The harms of regular soda consumption have been well-documented over the past many years linking them to promoting obesity, dental cavities and inflammation in the body.  Because of a strong public health push to reduce the consumption of regular soda, the sales of these beverages have taken a hit.  But diet sodas are not necessarily the answer or what people should switch to when replacing regular soda, and particularly not for someone with end-stage renal disease.

End-stage renal disease, also known as kidney failure, is the last stage of chronic kidney disease.  When a person has reached this stage of kidney disease, their kidneys are failing and have stopped working well enough for someone to survive without dialysis or a kidney transplant. 

A new study is showing that people who frequently consume artificially sweetened diet sodas appear to have greater risks of end-stage renal disease.  What the study found was that the more diet sodas consumed per week the higher the risk was. 

For a period of 23 years, researchers analyzed diet soda consumption assessed by food frequency questionnaires for 15,368 black and white participants (aged 45 to 64) from 1987 to 1989 and 1993 to 1995.  Over the time frame and a follow-up through 2012, end-stage renal disease developed in 357 participants.

It was found that within a general population, end-stage renal disease increased higher with the number of diet sodas consumed – those who consumed 1-4 diet sodas each week increased end-stage renal disease by 8%, those consuming 5-7 each week had an increase of 33% and those consuming at least 7 or more glasses of diet soda each week increased their risk by 83%.   A drink of a diet soda was based on an 8-ounce glass.

The researchers found there were weaker associations between diet soda and people in earlier stages of kidney disease.

Kidney disease is strongly influenced by food choices as they can determine how fast the disease progresses.  The driving factor of what is found in diet sodas increasing the risk of end-stage kidney disease appears to be dietary phosphorus.  Both sugar-sweetened and diet sodas contain phosphorus additives which can increase serum phosphorus and fibroblast growth factor-23.  These same phosphorus additives can increase dietary acid load which can contribute to end-stage renal disease. 

Phosphorus is a mineral found in the bones along with calcium keeping bones strong.  When the kidneys are working normally, they can remove excess phosphorus in the blood.  But when a person has chronic kidney disease, the kidneys struggle to remove phosphorus.  As phosphorus builds up, those high levels can cause damage inside the body – high phosphorus levels can pull calcium out of the bones making them weak, and can also lead to dangerous calcium deposits within the blood vessels, lungs, eyes, and heart.

People who have been diagnosed with chronic kidney disease need to pay close attention to their intake of phosphorus in order to slow down the progression of the disease.  Phosphorus is found naturally in foods such as meats, poultry, fish, nuts, beans, and dairy products.  The phosphorus found in animal foods are more easily absorbed than phosphorus found in plant foods.

Phosphorus can also be added to foods in the form of an additive or preservative and are found in fast foods, ready to eat foods, canned and bottled beverages, enhanced meats and most processed foods.  Phosphorus additives can be found listed in the ingredient lists on the nutrition facts labels of foods.  Look for “phos” within a word to pinpoint a phosphorus additive:

·         Dicalcium phosphate

·         Disodium phosphate

·         Monosodium phosphate

·         Phosphoric acid

·         Trisodium phosphate

These are just a few of the phosphorus additives that can be found within processed foods such as diet sodas.  Anyone with chronic kidney disease needs to avoid foods containing phosphorus additives as much as possible to help lower the intake of phosphorus and help reduce the workload on the kidneys.

Anyone with chronic kidney disease should seek the advice of a registered dietitian to help them sort out foods to eat and foods to avoid helping slow down the progression of the disease.