Chronic Kidney Disease & Renal Failure
Chronic kidney disease (CKD) has been a major focus of my clinical practice and has particular personal significance, originating from my own diagnosis with a rare genetic kidney disorder as a teenager. I therefore bring both clinical experience and a personal understanding of living with kidney disease to my work with people across the spectrum of CKD — from early-stage disease through advanced renal failure, dialysis and kidney transplantation.
Kidney disease is complex, and nutritional and complementary medicine requirements can change considerably as renal function declines. My approach is individualised according to the underlying kidney condition, stage of disease, pathology results, medications, nutritional status and current medical treatment.
Care may incorporate individualised renal nutrition, nutritional and herbal medicine, food as medicine and lifestyle interventions, alongside consideration of cardiovascular and metabolic health, inflammation and immune function, and gut and microbiome health. There is no single “kidney diet” appropriate for everyone; requirements for protein, sodium, potassium, phosphorus, fluid and overall nutrition need to be considered within the individual's clinical circumstances.
Complementary Medicine & Kidney Safety
People with impaired kidney function require particular care when using herbal medicines and nutritional supplements. Reduced renal function can change the safety and suitability of complementary medicines, while interactions with medications and the potential accumulation of substances normally cleared by the kidneys also need to be considered.
For this reason, treatment is selected and regularly reviewed according to kidney function, pathology, medications and stage of disease. My approach is designed to integrate with conventional renal care, with ongoing involvement from your nephrologist, GP, renal dietitian and other members of your healthcare team encouraged.
Early-Stage Kidney Disease
Early-stage chronic kidney disease (CKD) generally includes stages 1–3, where kidney function may still be normal or only mildly to moderately reduced. CKD may be identified through changes in eGFR, protein or albumin in the urine, or other evidence of kidney damage before significant symptoms develop.
This can be an important stage to address modifiable factors contributing to kidney disease and support long-term kidney and cardiovascular health. Naturopathic care is individualised according to the underlying kidney condition, level of kidney function, pathology results, medications, diet and other health conditions.
Areas of focus may include:
Individualised renal nutrition — including appropriate protein intake, sodium, overall dietary quality and other nutrients according to kidney function and pathology.
Blood pressure and cardiovascular health — addressing modifiable cardiovascular risk factors that are closely interconnected with kidney health.
Blood glucose and metabolic health — particularly where diabetes, insulin resistance or other metabolic factors are contributing to kidney disease.
Inflammation and immune function — including consideration of immune and inflammatory processes in conditions such as IgA nephropathy and other glomerular diseases.
Gut and microbiome health — considering gastrointestinal health and the gut–kidney axis where clinically relevant.
Nutritional and herbal medicine — carefully selected according to kidney function, medications, pathology and individual clinical requirements.
Lifestyle and environmental factors — including physical activity, sleep, stress, smoking, alcohol and relevant environmental exposures.
Importantly, people with early-stage CKD do not necessarily require the same dietary restrictions as those with advanced kidney disease. Protein, sodium, potassium, phosphorus and other dietary recommendations should be individualised rather than applying a generic “kidney diet”.
Care is designed to integrate with the management provided by your GP, nephrologist and other members of your healthcare team.
Advanced Kidney Disease & Renal Failure
Advanced chronic kidney disease (CKD), generally stages 4–5, occurs when kidney function has become significantly reduced. At this stage, declining renal function can affect fluid and electrolyte balance, nutritional requirements, cardiovascular health, energy levels and many other body systems. Some people remain relatively well despite very low kidney function, while others experience an increasing range of symptoms and complications.
Management becomes increasingly individualised as kidney function declines. Naturopathic care is designed to work alongside nephrology and conventional renal care, taking into account the underlying kidney disease, current eGFR and pathology, medications, symptoms, nutritional status and whether dialysis or kidney transplantation is being considered.
Areas of focus may include:
Individualised renal nutrition — balancing adequate nutrition with appropriate protein, sodium, potassium, phosphorus and fluid intake according to kidney function, pathology and medical treatment.
Maintaining nutritional status — supporting adequate energy and nutrient intake while reducing the risk of unnecessary dietary restriction, malnutrition and loss of muscle mass.
Cardiovascular and metabolic health — including blood pressure, glucose regulation and other cardiovascular risk factors that commonly accompany advanced CKD.
CKD-related symptoms and quality of life — addressing factors that may contribute to fatigue, poor appetite, nausea, gastrointestinal symptoms, sleep disturbance, itching, muscle symptoms and reduced wellbeing.
Gut and microbiome health — considering gastrointestinal function, constipation and the gut–kidney axis, including the increased burden of gut-derived uraemic metabolites as kidney function declines.
Nutritional and herbal medicine — carefully selected and adjusted for impaired kidney function, medications, electrolyte abnormalities and the altered clearance that occurs in advanced CKD.
Preparation for dialysis or transplantation — supporting nutritional status, general health and lifestyle as part of the broader medical preparation for renal replacement therapy when required.
Advanced CKD requires particularly careful use of supplements, herbal medicines and dietary interventions. Treatments that may be appropriate in earlier kidney disease may become unsuitable as renal function declines, making regular review of pathology, medications and treatment essential.
Care is provided alongside your nephrologist, GP, renal dietitian and other members of your renal healthcare team
Dialysis Support
Dialysis is a life-sustaining treatment for people with kidney failure, but it also introduces a different set of nutritional, metabolic and lifestyle challenges. People receiving haemodialysis (HD) or peritoneal dialysis (PD) may experience fatigue, changes in appetite and nutritional status, gastrointestinal symptoms, sleep disturbance, muscle cramps, itching and difficulties managing fluid, potassium and phosphorus.
Naturopathic care during dialysis is individualised according to the type and frequency of dialysis, pathology results, medications, residual kidney function, nutritional status, symptoms and other health conditions. The aim is to support overall health, nutrition and quality of life alongside the treatment provided by your nephrologist and renal team.
Areas of focus may include:
Dialysis-specific nutrition — individualising protein and energy intake while managing sodium, potassium, phosphorus and fluid according to dialysis requirements, pathology and nutritional status.
Maintaining muscle mass and nutritional status — addressing the increased protein requirements and risk of protein-energy wasting that can occur once dialysis has commenced.
Residual kidney function — considering strategies to support overall kidney and cardiovascular health while recognising the clinical importance of preserving remaining kidney function for as long as possible.
Dialysis-related symptoms and quality of life — addressing factors that may contribute to fatigue, poor appetite, nausea, constipation and other digestive symptoms, muscle cramps, itching, sleep disturbance and reduced wellbeing.
Gut and microbiome health — supporting gastrointestinal function and considering the gut–kidney axis within the particular dietary and medical requirements of dialysis.
Nutritional and herbal medicine — carefully selected according to dialysis modality, medications and pathology, with particular attention to electrolyte balance, accumulation and altered clearance in kidney failure.
Cardiovascular and metabolic health — supporting broader factors such as blood pressure, glucose regulation and cardiovascular health, which remain important during dialysis.
Dialysis does not mean that nutrition and lifestyle become less important; rather, nutritional requirements change considerably once treatment begins. Recommendations appropriate for someone with advanced CKD before dialysis may no longer be appropriate after dialysis has commenced, particularly in relation to protein and energy requirements.
Complementary care is designed to work alongside dialysis and the management provided by your nephrologist, renal dietitian, dialysis unit and other members of your healthcare team.
Transplant Support
Kidney Conditions I Work With
Kidney transplantation brings a significant change in nutritional and healthcare needs. The priorities during the early post-transplant period are different from those during dialysis and change again as recovery progresses and longer-term transplant health becomes the focus. Nutrition and complementary medicine therefore need to be carefully individualised according to kidney function, pathology, medications and stage of recovery.
Particular care is required with nutritional supplements, herbal medicines and even some foods following transplantation. Immunosuppressant medications can have clinically significant interactions, and inappropriate complementary medicines may alter medication levels or increase the risk of adverse effects. Any complementary treatment should therefore be carefully assessed and used in collaboration with your transplant and medical team.
Areas of focus may include:
Post-transplant nutrition — transitioning from dialysis-specific dietary requirements and supporting adequate protein, energy and nutrient intake during recovery.
Long-term kidney health — developing an individualised dietary and lifestyle approach that supports the health and function of the transplanted kidney over the longer term.
Medication and supplement safety — reviewing supplements, herbal medicines and relevant food interactions alongside immunosuppressant and other post-transplant medications.
Cardiovascular and metabolic health — addressing blood pressure, glucose regulation, lipids, weight and other cardiometabolic factors that can become particularly important following transplantation.
Gut and microbiome health — supporting gastrointestinal and microbiome health where appropriate while taking into account immunosuppression, medications and infection risk.
Nutritional and herbal medicine — where appropriate, carefully selecting complementary medicines according to kidney function, pathology, medications and the individual requirements of the transplant recipient.
Living Kidney Donors
Complementary care may also be appropriate for people preparing to become living kidney donors and following donation. Nutrition and lifestyle strategies can support general health and recovery while helping to address the long-term health of the remaining kidney. Any complementary medicine used around the time of donation should be coordinated with the donor's medical and transplant team.
Kidney transplant recipients require particularly careful complementary prescribing. Care is designed to work alongside your transplant nephrologist, transplant team, GP, dietitian and other healthcare providers rather than replacing or modifying prescribed transplant treatment..
I work with people across a broad range of kidney diseases and stages of renal impairment. The approach to nutrition and complementary medicine is individualised according to the underlying diagnosis, level of kidney function, pathology, medications and current medical treatment.
Conditions I commonly work with include:
Chronic kidney disease (CKD), stages 1–5
Diabetic kidney disease
Hypertensive kidney disease
IgA nephropathy (Berger disease)
Polycystic kidney disease (PKD)
Focal segmental glomerulosclerosis (FSGS)
Minimal change disease
Glomerulonephritis
Nephrotic syndrome
Lupus nephritis and autoimmune kidney disease
Renal tubular disorders and renal tubular acidosis
Recurrent kidney stones
Acute kidney injury and recovery following acute kidney injury
Advanced kidney disease and end-stage renal failure
Haemodialysis and peritoneal dialysis
Kidney transplantation
I also work with people preparing for dialysis or kidney transplantation, those living with a kidney transplant, and living kidney donors before and following donation.