By Maria Karalis, MBA, RD, LD Did You Know That... One in four adults have high blood pressure? In a Minnesota study, 40 percent of people with high blood pressure were unaware of it and only 17 percent were controlled on treatment (August 1999 issue of Hypertension). Studies have also shown about 90 percent of the population is diagnosed with hypertension by the age of 80. High blood pressure often causes no symptoms at all and is known as the "silent killer?" Some may have symptoms of dizziness, headaches or nosebleeds. High blood pressure is more common among African Americans? African Americans ages 25 to 44 are 20 times more likely than Caucasians to develop kidney disease related to high blood pressure. The average American consumes 4,000 milligrams of sodium per day? This exceeds the maximum of 2,400 milligrams recommended by USDA dietary guidelines and major health organizations such as the American Heart Association. High blood pressure (or hypertension) and diabetes are the two leading causes of kidney failure. Kidney failure is a condition that requires dialysis or transplantation to stay alive. These diseases can be controlled by treatment, thus preventing or slowing the progression of kidney disease. Your kidneys filter waste products and extra fluid from your body. The kidneys also release hormones to help regulate blood pressure, make vitamins that control growth and control the production of red blood cells. The kidneys also regulate the sodium level in your body. In persons with healthy kidneys, extra sodium is passed out through the urine. For example, if you eat a very salty meal, you may urinate more to get rid of the extra sodium. When kidneys do not work properly, that extra sodium does not get excreted and this causes edema (abnormal excess accumulation of watery fluid in connective tissue). Some early warning signs that your kidneys may not be working include: Burning or difficulty during urination. Blood in urine. Frequent urination, especially at night. Swollen hands or feet. Pain in the back or side below the ribs. High blood pressure.
How does high blood pressure cause kidney damage? High blood pressure can harm your kidneys. It makes your heart work harder and eventually can damage blood vessels throughout your body, including the blood vessels in the kidneys. If your kidneys are damaged, they will stop filtering waste products from your blood and will not remove extra fluid from your body. The extra fluid may then raise your blood pressure even more. There are many things you can do to help control your blood pressure, such as: The following will focus on helping you choose a diet moderate in salt and sodium: Tame your taste buds Cut back on your sodium intake gradually Salt is an acquired taste and as people cut back, their desire for that salty taste declines. The taste for salt is learned - and we can unlearn it. Hide the salt shaker Sodium is a mineral that is found in many foods and in salt. One teaspoon of salt has approximately 2,300 mg of sodium. One easy way to prevent too much sodium in your diet is to remove the salt shaker from the table and keep it in the kitchen cabinet. Enjoy plenty of fresh fruits and vegetables Avoid canned fruits and vegetables. However, you can decrease the sodium content of these vegetables by 40 percent if you rinse the vegetables in a strainer under cool running water. Limit processed meats Have processed meats in moderation. Limit corned beef, ham, bacon, bologna, salami, hot dogs and pastrami. Choose fresh meats instead. Sodium is everywhere - Beware of hidden sources of sodium Approximately 25 percent of daily sodium intake is added at the table. The remainder is unseen, consumed in restaurant and processed foods. Read the nutrition labels carefully and buy food with less sodium Overall sodium levels in processed foods have been reduced through better technology and the introduction of other preservatives. Over the last 20 years, food manufacturers have developed reduced and low sodium versions of many of their products. Check out the differences in these products: 2 ounces of canned tuna has 310 mg of sodium versus 2 ounces of low sodium canned tuna with 135 mg of sodium. 3 ounces of ham has 1030 mg of sodium versus 3 ounces of lean pork loin with 75 mg of sodium. 1/2 cup green beans (canned) has 170 mg of sodium versus 1/2 cup green beans (frozen) with 5 mg of sodium.
On the food label, look for ingredients that contain any of these words: Na, salt, soda (as in sodium bicarbonate) or sodium. Even everyday medications such as antacids and headache remedies contain sodium and must be labeled if the amount is more than five milligrams per dose, according to the American Heart Association. Buy products with less than 20 percent of the daily recommended sodium intake per serving. A product that contains less than five percent of the daily value per serving is considered low sodium. Check out the portion size. One serving of soup may contain 480 milligrams of sodium or 20 percent of the daily value. But if you eat the entire can you'll have consumed 40 percent of the daily value. Learn to prepare food with less salt or high sodium ingredients Start seasoning with herbs, spices, lemon, herbed vinegar or fruit juice. Put away the salt shaker when cooking pasta, rice or other vegetables. Buy yourself a low sodium cookbook - there are so many wonderful cookbooks in which to choose. Steer clear from salt substitutes Salt substitutes contain potassium in place of sodium. People with kidney disease may not be able to get rid of the extra potassium and this can lead to adverse health consequences. In place of salt, use lemon juice, balsamic vinegar, fresh herbs and garlic as seasonings. Eating out can be easier than you think It is easier than ever to eat out while following a low sodium diet. Don't be afraid to ask questions. Most restaurants understand the importance of providing healthful menu options to accommodate a wide range of dietary needs. Find out how the food is prepared and request that salt is not used during preparation. When ordering from a menu, descriptions can provide clues. Pickled and smoked items, as well as foods prepared with soy sauce and broth, are likely to be high in sodium. Choose dishes where the meat has been broiled, baked or grilled. Avoid sauces and salad dressings or order them on the side. Maria Karalis, MBA, RD, LD is a Renal Clinical Specialist in Winfield, Illinois. She is a Registered Dietitian that has worked in various positions in the nephrology field for close to 13 years. Maria is the Nutrition Consultant for iKidney.com and Assistant Editor of the Journal of Renal Nutrition . The information contained herein is intended for educational purposes only. It is not intended and should not be construed as the delivery of medical care. Persons requiring diagnosis or treatment, or those with specific questions, are urged to contact their local healthcare provider for appropriate care. This article originally appeared in the June/July 2003 issue of Kidney Beginnings: The Magazine, Vol. 2, No. 2.
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