question about diet and labs

[George Jung]

My numbers have been excellent as of late.  I have been told "you get an A+" by the center doctor.  The next session a tech told me I need to work on my numbers.  I was confused so I asked another doctor and they also said "you have a 4.0".  I think I will listen to the doctors.   My question is how can my labs be so good when I still eat all of the things you are not supposed to eat?  I told the doctor that I am still consuming dairy for example, she told me not to worry as everything looks good and that it is okay.  I am conscious about food and liquids so it's not that I just disregard the guidelines, I seem to simply use moderation and try to be smart about it.  I am not spooning ganache into my mouth everyday.  Can this be true?  Am I putting myself in danger?    How are my numbers so good?

[Sluff]

You must be another Bot just like Zach.   

[jbeany]

George, it all depends on how much residual kidney function you have.  Mine still function enough that I haven't really had to worry about potassium so far.  Like you, I've been sensible, and cut out things like bananas, oranges, tomatoes and potatoes, as well as eating more fruit that I know is lower in potassium, but as long as my labs are still good, I will keep eating as much fruit as I want to.  The medical establishment likes to prescribe "one size fits all" diets and fluid restrictions for all dialysis patients, but not everyone needs to be so restricted.  As long as your labs stay in the normal range, there is no reason for you to change what you are eating.

[George Jung]

I was under the impression that I had 0 kidney function.  Refresh my memory...how can you figure % of ability?  Should I then watch thing a little more to preserve it or will that not make much difference?

[jbeany]

I had a 24 creatine clearance test just before I started in Dec.  When I started dialysis, I was at about 10% function.  I don't know if there's a better way to check after you've started.  I don't think they care much about your % function after you start dialysis. I argued with my doc and nurses about wanting to preserve what function I had left when I needed to get contrast dye injected for a fistulagram - and they said I didn't need to worry about it since I was already on dialysis.  (Pbbbbbbbbbtttt to them for that attitude!)   

I don't think there's much you can do to preserve remaining function.  A low protein diet may help pre-dialysis, but that's not an option once you start - we need the protein too much.  Do you get copies of your lab reports?  I think the best thing you can do now is keep track of your labs yourself, and see what the trends are from week to week.  That way, if you notice a gradual rise in potassium or phosphorus, you can change your diet accordingly.  I get weekly labs on my phosphorous, and I can tell when I need to work harder at controlling my diet when it starts to creep back up into the 4.5 to 5 range.

[carolyn77531]

Jessica has high phosphorous every lab ..i try everything i can to try to get in down..she take binders...any suggestion

[jbeany]

Mine was high.  I fought the diet for quite a while, then finally started taking more binders.  I was taking 2 phoslo with every meal or snack.  I switched to 2 with a low-phos snack, 3 with a low-phos meal, and 4 with anything I knew was high.  If I'm having a really big meal, I might even take 2 more after I finish eating.  My phos went from 8-10 down to 3-4, without having to cut everything I love out of my diet.   I said something to my dietian about taking more binders and it finally working for me, and she says, "Well, doesn't it bother you to take that many pills?  Most people don't like to take that many."  What?  Two extra pills versus giving up dairy, peanut butter, chocolate, nuts, even in small amounts?  What kind of logic is that?   

[thegrammalady]

i think everyone has pretty much said it all....i REFUSE to follow the one size all mentality.......we are all different, in fact i pissed the dietitian off today because of exactly that.  the renal diet shouldn't be about denial, but moderation. eat what works for you, your labs are the key to how it's working or not working.  and george, the techs have no idea what your labs are, tell them to MYOB!!!!!!!

[George Jung]

Cool!!  Thanks for the input.   

[kitkatz]

If you have learned to do what works best for you, do not sweat it until your labs change for the worse. Then make changes.  By the way I love your recipes.