Hello PKD Warriors! Welcome to the first edition of my PKD Health & Nutrition newsletter.  PKD Pearls for you to learn from and take action on.  It just feels right to focus on bone health during Halloween Month...because if you don't support your kidney health they can't support your bones and well...that can lead to some spoooky outcomes!  🎃 👻 ☠️ 

Kidneys & Bone Health: Are They Connected?

Why Yes  — yes they are!

Your kidneys and bones are part of an intricate system that helps keep calcium, phosphorus, and vitamin D balanced in your body.  

Calcium and phosphorus are the main minerals that make up your bones.  Vitamin D functions both as a hormone helping to regulate them, but also increases absorption of calcium in your gut (that's a good thing).

Here is what your kidneys are is doing to support strong bones:

1. Activate Vitamin D, making it usable  
2. Filter excess phosphorus, keeping blood levels normal
3. Help regulate calcium levels in your blood, urine, and bones

With any decreased kidney function, a lower eGFR, this process can become inbalanced and slow down.  Over time, the result is weaker bones, higher risk for breaks and fractures, increased risk for kidney stones, and even an increased risk of heart disease.

The takeaway? Don't ignore your bone health. 

Diet & Bone Health

What you eat, and supplements you take, or don't,  can directly support stronger bones and better mineral balance. Here are a few PKD-friendly tips & tidbits:

• Check in on Calcium - how much are you getting in your diet? In general, an averagar of 1000 mg a day is a good goal.  Bump that up to 1200 mg if you are postmenopausal.

• Calcium Rich Food  — dairy, tofu, some leafy greens, fortified non-dairy milk. 

• Don’t Skip Protein. Adequate protein supports bone strength — even with PKD. The key is balance and knowing what a good amount if for you and your kidneys.

• Keep "Fake Phosporus" in Check - phosphate additives, added to processed foods, fast food, creamers, baked goods, etc. are absorbed at about 100%.  They increase your kidney workload but also puy you at higher risk of stone formation.

• Support Vitamin D - Sun exposure (hard with sunblock...), supplementation, or dietary sources (like fatty fish or fortified options) all help — if you supplement, just make sure your dose fits your lab results, goals, and has been reviewed for your stage of kidney function. 

Before you go adding a bunch of Calcium & Vitamin D supplements, know this: taken at the wrong time or at amounts that are too higher for you can create problems.  Please supplement wisely and with support from your MD and Dietitian.

Labs To Look At

Lab monitoring provides a look at how your kidneys and bones are working together. A few key labs to ask for, or discuss with your care team:

• Calcium – tells you about circulating levels, not always reflective of bone stores.  The main concern = elevated levels.

• Phosphorus – tells you blood levels, high levels can signal reduced kidney removal. The main concern = elevated levels.

• Parathyroid Hormone (PTH) – if this hormone gets too "juicey" it will pull calcium from your bones.  If you are Vitamin D deficient...or on the lower end, PTH will increase. 

• Vitamin D (25-hydroxy) – measures Vitamin D, helps guide if supplementation is needed and how much.  Do note, the "normal" Vitamin D levels listed on your labs aren't optimal.  

• Alkaline Phosphatase (ALP) – can indicate changes in bone turnover.  The main concern = elevated level.  

If you’re seeing shifts in these labs, that’s your cue to talk with your healthcare team — diet, medication, and lifestyle adjustments can all make a big difference in your future bone health.

Take Action NOW

1. Check in on how much calcium, on average, you are getting.  
2. Look at your lab trends, no PTH or Vitamin D - ask for them!
3. Add a calcium rich food or dish to next week's menu.
4. Looking for a nutrition deep dive, including a bone health check-in, hop on a connect call with me & explore options for working together.

From Diana, The PKD Dietitian 💌

Bone health doesn’t get enough attention in the PKD world — but it deserves it. October is National Osteoporosis Awareness Month, so take this as your reminder to review your labs, add a calcium-rich recipe to your rotation, and keep building strong foundations for long-term kidney and bone health.