PKD Recipes

A paper published in 2010 Kidney International (Phisitkul et al., vol. 77, Apr. 2010, pp. 617-623), alkalinizing helped preserve GFR.

Kidney Int. 2010 Apr;77(7):617-23. Epub 2010 Jan 13.
Amelioration of metabolic acidosis in patients with low GFR reduced kidney endothelin production and kidney injury, and better preserved GFR.
Phisitkul S, Khanna A, Simoni J, Broglio K, Sheather S, Rajab MH, Wesson DE.
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Comment in:
Kidney Int. 2010 Apr;77(7):567-9.
Abstract
Metabolic acidosis often accompanies low glomerular filtration rate and induces secretion of endothelin, which in turn might mediate kidney injury. Here we tested whether treatment of metabolic acidosis in patients with low glomerular filtration rate reduced the progression of kidney disease. Fifty-nine patients with hypertensive nephropathy and metabolic acidosis had their blood pressure reduced with regimens that included angiotensin-converting enzyme inhibition. Thirty patients were then prescribed sodium citrate, and the remaining 29, unable or unwilling to take sodium citrate, served as controls. All were followed for 24 months with maintenance of their blood pressure reduction. Urine endothelin-1 excretion, a surrogate of kidney endothelin production, and N-acetyl-D-glucosaminidase, a marker of kidney tubulointerstitial injury, were each significantly lower, while the rate of estimated glomerular filtration rate decline was significantly slower. The estimated glomerular filtration rate was statistically higher after 24 months of sodium citrate treatment compared to the control group. Hence it appears that sodium citrate is an effective kidney-protective adjunct to blood pressure reduction and angiotensin-converting enzyme inhibition.

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Kidney Int. 2010 Apr;77(7):567-9.
A basic approach to CKD.
Simon EE, Hamm LL.
Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
Comment on:
Kidney Int. 2010 Apr;77(7):617-23.
Abstract
Metabolic acidosis often complicates chronic kidney disease (CKD) and adversely affects bone, nutrition, and metabolism. Phisitkul et al. demonstrate that sodium citrate may ameliorate kidney injury in CKD patients not on dialysis. Further, they provide evidence in humans that treatment lowers urinary endothelin levels, and hence increased endothelin may be part of the mechanism whereby acidosis hastens CKD progression.
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And for those with kidney stones, here is an article

J Phys Chem B. 2009 Jul 16;113(28):9547-50.
The complexon-renal stone interaction: solubility and electronic microscopy studies.
Kustov AV, Berezin BD, Trostin VN.
Institute of Solution Chemistry of Russian Academy of Sciences, Ivanovo, Russian Federation. kustov@isuct.ru
Abstract
We have studied how complex formation between calcium and ethylenediaminetetraacetate or citrate ions influences the surface texture and the size of passed oxalate-phosphate renal stones. The four hour concrement treatment by sodium citrate or ethylenediaminetetraacetate aqueous solutions strongly affects the stone texture and provides a mass loss of 6-15%. We have found a significant decrease of the calcium and phosphor content on a concrement surface and formation of appreciable cracks. Our results do indicate that the Ca-complexon interaction can be effectively applied for disrupting some types of renal stones and, especially, residual concrements, which frequently occurs after a surgical operation or an extracorporeal shock-wave lithotripsy. This study provides an additional quantitative physicochemical basis for this slightly invasive therapy.
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Atubular glomeruli in a rat model of polycystic kidney disease.
Tanner GA, Tielker MA, Connors BA, Phillips CL, Tanner JA, Evan AP.
Kidney Int. 2002 Dec;62(6):1947-57.
PMID: 12427119 [PubMed – indexed for MEDLINE]Free Article

Citrate therapy for polycystic kidney disease in rats.
Tanner GA, Tanner JA.
Kidney Int. 2000 Nov;58(5):1859-69.
PMID: 11044205 [PubMed – indexed for MEDLINE]Free Article

Potassium citrate/citric acid intake improves renal function in rats with polycystic kidney disease.
Tanner GA.
J Am Soc Nephrol. 1998 Jul;9(7):1242-8.
PMID: 9644634 [PubMed – indexed for MEDLINE]Free Article