Kidney Nutrition: Hypertension and PKD
Hypertension or high blood pressure is common with kidney disease. With Polycystic Kidney Disease (PKD), high blood pressure and its complications are found at earlier ages, and higher kidney function, compared to those living with chronic kidney disease
Blood pressure is a measure of the force of the blood pumped from the heart against the blood vessels. High blood pressure occurs when there is too much pressure on the blood vessels. This extra pressure over time can cause a stroke or heart attack. May is Hypertension Month, and a great reminder to discuss the connection between blood pressure and PKD as well as some strategies to help manage blood pressure. So, let’s dive in.
Blood Pressure Goal
Higher blood pressure with PKD is related to increased activity of the renin-angiotensin system, a hormone system responsible for blood pressure control, fluid and electrolyte balance, and cyst formation and expansion. And nutrition, lifestyle changes and medications can help to manage blood pressure.
The goal for blood pressure control is less than 130/80 mmHg, but this number may differ and speaking with your healthcare team for personalized recommendations is important. A combination of medications and nutrition may be needed to manage blood pressure. Here are some lifestyle strategies to help control blood pressure.
Following a low sodium or salt diet is often recommended for those with any kidney condition. Because we know most Canadians are consuming more salt than what we truly need. In fact, the average Canadian consumes about 3500 mg salt per day. With PKD, higher sodium intake is associated with higher urine osmolality and an increased release of vasopressin hormone which causes cyst growth. With PKD it is not a no salt diet, but rather a low sodium diet and targeting 2300 mg sodium per day (or less depending on your healthcare team) to help manage blood pressure. Get started by reading food labels for low sodium products, using less salt in cooking, and eating at home more often to reduce your sodium.
Vegetables and Fruit
Increasing your vegetable and fruit intake can also help to manage blood pressure. This is one of the important aspects of the Dietary Approaches to Stop Hypertension (DASH) Diet. By aiming for half your plate in vegetables at meals and including fruit as a snack, important nutrients, like potassium and magnesium from these foods can help to manage blood pressure. With any vegetables or fruit, these are often less processed meaning lower in sodium naturally. Choosing fresh or frozen are also great additions to your diet. If you are following a low potassium diet, speaking with a renal dietitian to help you manage your potassium and nutrition needs may be helpful.
It can feel easier to just grab something on the go for lunch, but these meals are often higher in salt and lower in vegetables. Combined this can lead to higher blood pressure readings. This Mediterranean Chickpea and Couscous Lunch Bowl recipe is packed with vegetables and low in salt. It is great for a quick lunch and will keep you full. The best part about this recipe is you can prepare these bowls ahead of time to save stress during the week.
1 cup couscous, dry
2 cup low sodium vegetable broth
2 cup cucumber, chopped
1 cup grape tomatoes, chopped
½ cup red onion, chopped
1 cup orange bell pepper, chopped
2 cup arugula
2 cup no added salt canned chickpeas, drained and rinsed
1/3 cup olive oil
2 TBSP lemon juice
1/2 cup red wine vinegar
1 TBSP Dijon mustard
2 TBSP oregano
2 tsp black pepper
1. In a small pot, cook couscous with vegetable broth as directed on package. Once cooked set aside to cool.
- While couscous is cooling, wash and chop the vegetables and set aside.
- In a small bowl, mix the dressing ingredients together. Divide into 4 small meal prep containers.
- Drain and rinse the chickpeas in a colander.
- Divide the couscous equally among 4 medium meal prep containers. Then divide the chopped vegetables and chickpeas into the containers evenly.
- When ready to enjoy, add the dressing to bowls and mix well before eating.
Makes 4 Servings. Per Serving: 500 calories, 54 g net carbohydrates, 21 g fat, 14 g protein, 620 mg potassium, 179 mg sodium, phosphorus 205 mg.
Did you know: Arugula is a great low oxalate leafy green vegetable. Couscous is a medium glycemic index carbohydrate that can also be included with kidney stones. Chickpeas are a wonderful plant-based protein for those with PKD.
Physical activity in addition to routine activities of daily living can help to manage blood pressure. Aim for an accumulation of 30-60 minutes moderate intensity like walking, cycling, or swimming 4-7 days per week to help manage blood pressure. Higher intensities of exercise are no more effective at lowering blood pressure, so aim for moderate intensity. Speak with your healthcare team before starting any new activity or exercise routine.
Other Lifestyle Strategies
Of course, other lifestyle strategies like reducing alcohol consumption, stress management, and smoking cessation are also important in blood pressure management.
Are You Trying To Manage Your Blood Pressure?
Making sustainable nutrition changes is important with PKD to help with long-term success. Start with making small changes, like reading food labels or the nutrition information if eating out to determine sodium content of foods. Or perhaps you focus on your plate and aim for lots of vegetables at each meal. These small but consistent changes can help to improve your blood pressure overtime. When making nutrition changes speak with your healthcare team to determine your blood pressure and dietary sodium targets.
Written by: Emily Campbell, RD CDE MScFN is a Registered Dietitian and Certified Diabetes Educator with a Master’s Degree in Foods and Nutrition. Emily specializes in renal nutrition helping those with kidney disease overcome the confusing world of nutrition to promote health. Emily can be found at kidneynutrition.ca.