A Personalized Lifestyle Medicine Approach to Kidney Disease

Average life expectancy for a person with kidney disease on dialysis is between 5 and 10 years, according to the National Kidney Foundation, but many patients can live well for up to 30 years. Dr. Jeffrey Bland, the president and founder of the Personalized Lifestyle Medicine Institute in Seattle, Washington, believes lifestyle habits account for this large standard deviation in life expectancy, and he recommends a personalized lifestyle medicine approach to slow the loss of kidney function.

Chronic kidney disease (CKD) is the ninth leading cause of death in America, affecting an estimated 10% of US adults—more than 20 million people. The incidence of CKD in people 65 years and older more than doubled from 2000 to 2008, making CKD a growing burden on the medical system at a cost of more than $50 billion each year.

Kidney disease treatment is not just a financial burden on patients, but also a personal burden, requiring most patients to live their lives around treatments scheduled at dialysis centers three times per week for four hours each visit. Treatments may cause side effects such as nausea, vomiting, cramps, dizziness and constant fatigue, and may interfere with travel and work.

Anecdotally, Dr. Bland has seen a correlation between poor health outcomes and dialysis patients who eat fast food and drink carbonated beverages. Research now supports Dr. Bland’s personal observations linking diet and lifestyle, with evidence that personalized diet and lifestyle interventions can be a primary treatment for CKD and can help preserve kidney function even in high-risk patients.

Dr. Bland has seen a correlation between poor health outcomes and dialysis patients who eat fast food and drink carbonated beverages.

Hypertension is the major contributing factor to kidney disease. Studies show that obesity and a sedentary lifestyle contribute to increasing blood pressure and the progression of CKD. A lower protein, low glycemic diet along with regular exercise have been proven effective in managing CKD. Research has shown that smoking cessation, reducing alcohol consumption, increasing physical activity, and increasing social support all correlate with improved biomarkers associated with CKD over the course of about five years.

Dr. Bland encourages early intervention with a personalized lifestyle medical program that takes into account factors that will encourage compliance with the recommendations and may be delivered by a professional health coach. Dr. Bland says, “We cannot solve this problem through the building of more dialysis centers or by providing a greater number of kidney transplants.” He states that to truly bend the curve and decrease the prevalence of kidney disease, healthcare providers must incorporate effective lifestyle management programs into patient treatment plans.