8 Key Things to Know Before Taking Supplements

Getting enough nutrients every day is important for health. Nutrients give you the energy to complete daily tasks, build muscle, repair body tissue, prevent infection and maintain a healthy weight. The “key” nutrients are protein, calories, vitamins, and minerals. Your body needs all of these every day. 

Most people get enough nutrients by eating a wide variety of foods each day. However, if you have kidney disease or kidney failure, you may need to limit some foods that would normally give you enough nutrients for good health. Also, kidney disease and kidney failure can change the way your body processes certain nutrients, so supplements can help ensure that you’re getting all of the nutrients you need. Many supplements are available, but some are made just for people with kidney disease, diabetes, or kidney failure.

It’s very important to check with your healthcare provider or dietitian before taking any supplements because some can actually be quite harmful to people with kidney disease or kidney failure. Your healthcare provider can tell you which specific supplements are right for you. Here are 8 key things to know:

1. Supplements span a wide spectrum. The supplement market is a multi-million dollar business and nutritional supplements include a broad range of products. Some are available over the counter, while others require a prescription. Some supplements have a lot of protein and calories, the nutrients that help you gain weight. There are also bodybuilding supplements, and on the other end of the spectrum, weight loss supplements. Supplements can be for single nutrients, such as vitamin D or iron, or multiple nutrients, such as a multivitamin. Herbal products also fall under the umbrella of nutritional supplements.
    
2. Heed caution. Even if you don’t have kidney disease, you should talk with your healthcare provider before taking any nutritional supplements in order to find theone(s) that might be right for you. The Food and Drug Administration (FDA) is not authorized to approve dietary supplements for safety and effectiveness before they are marketed, and some products can be dangerous for people with kidney disease. Supplements for weight loss, bodybuilding, or an “energy boost” should not be used by people with kidney disease or kidney failure. You may hear a friend or family member claim an herbal supplement has improved their health or well-being. While this advice may be okay for them, it can be dangerous for you, because some herbal products can harm your kidneys and actually make kidney disease worse.
    
3. Nutrients can build up in your body. Damaged kidneys cannot clear waste products that build up in the body, so as kidney disease progresses, certain nutrients may accumulate. Potassium is a clear example of this problem. With kidney disease, it is very important to check your blood levels of potassium. If your level is high, you should stop taking any supplements with added potassium.
    

4. You’re unique, so your supplement regimen should be too. Everyone with kidney disease or kidney failure doesn’t have the same dietary needs. For example, you may need less protein, whereas someone else might need extra protein. Or, you may need extra calories, but someone else might need fewer calories. It’s important that you work with your dietitian or healthcare provider to choose the right supplements for you based on their recommendations.

5. Your diet can offer clues. A dietitian will ask you about the foods you eat in order to determine which supplements may help you. You may also be asked to keep a "food diary." In addition to the physical exam your healthcare provider may perform, your dietitian may also do a physical exam to check your nutrition.  Your dietitian will also review your lab work and your medication list. You can learn more about the tests your healthcare team will use to check your nutrition status by calling the National Kidney Foundation’s NKF CARES at 855.NKF.CARES (855.653.2273) or by visiting www.kidney.org.
    
6. Supplements come in many shapes, sizes, forms and flavors. Many people are familiar with liquid supplements in the form of special drinks, shakes or juices that have protein, calories, vitamins, and minerals. There are liquid supplements just for people with kidney disease, but you must check with your healthcare provider before taking them, especially if you are on a fluid restriction. There are also puddings, bars, cookies and other foods that can be used instead of liquids. If you are not well nourished, then your social worker may be able to help you get these supplements through your insurance.
    

7. Stick with the science. And, we mean science specific to you. Nutritional supplements are given to patients with kidney disease in a very careful manner. Blood work, urine testing and a physical exam are needed to determine whether or not you are getting enough nutrients. From the results of these tests, your healthcare provider can determine which supplements make the most sense for you. You may also need to see a dietitian with special training in kidney disease. 
    

8. Special kidney-safe supplements exist. There are supplements, vitamins, and mineral pills especially tailored for patients with kidney disease. These supplements provide only what your healthcare provider knows you need. As a result, you may need a prescription to order them since they will not contain specific nutrients that you would find in over-the-counter (OTC) products. This way, there is no danger of unwanted nutrients building up in your body and causing harm. Some of these special supplements do not have extra protein and calories. Many vitamin and mineral pills can also be reimbursed by your insurance when they are ordered with a prescription.

At any stage of kidney disease, talk with your healthcare provider before you take any kind of nutritional supplement.

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