Inflammation is a natural immune response that occurs when the body’s white blood cells and immune chemicals mobilize to protect against infections and foreign substances, such as bacteria, viruses, and injuries.

There are two types of inflammation:

1. Acute Inflammation: This type occurs briefly in response to an immediate threat.
2. Chronic Inflammation: This form persists over an extended period and may not resolve.

While inflammation is a crucial defense mechanism when the body faces a threat, it can also occur when there’s no apparent danger. In such cases, inflammation can harm the body and contribute to conditions like rheumatoid arthritis, hay fever, and atherosclerosis. For individuals with chronic kidney disease (CKD), chronic inflammation can increase the risk of cardiovascular disease and even mortality.

Causes of Inflammation in CKD

Inflammation in CKD can result from various factors, including:

– Poor nutrition due to a reduced appetite
– Infections in dialysis vascular access
– Gum disease or inadequate dental health
– Foot ulcers
– Anemia
– Uremia (accumulation of waste in the blood)
– Non-functioning transplanted kidneys

Other factors contributing to inflammation, affecting individuals with or without CKD, comprise lingering infections, exposure to toxins, pollutants, insomnia, lack of physical activity, and obesity—particularly excess abdominal fat.

Identifying Inflammation

Symptoms of acute inflammation may resemble flu-like symptoms and encompass:

– Redness
– Fever
– Chills
– Swollen joints that feel warm
– Fatigue
– Muscle stiffness
– Loss of appetite
– Headaches

People with CKD might not experience all these symptoms and may face additional challenges like anemia, anorexia, muscle loss, and weakness.

To diagnose chronic inflammation, healthcare providers rely on various laboratory tests.

Malnutrition, Inflammation, and CKD

In individuals with kidney disease, malnutrition and chronic inflammation are interconnected. Eating difficulties are common among kidney disease patients, particularly those with end-stage renal disease (ESRD) undergoing dialysis. Reduced appetite leads to inadequate calorie and protein intake, eventually resulting in protein-energy malnutrition (PEM). This condition leads to weight loss and muscle wasting as the body breaks down muscles to supply essential proteins for vital functions. Medical professionals and dietitians assess albumin levels to gauge the severity of PEM.

Prevention and Treatment of Inflammation in CKD

Preventing and treating inflammation in individuals with CKD often begins with a healthy, kidney-friendly diet. To prevent malnutrition and address inflammation, focus on sufficient calorie and protein intake and consume foods rich in antioxidants. High-quality protein sources include:

– Fish
– Poultry (e.g., chicken breast)
– Lean red meat
– Low-cholesterol egg products
– Eggs or egg whites
– Soy products (check sodium, potassium, and phosphorus content)

Foods high in antioxidants include:

– Fish rich in omega-3 fatty acids
– Olive oil
– Red bell peppers
– Cabbage
– Cauliflower
– Garlic
– Onions
– Apples
– Cranberries
– Blueberries
– Raspberries
– Strawberries
– Cherries
– Red grapes

Incorporating fish into your diet two to three times a week can help combat inflammation, thanks to the anti-inflammatory properties of omega-3 fatty acids found in fish. Omega-3-rich options include albacore tuna, herring, mackerel, rainbow trout, and salmon. Fish oil supplements may also be considered to boost omega-3 intake.

A kidney-friendly diet regulates potassium, phosphorus, and sodium consumption and provides sufficient protein to deter malnutrition. Such a diet, featuring the foods mentioned above, can contribute to inflammation management.

Medical professionals may prescribe medications to address inflammation. Before taking any over-the-counter medicines, it’s crucial to consult your doctor, as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and naproxen are generally not recommended for individuals with kidney disease unless advised by a nephrologist. NSAIDs have been linked to acute kidney failure in those with diminished kidney function. Your healthcare provider can assess if NSAIDs are suitable for your situation.

Hemodialysis patients using catheters for access face an elevated risk of inflammation. Switching to a fistula or graft for access is recommended to enhance health and reduce inflammation risk.

Additional considerations for managing chronic inflammation include ensuring adequate dialysis for toxin removal, addressing anemia and vitamin D deficiency, and increasing physical activity. Obesity is associated with elevated CRP and cytokine levels, and weight loss in obese individuals can reduce inflammation by lowering these markers.