Renal Diet

[Whamo]

I was following Dr. Walzer's low-protein diet, supplemented by ten grams of the essential amino acids, which consists of 20 grams or less of protein a day, to avoid dialysis.  After five years, however, my kidney failed, 9% left, and I am now on dialysis.  I've been eating protein: egg whites, whey protein, and low-salt tuna, and I feel better most of the time.  I've been following my nutrional program: 2,000 mgs or less of sodium (well, most of the time); phosphorous (<1,000 mg. per day; potassium (2,000 mg. per day), and fluid restriction.  I've read where a high protein diet during dialysis results in a complete failure of the kidneys.  Is this true?  New research, I've read, points out that people who continue to urinate, even though at a reduced rate, are able to clean the toxins from the body and survive longer while on dialysis.  I've noticed that my urine output seems to get less on the high protein diet.  However, I can't see myself going back to the low protein diet.  It makes you feel weak.  Besides, I love food too much to quit eating eggs and tuna, again.   I wonder if other people have gone through this dilemma.

[MooseMom]

I've read Dr. Walzer's book, and I found it to be extremely helpful in determining whether or not my neph was addressing all of the pre-D issues that can confront us.  But I didn't follow the diet religiously because I found it to be too expensive and too onerous.  Still, I did follow the priniciples.

The idea is that protein is hard on the kidneys, so to relieve their workload, consume less.  And that makes sense.  But if there is an underlying disease process, your diet is not going to "cure" you.  And that disease process continues once you are on dialysis, and it is this process that continues to rob you of your ability to urinate.  It's different for every patient, though, just as the progression of disease is a very individualized process.

People who still urinate are at an advantage because they have better fluid control.  In this context, it's not so much that they can better get rid of toxins, rather, they can better rid themselves of fluid.  Toxins and fluid...those are the two bugbears in dialysis basis.

That's my understanding, but if someone else has better information, please post!

[Riki]

I always thought that you needed more protein while on dialysis because it was one of the things that your body actually needs that is easily filtered out.  I could be wrong, though

[boswife]

Once ON dialysis it's a definate more/most protien you can get the better

[jeannea]

From what I understand, the low protein is old science. I went on low protein 20 years ago. But when my transplant failed and I said something about low protein, they told me research has shown it's a bad idea. It was contributing to more deaths. So now they recommend eating the amount of protein you need to keep your albumin above 4. For me that's quite a lot of protein.

[Whamo]

I was above 4.0 albumein (spelling) by supplementing with 10 grams of amino acids.  But my muscles said goodbye.  It worked for me for five years, so I'm glad for that, but I'm not going back to it.   I did get good results with it, but eating 20 grams of plant protein a day was no fun.  Besides, I wound up getting too much potassium and wound up in the hospital for two weeks.

[Rerun]

You are on dialysis now so you need to follow those rules which is to try and keep your albumin above 4.0.  Dialysis takes out bad toxins but it also filters out good things like protein so you need to replace it.  ALOT....

[Whamo]

That's what I'm doing, but I still have doubts.  See "The Vegetarian Diet for Kidney Disease" by Joan Hogan, R.D. (Registered Dietician) who says (2010) Vegetarianism has not only become acceptable, it is now considered superior to animal-based diets for the prevention and treatment of chronic kidney disease."  I brought my amino acids from Calwood Nutrionals, which embraces Dr. Walzer's program, and they cite research supporting their approach.  Their amino acids aren't cheap, but the program works, probably because it reduces the phosphorus in the diet?  It keeps your albumin levels above 4.0, but I can' see myself ever returning to it.  However, I personally would testify to the fact it works for avoiding dialysis once your Creatinine numbers start to rise from stage one  upwards. 

[MooseMom]

I would love to be vegetarian, and as it is now, I don't eat much meat anyway, but I really worry about potassium.  With a gfr of 16 on a good day, what in the world would I eat?  I LOVE veg and fruits, but so many are so very high in K that I'm scared to rely on just that. 

I have read some new research that suggests that phosphorus derived from plants (like legumes) is not as harmful as phos derived from meat, but again, legumes are too high in potassium, as is potatoes and all root vegetables. 

I've had fsgs for 20 years, and it has been only for the past 7 that I've been on the pre-renal diet.  I have no idea if it is responsible for my slow decline or not; I suspect not, actually. 

I've always eaten for good health and have seen food as mediciine, so now that food is basically my enemy, it's really been hard to convert to an entirely different set of rules.  My mother was on D for five years, and she became malnourished due to the diet, so I get a bit anxious about it all.

[kristina]

Hello, Whamo,

I have been a vegetarian for over 40 years, ever since my kidneys first failed in 1971.
I was then told by a Professor of Medicine that if I would go on a vegetarian diet
I might have a chance to get some kidney-function back and I was lucky to avoid dialysis
and my two little fighters are still with me, even though these days they
are pre-dialysis with a kidney function varying between 10-12%.

I never had any problems with my vegetarian diet (touch wood),
but these days it has become a bit of a job, so to speak,
because our general food industry is producing less pure food,
and therefore, in order to protect my vegetarian diet,
I have to avoid super-markets as much as possible
and I have to travel to buy my fresh fruit and vegetables
at a farmer’s market to get it as fresh as possible.

I also have to bake my own salt-free bread
and I have to cook everything from scratch every single day.

That sounds like a job, and believe me, it is.
I find it sad that in order to keep as healthy as possible
I have to avoid Restaurants
(artificial items, food-colouring, preservatives to cause me allergies etc)
and I also have to avoid super-market-items as much as possible
and I have to prepare my food correctly.

I also avoid any frozen food and tin-food etc.
and I have to cook everything myself from scratch
to preserve my health as best as I can.

We are living in the 21st century, but instead of having an easier life
because of the development of the food industry in the 21st century,
I was forced many years ago to “opt out” of the general food market
because I have kidney-issues which do not fit into
the food-industry of the 21st century.

I would very much prefer to use my time for other things, but here I am,
I have to “put away” every day a certain amount of my time
just for my cooking and baking etc.,
because the food-industry does not cater for vulnerable people like myself.

The food-industry does not really tell us what additives they put into food.

For example, I was talking recently with some gentlemen
who were researching the types of coffee sold by well known chains of Cafes.
They took samples of coffee and had them analyzed and to their amazement
they discovered that these Cafes use coffee which has a similar additive as put into cigarettes
which make people addicted to the coffee, and this is why one sees so many people in these Cafes.
If one wants coffee, one has to buy beans and grind them oneself.

This is just one example and there are many types of deceit
used by food- and drink-manufacturers to sell their products,
but these additives may harm general health and the kidneys further.

Good luck from Kristina.

[cariad]

I would love to be vegetarian, and as it is now, I don't eat much meat anyway, but I really worry about potassium.  With a gfr of 16 on a good day, what in the world would I eat?  I LOVE veg and fruits, but so many are so very high in K that I'm scared to rely on just that. 

I have read some new research that suggests that phosphorus derived from plants (like legumes) is not as harmful as phos derived from meat, but again, legumes are too high in potassium, as is potatoes and all root vegetables. 

I've had fsgs for 20 years, and it has been only for the past 7 that I've been on the pre-renal diet.  I have no idea if it is responsible for my slow decline or not; I suspect not, actually. 

I've always eaten for good health and have seen food as mediciine, so now that food is basically my enemy, it's really been hard to convert to an entirely different set of rules.  My mother was on D for five years, and she became malnourished due to the diet, so I get a bit anxious about it all.

MM, what is your potassium limit? Quite a few meats are high in potassium, and there has been research suggesting that tofu is actually beneficial to kidneys.

At any rate, you can become a vegetarian after transplant easily. I would give yourself a few months to recover, and then go for it. It seems to have worked for me! It's been over 25 years and I cannot say I've regretted it for an instant. Eating in restaurants becomes much more challenging, and you'll find most cooking programs no longer apply to you, but that doesn't trouble me in the least.

[MooseMom]

Tofu and soy are actually very high in protein, and I have to be careful here.  I'm at that point where a renal diet is the most restrictive, and I've been here for 7 years.   I am not sure what my potassium limit is (my dietician wrote it down, and I've lost it), but I've had trouble with potassium for several years now.  I am quite careful with my diet, but my potassium is problematic.  This is why I take 12 sodium bicarb tablets a day, and even then, my K runs just outside of the normal range.

Believe me, if I am ever lucky enough to get a transplant, I would happily give up meat.  I like meat well enough, but I've always preferred fruit and veg, so I would not find this particularly onerous.  But that's for the future.  I have to eat according to my body's needs TODAY. 

I stopped watching cooking shows a long time ago, and I no longer subscribe to the Bon Apetites of the world.  Not much point.

[ToddB0130]

MM --- I take 12 sodium bicarb a day too..........what a PITA !!!  But you've gotta do what you've gotta do !!

[MooseMom]

MM --- I take 12 sodium bicarb a day too..........what a PITA !!!  But you've gotta do what you've gotta do !!

Do you really?  You know, you are the first person I've heard of, other than myself, that also takes this much sodium bicarb.  I started taking it to help control my potassium, at least that's what I was told.  Why exactly are you taking it?  Do you know?  I'm not entirely sure what it does!  I should know, but I keep forgetting to ask.

[Restorer]

As far as I know, sodium bicarb will reduce acidosis, which is common in people with kidney failure who are still urinating. To control your potassium, I'm not sure - maybe having to excrete less acid (which you're already struggling with) or excrete more bicarbonate helps take some potassium along with it.

I had to take some bicarb before I was on dialysis too.