The RenalTracker Team
June 16, 2020

Managing CKD in Summer

Hydrating, blasting off the AC, and wearing loose clothing -- these are common quick fixes to cool down during a particularly hot day. 

However, people with Chronic Kidney Disease (CKD) may have to go beyond the usual cooling down regimen to managing CKD in summer. 

Exposure to sweltering temperatures can have a significant impact on your body, especially on your kidneys. 

How Can Heat Impact the Kidneys?

As the environment heats up, the body warms up as well. In the summer, heat-related illnesses can affect many people as temperature and humidity levels are expected to surge. Serious heat illnesses include heat exhaustion and heat stroke. These occur when the body temperature exceeds a person’s capacity to release that heat. 

Heat illnesses usually happen when the humidity rate goes beyond 70% and the body temperature climbs to 104 degrees Fahrenheit (40 degrees Celsius). At this point, sweat can no longer evaporate quickly, preventing the body from releasing excess heat to cool itself. 

The buildup of metabolic heat (heat generated in the body) plus heat gained from the environment can lead to heat stress. In extreme heat wave conditions, body temperature can shoot up to dangerous levels within 10 to 15 minutes.

Symptoms of heat stress:

  • Headache
  • Fatigue
  • Muscle Cramps
  • Weakness
  • Nausea
  • Dizziness
  • Vomiting
  • Low blood pressure
  • Weak and fast pulse
  • Confusion, altered mental state
  • Loss of consciousness

In addition to these symptoms, heat stress is also often accompanied by dehydration. Research suggests that heat stress resulting in chronic dehydration can have a negative impact on kidney function. This is because the loss of body fluids can cause renal arteries to constrict (renal vasoconstriction) and the urine concentration to increase. 

Constricted renal arteries decrease blood flow to the kidneys, reducing the kidneys’ filtration capacity. This eventually results in the decline of glomerular filtration rate (GFR). Frequent episodes of heat stress and severe dehydration can cause kidney injury, which may develop into Chronic Kidney Disease (CKD) and permanent kidney damage. 

Who’s at Risk?

Elderly individuals (aged 65 and over), infants, and children (up to 4 years old) are at a higher risk of dehydration and heat-related illnesses. This is because these populations adjust more slowly to heat than others. Workers (e.g. farm workers), who are constantly exposed to hot temperatures and do not take enough breaks to rehydrate are also at risk.

People with CKD are also prone to heat exhaustion and heat stroke, as well as others who have existing medical conditions like heart/lung disease, diabetes, high blood pressure, and those who are obese. 

Even certain medications can lower your defense against heat illnesses. These medications include, heart and blood pressure medicines, sedatives, stimulants, tranquilizers, and medications for psychiatric conditions.

Residents of “concrete jungles” may experience warmer temperatures at night due to the “heat island effect,” especially in areas with stagnant atmospheric conditions and poor air quality. During the day, concrete and asphalt absorb solar heat and dissipate it at night.

You can’t control sweltering temperatures, but there are helpful actions you can take to prevent the heat from exacerbating your CKD and harming your overall health. 

Read on as we break down the steps in managing CKD in summer for you!

Ways to Care for Your Kidney Health During Hot Weather

1. Stay Hydrated (But Not Too Much)

Old Man Drinking Water

Too much of anything can do more harm than good. The same holds true when it comes to fluid intake among CKD patients. 

It may be tempting to drink more than usual to quench your thirst on a hot summer day, but you still need to limit your fluid consumption. Remember that drinking plenty can overwork your kidneys and cause electrolyte imbalances.

When you’re on a renal diet, choosing the right beverages is equally as important as regulating your fluids. Consider these fluids when managing your CKD in summer:

  • Water - Ideally, everyone should drink 8 glasses of water everyday. However, this amount can be too much for your impaired kidneys to process. Excess fluids can build in your system and may result in edema. Daily water intake will vary for every person based on one’s age, climate, and health condition. Consult with your doctor/dietitian to know the specific amount you’re allowed to drink based on your CKD stage.
  • Cranberry juice - Craving for some juice? Cranberry is a great choice. It’s healthy for your kidneys, too. When diluted in water, cranberry juice can bring down the phosphate and oxalate levels in your urine, minimizing the risk of kidney stones formation.
  • Ginger ale - This delightful mixture of ginger and carbonated water is gentle to your kidneys. It’s also great for easing up digestion, inflammation, and nausea. Alcohol is bad news for your kidneys, so switch up alcohol with a glass of ginger ale when you want to cool down on a hot day. 

Check out this article on kidney-friendly beverages for more ideas.

2. Stick to a Kidney-Friendly Diet While Cooling Down.

Take advantage of this time to nourish your body with the right vitamins and nutrients from kidney-friendly food sources. By kidney-friendly, we mean foods that have low sodium, phosphorus, potassium, and protein content.

Fruit and vegetables are your go-to source for nourishment. Besides being rich in a wide gamut of vitamins and nutrients, they have the highest moisture content and have a cooling effect to the body.

The following are examples of fruits and vegetables you can eat that are good for your kidney health:

Fruits

CKD-friendly food

Healthy food clean eating selection: fruit, vegetable, seeds, superfood, cereal, leaf vegetable on gray concrete background

  • Grapes
  • Cherries
  • Plums
  • Peaches
  • Strawberries
  • Watermelon
  • Blueberries

Vegetables

  • Carrots
  • Cucumber
  • Celery
  • Lettuce
  • Eggplant
  • Cauliflower
  • Onion
  • Garlic

If you feel snacky and have an aversion to a rigid plant-based diet, here are quick snack ideas that are also easy on your kidneys. Still, you need to watch your protein limits for the day. These foods consist of common items often found in the fridge and pantry:

  • A slice of fruit pie, like apple or cherry pie
  • Two rolls of vanilla wafers, unsweetened cookies, and unsalted pretzels
  • A serving of fresh fruit, such as strawberries, blueberries, raspberries, and grapes
  • A serving of fresh vegetable, such as red leaf lettuce and red bell peppers, slightly spread with or dipped in hummus.

To learn more about the specific vitamins and nutrients these snacks contain and why they’re beneficial for your kidney health, read more about these healthy snack ideas.

Making adjustments to your dietary habits can be challenging from the get-go, but it’s an essential step towards preserving your kidney functions (and delaying dialysis).

3. Be Extra Mindful of Your Desserts!

Strawberry Smoothie

Eating ice cream or chilled yogurt is, without a doubt, the most pleasurable way to beat the stifling heat. However (at the risk of being buzzkill), people with CKD need to go easy on desserts. 

Ice cream and yogurt, which happen to be considered as the most popular summer desserts by many, are rich in potassium and phosphorus. A serving or two of these summer staples can hurt your kidneys.

If you really should indulge your cravings, the National Kidney Foundation (NKD) suggests that you pick simple desserts with minimal ingredients (ones that don’t require toppings and extra flavoring). 

Desserts with elaborate preparations tend to have hidden potassium and phosphorus. These include chocolate, cream cheese, nuts, and of course, ice cream.

If the craving gets overwhelming, try to eat a small amount (just enough to cure the craving) then share the rest with somebody.

There are kidney-friendly dessert alternatives you can consider when your taste buds are crying for some sweets.

4. Exercise.

Seniors Exercising

Don’t let the heat stop you from engaging in physical activities this summer. 

Exercise is also believed to slow down the progression of kidney disease. A pilot study conducted by renal physiotherapists at King’s College London suggests that patients with stage 3 to 4 CKD who do aerobic and resistance exercises can experience a “slower decline in kidney function” and “better-improved” kidney function after 12 months of consistent exercise training.

Clinical studies suggest that routine physical activity can reduce the risk of chronic disease and improve mental well-being

In addition, exercise also:

  • Increases your energy

  • Improves your muscle strength and function

  • Improves blood pressure control

  • Reduces levels of blood lipids

  • Helps manage blood sugar and insulin levels

  • Induces better sleep
  • Better body weight control

Note: Before you engage in any physical activity, make sure to consult your doctor/nephrologist first. They will help you design an exercise routine that takes into consideration your kidney condition and fitness level.

ALWAYS begin with warm-up exercises (e.g. walking for a good 10 minutes) prior to performing your workout routine. Cool down with some stretching exercises to relax your body and normalize your heart rate.

A good workout plan for Chronic Kidney Disease patients should consist of three types of exercises: aerobic, resistance, and stretching.

  1. Aerobic/cardiovascular exercises (3 or 4 days each week) - These physical activities target your heart, lungs, and blood vessels, but they can greatly benefit your whole body. Top examples of these include walking, running, swimming, dancing, and cycling. 
  2. Resistance exercises (2 to 3 days a week) -These types of exercises aim to strengthen the different muscles in your body.
    Resistance-based workouts are helpful for kidney patients who are experiencing muscle weakness. Building your muscles helps boost your endurance to do other exercises and perform everyday activities. Regular resistance exercises also help in strengthening your core muscles to improve your balance. You can do resistance training by lifting weights slowly and controlling your movements. When doing this at home, choose any weight that you can lift 8- to 12 times (ideal starting weight for beginners) before you take a rest.  Breathe normally and do not hold your breath. Avoid lifting weights above your head. Focus on your lower body muscles since these are the muscles you use often.
  3. Stretching exercises (daily, as long as they don’t wear out your body) - CKD patients need to improve their flexibility, too. Stretching exercises elongate the muscle fibers and train the joints so you can maintain a full range of movement. Increased flexibility allows you to do everyday activities with ease and without risk of injury.
  4. The proper way of stretching is to stretch a certain part of the body until you can feel the tension without feeling pain. Hold the position for about 20 to 30 seconds. 

    Maintain a good posture and breathe normally. Don’t hold your breath.

Progression is important when it comes to improving your physical fitness through exercise. The theory of exercise adaptation tells us that lifting the same weights and doing the same variations of exercises each week will keep you in the same place. To see significant progress, you need to change your workout patterns.

For example, if your body has fully adjusted to a certain exercise you’ve been doing consistently for 3 months, consider slowly increasing your intensity, duration, and frequency every week. There are many ways to progress your exercises; the key is to gradually introduce any changes to improve your strength and endurance levels over time.

Ensure that you put in ample effort to improve your health and give your body the maximum capacity to do various activities. However you want to do your exercises, it’s important that you pay attention to the needs of your body. Do not force or push yourself hard when you don’t feel well. Rest as much as you can to give your body the chance to replenish energy.

Bottomline

Never lose sight of your kidney health as summertime rolls in. Drink adequate amounts of fluids based on your doctor’s advice. 

Being conscious of your eating and drinking habits remains to be the best way to preserve your kidney health. Remember to limit your sodium, phosphorus, potassium, and protein intake to avoid straining your kidneys. 

Lastly, engage in physical activities you enjoy to strengthen your body like dancing or aqua aerobics. Tag your friends or family members to make it more fun!

To make the most of your summer without compromising your kidney heath, keep in mind the steps outlined. 

If you wish to learn more expert-certified tips to better care for your kidney health throughout the year, get in touch with the kidney care specialists at RenalTracker. It’s our goal to equip you with the right knowledge and support to manage your kidney disease!