Mortality in Lupus Patients Does Not Differ By Dialysis Type

Lupus affects mainly the joints, kidneys and skin.  It can affect the skin, joints, kidneys, lungs, nervous system and other organs of the body. These symptoms vary over time in intensity and duration for each patient as well as from patient to patient. Many of these interventions can be modified for the hospitalized patient.

The mortality risk among patients with end-stage renal disease (ESRD) and lupus is similar regardless of their initial dialysis modality, according to a new study.

Gabriel Contreras, MD, of the University of Miami Miller School of Medicine, and colleagues used propensity score matching to create 1,352 matched pairs of patients with ESRD patients and systemic lupus erythematosus (SLE) who started hemodialysis (HD) or peritoneal dialysis (PD). The matched pairs were mostly women (86%) with a median age of 39 years. The median follow-up period was 3 years.

The HD and PD groups had overall mortality rates of 22.5% and 21.4%, respectively, within the first 3 years of observation, a non-significant difference between the groups, investigators reported online ahead of print in the Clinical Journal of the American Society of Nephrology. The matched pairs also had similar cardiovascular-related mortality rates (9.5% in the HD group, 10.5% in the PD group) and infection-related mortality (4.4% in the HD group and 3.0% in the PD group).kidneyhospitalabroad@hotmail.com.

Can We Treat SLE with Special Foods or Diets

Unfortunately, there are few well-conducted studies regarding the treatment of SLE with foods. From animal studies, we know that restricting the amount of calorie (the amount of energy in food) eaten tends to prolong life and reduce heart disease in mice. There are special mice that develop a condition similar to SLE. When they are fed a diet rich in polyunsaturated fat, they developed less kidney damage and lower antibody levels. Polyunsaturated fat is found in vegetable oils, like margarine and corn oil, while saturated fat is found in food made from animals, like lard, ghee and butter. We also know that too much or too little iron in the body can worsen kidney damage and shorten life in rats. One study in humans found that polyunsaturated fat diet improves the blood chemical tests in twelve lupus patients, but they remained the same from other points of view.

In summary, there is no evidence that special foods or diets can be used to treat SLE. However, the lessons learnt from animals are generally useful: we should have enough iron and polyunsaturated fat and we should not overeat. It is not clear if these help treat SLE, but they are good practices anyway.

How, then, should a lupus patient eat? The key is to take a healthy diet, just like anybody else. The Food Guide Pyramid from the United States Department of Agriculture (USDA) provides some good concepts for us to follow. It suggests the number of servings of each food group we should consume in a day. Going from the bottom of the Pyramid upwards, we should consume 6 to 11 servings of the carbohydrate group (bread, cereal and rice), 2 to 4 of the fruit group, 3 to 5 of the vegetable group, 2 to 3 of the meat group and we should use very little oil and fat. What is a serving? Well, it is difficult to define but examples of a serving each are a slice of bread, one cup of raw leafy vegetables, three-quarters cup of fruit juice, two to three ounces of cooked lean meat, poultry or fish.

If you are interested in the efficient treatment for SLE or if you are suffering from the complications of SLE, remember that we are here to help.

Lupus: Fish, Omega Vitamins, Soy Milk

Diet and nutrition guidelines for people with lupus are not different than for anyone else. In general, people with lupus should try to eat a nutritious, well-balanced, and varied diet that contains plenty of fresh fruits and vegetables, whole grains, moderate amounts of meats, poultry, and oily fish.In order to increase the amount of omega 3 fatty acids in your diet, there are alternatives to fish. Walnuts/walnut oil or flax seeds/flax seed oil are some of the best sources. In fact, these foods are as good as fish!

Soy products are high in isoflavones, a type of phytoestrogen, and have estrogenic activity in the human body. There is relatively little research on the effects of a soy diet on lupus. One animal study from Japan that was conducted within the past several years found that mice put on a diet high in soy had a worsening of the clinical course of lupus, but another more recent study (also in mice) found that not only did soy isoflavones not lead to worsening of lupus, the disease may actually have been improved. What this means is that the "jury is still out" on the effects of a diet high in soy. Keep in mind that the studies mentioned here were conducted in animals; not humans. So while there is the potential for large quantities of soy to contribute to a worsening of your disease, smaller amounts are probably OK. Talk with your health care provider about your specific situation though.

Lastly, it is common for people with autoimmune diseases such as lupus to be anemic (low hemoglobin). In general, foods high in iron should be included as a regular part of your diet. Specific recommendations may vary depending on your particular disease, but the best sources of iron are red meat (other meats are good too), legumes, iron-enriched breads and cereals, and green leafy vegetables. Iron absorption is increased if you consume it along with a vitamin C source – try an enriched cereal with orange juice in the morning!

If you still want to know more about diet for lupus or related information about complications of lupus, you can send us an email to doctornickzhang@hotmail.com or you can leave us a message.

Are There Certain Foods that Aggravate Lupus Symptoms

One food that should be avoided is alfalfa. Alfalfa supplements have been associated with lupus flares, perhaps because of the amino acid L-canavanine which can increase inflammation. Other foods that are sometimes mentioned as ones to avoid include ‘night shade’ vegetables (potatoes, tomatoes, eggplants and peppers), but there is only anecdotal evidence that they may increase inflammation. Scientific evidence has not suggested that these vegetables aggravate disease symptoms. In general, unless a particular food seems to trigger a lupus flare, there is no reason to avoid most foods. Foods that seem to trigger a flare vary greatly from person to person, so a food that causes problems for one person may have no effect on you. There is no ‘lupus diet’ of foods that either should or should not be consumed, unless someone has kidney damage and has been advised to limit their protein intake.

If you still want to know more about diet for lupus, you can leave us a message or send us an email to doctornickzhang@hotmail.com. Moreover, we have to say that lupus can affect many organs in the body, once your notice your high creatinine levels, you should know that only reasonable diet is not enough to help you control the condition well.