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meet Nancy a 63-year-old woman who
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decided to improve her diet she had a
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habit of snacking on chips in the
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evening so she decided to swap out the
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chips for a healthier option but little
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did she know that her choice of snack
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would cause her kidneys to start
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shutting down and affect the rest of her
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life weeks went by and Nancy started
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feeling more and more exhausted no
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matter how many cups of coffee she had
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she just felt like she was dragging
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herself through the day so she went to
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her doctor who ordered some blood work
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when Nancy looked up her results she was
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surprised to see that her kidney
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function was highlighted in red and
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labeled as abnormal that's weird just 8
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months ago her lab work was completely
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normal the next day Nancy got a call
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from her doctor's office asking her to
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repeat the blood work hopefully it was
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just a lab error nope the lab results
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came back showing the same thing ny's
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kidneys were filtering at a rate of only
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25% of a normal kidney at this rate it
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won't be long until their kidneys aren't
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working at all so the big question is
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what's causing this kidney damage and
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can it be
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reversed okay so when I'm approaching a
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patient with new kidney disease I always
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think about three main categories of
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possible causes first is there enough
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blood getting pumped to the kidney in
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other words is the person dehydrated or
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do they have a problem with their heart
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or their liver second is there a problem
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with the kidney itself now this is a
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really long list everything from high
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blood pressure to cancer or lupus and
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third is something blocking the urine
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from coming out of the kidney causing a
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backlog of pressure in men we often
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think about the prostate but that's not
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an issue for Nancy so now the Hunt is on
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to figure out which of these conditions
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is affecting nany's kidney function she
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went to see a kidney specialist who
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listened to her story and reviewed all
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the investigations that had been done so
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far there were no signs of dehydration
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heart or liver disease and an ultrasound
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of the abdomen was normal with no signs
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of a blockage so it looks more like a
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problem with the kidney itself but
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here's what's odd usually when the issue
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is inside the kidney itself you find
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Clues within the urine sample like high
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protein levels because the kidney
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filtration system is damaged or
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misshapen red blood cells because of an
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inflamed kidney but surprisingly nany's
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urine was pristine with no blood and no
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protein as an aside there are a lot of
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things that you can learn about your
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health just by looking at your urine so
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if you want to learn more about
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practical things to watch out for then
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take a look at this video next ny's
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doctor ordered more tests they looked
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for narrowing of her blood vessels
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autoimmune diseases she even had a bone
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marob biopsy to rule up cancer and
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everything came back normal 3 months
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went by and her kidney function
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continued to deteriorate now her kidneys
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were only functioning at 20% of normal
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capacity things were getting dire with
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no time to waste Nancy had a kidney
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biopsy this allowed her doctors to
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actually examine a tiny piece of her
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kidney under the microscope to try to
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find a clue at first glance it just
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looked like General kidney damage
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nothing to really help with the
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diagnosis but then they expose the
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specimen to polarized light and this is
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what they saw notice how it looks like
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someone sprinkled glitter on the kidney
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well those are actually calcium oxalate
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crystals and that's what's damaging ny's
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kidneys it's a condition called
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nephrocalcinosis nefro for kidney and
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calcinosis meaning calcium deposition
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and for those of you who are thinking
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isn't that the same as kidney stones the
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answer is no while kidney stones can be
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formed by calcium oxalate crystals the
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difference lies in where the crystals
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form think of it like this if crystals
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form inside the urine it can form kidney
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stones but if the crystals form inside
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the kidney itself it can cause kidney
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damage without actually forming any
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stones and the reason that stones form
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in some people and not in others seems
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to be related to the immune system okay
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so now we know what's wrong with nany's
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kidneys but we still have to figure out
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why her body is forming these calci
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oxalate crystals so Nancy met with a
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dietitian at the Kidney Clinic who asked
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her to go through what she typically
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eats for each meal oatmeal and coffee
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with milk for breakfast an omelette on
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toast for lunch and meat and potatoes
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for dinner pretty classic what about
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snacks Nancy confidently explained that
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she used to eat lots of chips and
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popcorn for snacks but now she had
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switched the healthier option she was
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eating cashews about 1 kilogram of
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cashews per week now don't get me wrong
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1 kogam of cashews a week is a lot it's
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definitely an expensive snack but it
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just doesn't strike me as an absurdly
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large amount that would cause two organs
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to fail so could there be something else
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going on ny's dietitian did a few
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calculations which revealed two things
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ny's diet was high in oxalates and very
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low in calcium and further testing
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confirmed it her urine was full of
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oxalates and very low in calcium that's
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the worst combination and it's the key
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to this entire case and to understand
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why we need to talk about oxalates so
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first what are they so oxalates are
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natural compounds that are found in so
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much of our Foods fruits vegetables
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grains and nuts the strange thing is
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that they don't seem to provide us with
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any nutritional benefits and they can
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cause issues which is why they're often
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called anti-nutrients and that's usually
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not an issue because only about 10% of
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the oxalates in your food actually get
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absorbed into your body that is as long
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as you're eating enough
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calcium that's because calcium binds to
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oxalate which prevents it from getting
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absorbed and then it just passes through
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your system without causing any issues
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don't you love when the pieces of the
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puzzle start coming together so Not only
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was she eating a diet high in oxalates
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mainly because of her cashews but she
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was also absorbing so much of it because
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she was lacking calcium and oxalates
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aren't as bad for the kidneys over time
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when they build up they can deposit in
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areas like the brain and the nerves
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so what happened to Nancy well she
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immediately stopped eating cashews and
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started tracking her oxalate intake she
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soon learned that almonds actually have
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way more oxalate in them than cashews so
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it's a good thing she didn't choose
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those to snack on Nancy also increased
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her water intake to stay well hydrated
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and finally she added a calcium
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supplement to her meals as an oxalate
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binder so now if you're examining your
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own diet make sure that you're getting
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around 1,000 to 1200 Mig of calor
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per day depending on your age and gender
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ideally it's best to get it through your
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diet things like dairy products broccoli
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or fortified beverages but if you're
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allergic to dairy products like me or
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you choose not to eat them then you may
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need to take a calcium supplement to
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make sure you're getting your daily
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requirements and if you're not sure then
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chat with your healthcare provider okay
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back to Nancy so after just 2 months of
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making these changes her oxalate levels
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completely normalized and her kidney
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function significantly improved
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unfortunately her kidney function never
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completely normalized so ny's left with
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mild chronic kidney disease for the rest
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of her life so the moral of the story is
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everything in moderation because even
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too much of a healthy snack can be
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dangerous just promise me that you're
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not going to leave this video thinking
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that you need to cut out all high
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oxalate foods from your diet you really
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only need to focus on limiting them if
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you have a medical condition where it's
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necessary like Nancy instead focus on
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eating a balanced diet with enough
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calcium and plenty of water to prevent
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kidney stones fruits vegetables nuts and
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grains are healthy they're packed with
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vitamins minerals fiber that you need so
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don't write them off just because
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they've got some oxalates in them and if
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you're still not convinced then watch
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this video next where a woman cut out an
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important part of her diet and something
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pretty dramatic happened this video was
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based on an article published in the
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Canadian Medical Association Journal so
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if you want to learn more I'll leave a
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link in the description be sure to
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subscribe and that way I'll see you in
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the next video so bye for now now
