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People with chronic kidney disease have additional concerns when it comes to supplements and over-the-counter drugs.
Dr. Yen Tzung-hai, an attending physician in the Department of Nephrology at Chang Gung Memorial Hospital said on NTD’s “Health 1+1,” a sister program of The Epoch Times, that while many supplements are safe when used appropriately, some may contain contaminants, interact with medications, or provide excessive amounts of minerals that impaired kidneys cannot effectively eliminate.
4 Main Pitfalls of Supplements
Research has found that some dietary supplements may contain heavy metals or pesticide residues, particularly products with poor quality control. Chen Chia-ling, a lecturer and pharmacist at Chia Nan University of Pharmacy and Science who also appeared on the program, said supplements made from natural plant ingredients may also contain unexpectedly high levels of potassium, phosphorus, sodium, or protein, increasing the workload on already damaged kidneys.
1. High-Potassium Products: People with poor kidney function have difficulty metabolizing potassium, and high blood potassium levels may cause arrhythmia or heart damage. Common high-potassium products include herbal powders, fruit and vegetable powders, tea powders, noni fruit, and traditional Chinese medicine infusions.
2. High-Sodium Products: Excessive sodium makes blood pressure and edema harder to control. In people with poor kidney function who are prone to water retention and high blood pressure, excessive sodium intake will place an additional burden on the kidneys.
Effervescent tablets are an easily overlooked source of high sodium. They use an acid-base reaction to produce bubbles and contain elevated levels of sodium or potassium salts.
3. High-Phosphorus Products: Phosphate can increase a food’s water retention and improve its taste, and it is added to some healthy foods. If patients with kidney disease cannot excrete phosphorus normally, it can easily lead to high blood phosphorus levels, increasing the burden on the kidneys and blood vessels.
4. Highly Concentrated, High-Protein Products: For patients in the later stages of chronic kidney disease, it is not advisable to supplement with high amounts of high-protein products such as chicken essence or protein powder. These substances tend to produce a large amount of nitrogenous waste in the body, which may increase the glomerular filtration pressure and accelerate the deterioration of kidney function.
Beware of Popularly Used Medications
Some over-the-counter medications can increase the risk of kidney damage in patients with chronic kidney disease, including non-steroidal anti-inflammatory drugs (NSAIDs), compound cold medicines, and gastrointestinal medicines, Chen said. Especially when purchasing over-the-counter medications while traveling abroad, the labels may not be easy to understand. Taking them without understanding the ingredients can increase risks.
NSAIDs: Include ibuprofen, naproxen, and diclofenac. While these drugs have anti-inflammatory and analgesic effects, they reduce blood flow to the kidneys, increasing the risk of renal tubular damage.
Combination Flu Medicines: Contain multiple ingredients, including nasal decongestants, which may increase blood pressure and further damage the kidneys.
Gastrointestinal Medications: Often contain magnesium and aluminum ions, which can place a significant burden on the kidneys.
Can People With Kidney Disease Take Vitamins?
Regarding whether patients with kidney disease can take vitamin supplements, their needs differ from those of dialysis patients, Yen said. Before prescribing any supplements, the attending physician should first assess kidney function.
Dialysis patients are advised to supplement with water-soluble vitamins, including B and C vitamins. Sometimes, active vitamin D supplementation is necessary and should be prescribed by a physician. Dialysis patients should avoid vitamins A, E, and K.
For patients with a history of kidney stones, excessive supplementation with vitamin D or calcium tablets should be avoided. Excessive vitamin C intake is also not recommended, as it will be metabolized into oxalic acid in the body, increasing the risk of calcium oxalate stone formation.
High doses and high concentrations of vitamins are not necessarily better, Chen said. Patients with poor kidney function have reduced metabolic capacity, and excessive supplementation may increase the burden.
3 Things to Consider Before Taking Supplements
Chen summarized three points for patients with kidney disease taking health supplements or over-the-counter medications:
1. Check if the supplement is high in potassium, sodium, or phosphorus
2. Avoid products that claim to be “powerful” or “concentrated.”
3. The safest approach is to bring the health supplement packaging, photos, or ingredient list to the clinic for evaluation by the attending physician or pharmacist.
3 Ways to Avoid Dialysis
To protect your kidneys and avoid dialysis, Yen said, it is advised to mind the following three things:
1. Dietary Control: Quit smoking and drinking alcohol, maintain a diet low in oil, salt, and sugar, and strictly control your intake of sodium, potassium, and phosphorus.
2. Correct Medication Use: Take your blood pressure and blood sugar medications as prescribed by your doctor to maintain stable blood pressure and blood sugar levels. Never replace regular medications with health supplements.
3. Avoid Taking Health Supplements Indiscriminately: Do not be tricked by exaggerated marketing tones. The best way to protect your kidneys is not to increase their burden.
“The goal is not simply to take fewer pills,” Yen said. “It’s to protect your kidney function for as long as possible. Before starting any supplement, discuss it with your physician or pharmacist to make sure it’s both safe and appropriate for your condition.”
