Vegetarianism and renal diet restrictions

[Falkenbach]

... anyone else had a complete upheaval to their diet for this reason?

I am about to have a pre-emptive transplant. My phosphorous level has been high for a while now and the renal dietitian advised me of the foods I needed to avoid completely - and they were virtually all the things I was eating! E.g. legumes, nuts, wholegrain breads etc. My dairy (which I love) is restricted to 250ml a day of milk, or else 2 small slices of cheese.

All my favourite things in the world - Coca-Cola, beer, Indian food and Mexican food - went out the window in one big sweep.

I try to behave but it's SO HARD. As I already have osteoporosis I really do have to be carefuly. I look forward to less restrictions after the transplant.

Also, one renal dietition told me that if I went on dialysis, I would have to eat meat in order to meet the higher protein requirements. I was angry at being told this, because I felt that she simply hadn't done enough research with a comment like that. I am pleased to say that one of the renal physicians I met yesterday, who is part of my transplant team, agreed with me that her advise was "bull****" - his words, not mine! 

[BigSky]

Hate to tell you this but doctors know relatively little compared to renal dietitians about diet. 

Protein is very important once one is on dialysis.

The problem with vegetarian sources of protein is that are are relatively low bv  and are incomplete and they tend to be very high in K and PO₄ compared to protein content, which then can lead to a person maxing out their K and PO₄before getting their required protein level for the day.

Take a 1/2 cup black beans,  roughly  300 mg of K and 120 mg of PO₄ and only 7.5 grams protein.

compare this to 3 oz of cooked chicken breast, roughly 160 mg of K and 140 mg of PO₄ and 24.5 grams of protein.

If a person is 60 kilos (132 pounds) they need 72 grams of protein a day once on dialysis. Many patients are only allowed 2000-2500 mg of K and from 700-1200 mg of PO₄ a day.

Protein requirement is 1.2 grams per kilo of dry weight to maintain at 3.6 albumin.  If eating that and below 3.6 albumin level one needs to eat 1.5 grams + per kilo of dry weight.

There is always whey based high bv protein powders, but many patients do not like the taste, fluid required to take them, nor do they like the greater expense in buying the higher bv powders vs regular powders.

I might add you could always buy amino acids and try to supplement with that, but they are not cheap either.

[Chicken Little]

I feel for you.  I struggle with this daily.  I'm not a vegetarian, but I've always considered meat to be a flavoring for my starch and veggies.  

My diet pre-dialysis was dairy, cereal, pasta, beans, fruit and vegetables.  Now, it's mostly Designer Whey shakes, eggs, apples, white bread and rice and salad.   I try to eat meat 2-3 times a week, but it's really tough.  I don't like cooking it and since getting sick before going on PD, it turns my stomach to eat it.    

I am also allergic to soy, which it looks like premenopausal woman shouldn't eat anyway, but it really limits the protein bars/supplements.  If it weren't for Designer Whey shakes, I'd be up a creek.  It doesn't taste great, but it's better than eating meat.

[angela515]

I look forward to less restrictions after the transplant.

I have no restrictions after transplant. Of course everyones different. Just wanted to give you some hope. 

[jbeany]

Vegetarian?  Hooo boy, and I thought the renal + diabetic diet was bad enough!

I'm sure it can be done, but it would take an awful lot of self-discipline to manage.  The renal diet is so counter-intuitive if you've been trying to eat a healthy diet before.  The idea that fruit, whole grains, beans and nuts are bad for you just seems soooooooo wrong.

With a transplant coming up, just try to remember that it's temporary, and treat it like something you just have to do to get to the next step.

[kitkatz]

I hate the renal diet.  Why make it harder than it is with other complications?  Good luck and I hope you figure it all out.

[Falkenbach]

Thanks for everyone's input.

The doctor I spoke with gave me the name and number of his renal unit's dietitian, so I'll be getting some advice from him also. Even if I don't get in contact with him straight away, they will be having me see the dietitians automatically after my transplant apparently.

[carson]

I've been vegetarian for about 10 yrs now. I do this by choice. Coincidentally, I am also on PD for 10 yrs. Anyway, my renal dietician just sent me some great recipes for Indian food that's ok for renal diet. Also, I eat alot of "fake meat" and enjoy tacos and the like.
I used to be a real fitness buff and even after  being on PD  for all these years I still have trouble getting it through my head that all the "good" things I used to eat are now very bad for me. I'm not the best example of one who follows a strict renal diet, but I'm trying more as time goes on. I still have pizza every now and then. My husband has made me a great pizza with a little goat cheese, pesto, olive oil, red onion, green peppers, red peppers. Mmmmm, I love it! I still eat chips and nachos every once in a while. My mom made me oatmeal cookies the other day. She sent some home with me for my husband (I told her she was trying to kill me) but I ended up eating them all anyway.
But back to the topic, if you'd like I'd be happy to email you the Indian recipes and any other I think you may like (the dietician sent me a cookbook). Also, she said protein drinks are "iffy" because they're not regulated like medicine so what the label says may not be what's in them!

[Falkenbach]

I would LOVE some of your Indian recipes. I'll pm my email address. Or you could start a thread for thim in this forum!

I have to say that I'm not a huge fan of the meat substitutes though though I eat them occasionally. I don't even like a lot of vegeterian standards, such as tofu. I'm actually very picky.

[sophiasmom]

Hi,

Be careful of beans and certain seeds and nuts they are very high in Phosphorus.
If you eat alot of them be sure to take whatever binders prescribed for you.

Everything in moderation, enjoy your life!

Chris

[Falkenbach]

Thanks Chris! I have very little in the way of restrictions now - I had my transplant on 30th May. I'm now allowed to eat all my legumes and dairy and so on. I no longer have to take binders as my phosphorous levels are now good.

Oh, it feels so good!

The senior renal dietitian came to see me in hospital just after my transplant, and I explained that I was a lacto-ovo-vegetarian, and that I was aware of the correct food combinations required in order to get complete protein in one meal. I also admitted I was often too lazy to worry about the correct combinations, and on these occasions I just drink a glass of milk with my meal (this is the quick way to get complete protein with your meal). He was really pleased with everything I had to say and didn't feel he needed to change anything I was doing - except of course for the fact that I could go back to eating the things I was restricted from prior to transplant.