain symptoms by choosing a lifestyle that optimizes their good health and that may delay the progression of symptoms of PKD.

In addition to maintaining ideal body weight and regular exercise, dietary modifications that are recommended by some nutritionists and health care professionals include:

• Reducing the intake of foods that cause significant waste products for the kidney, (e.g., protein from red meat) is suggested by some physicians. The source of protein should come from other dietary foods such as chicken, fish, or beans. Debate continues as to whether a low-protein diet slows the rate of deterioration of renal function.

• Patients with PKD may also benefit from reducing their salt intake since salt causes retention of fluids in the body that can lead to high blood pressure. Foods with high salt content include canned foods, prepared foods, soda, and fast-foods.

• Patients with advanced kidney disease may need to follow a special diet. If so, consultation with a dietician can be very helpful in learning what foods are recommended and how to prepare them.

• Drink lots of water since it creates more urine and enables the body to flush out waste. Water also prevents dehydration which can occur in patients with PKD since the kidneys have trouble retaining water.

• Avoid excessive caffeine which is found in coffee, tea, colas, chocolate, and some over-the-counter medications (especially headache medications) since there is some indication that caffeine may increase the size of kidney and liver cysts.

• It is important for people with PKD to avoid smoking and heavy drinking of alcoholic beverages as both of these activities have been linked to hypertension.

It should be noted that no specific diet is known to prevent cysts from forming or to prevent progression of the disease in patients with polycystic kidney disease. The objective in maintaining a healthy diet and following an effective treatment plan is to reduce the severity of the symptoms and maximize the good health of the patient.

While exercise is very important, it is suggested that patients avoid any contact sports since physical impact could be harmful to the kidneys. It is also important not to become dehydrated in the course of exercising or doing any physical activity. When exercising, be sure to drink plenty of liquids to prevent dehydration.

Because some patients with polycystic kidney disease develop cardiac valve impairment (e.g. mitral valve prolapse), it is important for them to discuss with their health care provider the need to take antibiotics prophylactically before any medical or dental procedures are undertaken.

Since pain is such a prominent symptom for many people with PKD and it is not always successfully managed, patients with unremitting pain may benefit from seeking out help from a pain clinic. Pain clinics not only treat pain but also teach the patient how to cope with persistent pain and optimize their quality of life despite the pain. They also may provide counseling for the patient and family regarding continuation of daily routines regardless of pain level. Behavior modification techniques may also be effective in helping patients with PKD adapt to the pain so that interference with lifestyle is kept to a minimum.

Some patients have reportedly found pain relief from using the Alexander Technique which is a non-exercise approach to the improvement of body alignment. Patients learn how to hold and move their bodies in a correct position while being cued by the therapist.

Children who exhibit signs of polycystic kidney disease or medullary cystic disease (nephronophthisis) may be smaller than usual since the body requires good kidney function in order for normal growth to occur. These children should be evaluated by their physicians to determine whether they should be given growth hormone to promote optimum growth.

Patients with PKD must be monitored regularly by health care providers and should rigorously attempt to keep each appointment that is made for that purpose.