I have been using Albutrix for one month. Until I receive my next blood and 24-hour urine test results, I do not know how well it works. I have read the entire book, Stopping Kidney Disease by Lee Hull. It is excellent. I have started to read some of the referenced scientific articles, such as:
American Journal of Kidney Diseases
Volume 65, Issue 5, May 2015, Pages 659-673
Is There a Role for Ketoacid Supplements in the Management of CKD?
Anuja P. Shah, MD; KamyarKalantar-Zadeh, MD, PhD; Joel D. Kopple MD
I use Cronometer to monitor my nutrient balances. The most difficult aspect of a very low protein diet for me has been finding a good combination of foods with sufficient calories.
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PaulSheldonFoote
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Unless you got 2+ more of protein in urine and losing kidney function fast its not worth it. Its not a sustainable diet long term in my experience . Plus the supplements are not cheap. Randomized clinical trials have not shown a definite benefit of doing this diet. The true test is how well will it improve protein in urine or microalbumin. That is what dictates how fast you are losing function. Good luck, you will need it
silverfox81 do you know how the 2+ translates into mg? Dr. Stephen Rosansky has mentioned 2+ on his episodes of DadviceTV, but my results came back showing md/dl for creatinine, ug/mL for albumin, and mg/g for albumin/creatinine ratio. I had 211 for the ratio, and 0-29 is normal for my lab. So I was in the 'moderately increased' category. Trying to figure out how that corresponds to the 2+ and 3+ so I can understand Dr. Rosansky's references! Thanks!
I honestly dont know. The chart that I have shows that 30-300 is microalbuminuria and 301-3000mg is moderate. Anything over 3000 is considered nephrotic syndrome. I had 1+ protein in urine for a while and i was hovering around 300-350 mg range. I would think 2+ would be well over 350 mg range. I would classify you as microalbuminuria stage from the information I have. I would not even classify you as 1+
Glad you posted. I'm interested in finding out how your blood test come out. I too have been reading Lee's book and thinking about at least partially taking albutrix. I have basically quit meat and working on getting enough protein as too little is just as bad as too much. Let us know how it goes! Thanks!
Getting enough protein is like falling off a log - there's protein in virtually everything!
Going no meat is a good step but there's little point in substituting it with a high protein plant. The hardest thing is to keep to very low protein whilst obtaining calories. It's okay if you want to lose weight but if your weight is good, like mine, and you can't afford to lose it by reduction in calories then you struggle. You can always throw an apple or honey or something in to add a few hundred calories at the end of the day. But you actually get sick of eating and God help if you skip a breakfast or lunch -- very hard to make it up.
And hydration. Ugh .. I just ain't that keen on water (even filtered).
I have received my new blood test results after using Albutrix since January plus following a very low protein vegan diet. My nephrologist told me that the results improved to stage 2. He was amazed that my BUN went from 27 to 12 (lower than his BUN). Albumin improved. My A1C dropped to 5.4.
My remaining concern is that my Cystatin C GFR did not improve. I shall research about the effect that diet has on this. My nephrologist told me that he monitors trends in the numbers.
I shall be taking my 24-hour urine sample on Monday for analysis. Until I receive the analysis, I have no comparison to report.
That's great news! How many are you taking a day? Also, May I ask what was your gfr before and now after? It is my understanding though that once you have ckd it can't be repaired but I'm thinking when your grf raises you get better flow/management of your disease thus preventing progression. I'll take that any day! Mine has fluctuated between 51-57 for about two years. Proteinuria at around 700 taking losartan. Hoping mine is slower progressing ckd. Keep up the good work!
I've been on Albutrix/Microtrix since about May last year.
1. My BUN took a tumble from from well outside range to well within range. Not too surprising since the reduction in protein intake naturally reduces nitrogen waste.
2. Cholesterol took a decent tumble too.
3. eGFR has stayed steady (fluctuating a few points up and down). I had slow moving CKD anyway so wouldn't yet attribute this to Lee's approach
4. My renal dietician has moved me down from Lee's 0.8gr/kg recommendation (half dietary protein / half keto protein equivalent). Her view was that the science suggest 0.63gr/kg overall and so I ought stick to the science. And so I do 0.43gr kg dietary and the rest Albutrix. This has halved my daily Albutrix .. which has halved my Albutrix costs!! I'm not sure what basis Lee had for 0.4 gr/kg Albutrix.
5. Agree that getting calories is an issue. I can just about scrape it but it's it's challenge.
6. It looks as if proteinuria has dropped (very) significantly but I'm waiting for latest urine to confirm. My neff has been relying on spot urine but there's not a hope in hell this can be representative imo. I can see myself that bubbles in the toilet follow protein/water intake. Therefore this latest lab I took a 24hr urine and a spot to compare.
I'm thinking 100% along your lines Skeptix. I am almost too thin at this point with a bmi at 20. It seems like I eat all day long (fruit/veggies) and by dinner my protein level is at maybe 22? I know meat will get me up but don't want to eat it anymore. I have 1/4 cup pecans as a snack that helps but don't like eating rice or beans, lentils every day either. I have this thing about lectins and inflamation? that I need to re-read up on. So, if I go 40-45 g. protein it would be about 1/2 food/1/2 albutrix. All my numbers are good now - bun 12, good cholest., h20/co low but pot/phos/cal levels normal. I'd like talk to Lee before I start to see if we're on the right page. I'm 3a, 52-57 /spilling 550-900 spot urine. Scared to do 24 hour test for protein cause I like where I'm at!
Although calories are troublesome (in the sense that you have to pay attention, otherwise you'll fall short) I don't find the move to vegan (mostly) that bad. Sure, I treated myself to turkey/ham for Christmas and it was delicious, but I've dug out a fair few recipes that are more than tolerable! I mass produce and freeze so as to take the workload out of it.
There seems to be no argument against going very low protein and keto (although quite how dramatic / how dialysis staving-off the benefit is open to question). The question is why does it work? I can understand eating less protein = less nitrogen waste. But if your BUN is okay then your kidneys are clearly filtering nitrogen waste. So why reduce protein?
I read somewhere on a link someone posted here about the kidneys maladapting to CKD. They hold metrics (such as BUN) in check, but by maladaptive, damaging means. So perhaps the low protein, "taking your foot off your kidneys" approach works by minimizing the maladaptive tendencies of CKDed kidneys?
What's 550-900 spot protein? What units? What's your PCR/ACR ratio? You on ACE meds to reduce spillage?
I went from a PCR of 78 to 18 in a few months. I suggested to my neff that I move from 5mg ACE to 10mg and also went on the very low protein veg diet + keto at the same time. So I don't know what effect the ACE had and what effect the diet had on the lessening of protein spillage. I want to go back to 5mg for a brief period pre-next urine to isolate dietary contribution (so as to know for myself and to let you guys know) but my neff isn't keen for some reason.
FYI, my creatinine and cystatin-c egfr are also wildly different. At my last bloods, my creatinine eGFR was 49, while my cystatin-c was 88. Pretty crazy.
Hi Marvin. A quick read around indicates that cystatin is useful when you've non-standard situations which could skew a creatinine based result. For example someone who much higher or much lower than normal muscle mass. Or someone seriously ill.
What (if anything) does your doc say about your crazy results? I mean, you haven't CKD according to one measure and have according to the other. So have you CKD orr not??
Will definitely be asking him on my next visit. Trying a new nephrologist on for fit next month. My present nephrologist did say that I had more muscle mass for my size than most (I'm pretty cut) and that that could be a factor, but I only weigh 143 lbs dripping wet and I'm 5'6". Doesn't make sense to me, although he does have a great reputation in my city.
Same weight and height as me - but I wouldn't describe myself as pretty cut (although I've not too much flab). More skinny!
Be interesting to hear what's to be said about this. I'll add cystatin to my next bloods in any event. It may be that it doesn't alter anything but if I got a result like yours that would set the cat amongst the pigeons
Please let us know how your blood work goes. I'm seriously considering Albutrix myself. May I ask what stage your in? Also, from what I've read of Lee's book so far I usually eat 1/4 cup of pecans daily which add some calories vs. all the fruits/veggies I'm eating. Not a whole lot of calories but every little bit helps!
A bloke with long time CKD who wrote a book called Stopping Kidney Disease. It stems from his digging around for a cure / way to slow or halt the disease.
Although he hasn't got a med background, he nonetheless dug up the science pointing towards very low protein diets as kidney protective. This same science undergirds the somewhat later KDIGO 2020 guidelines (issued y the authorities US body, the NKF).
Lee has also formulated/flogs a keto acid analogue, kaa's being central to very low protein diets. He claims it has advantages over the (few) alternatives.
Whilst you could suppose him suspect (guy in expensive supplement rip off scam), the science is sound and you'd have to buy a keto acid somewhere if not from him!
thanks for responding. you're right - I am skeptical of someone who's "done their own research" and is selling something to people who have no hope of "cure" outside a time-indeterminate delay for some kinds of kidney disease and followed by dialysis and/or transplant. It seems cruel to me. And for sure nutrition science on kidney disease and nutrition information from docs is way behind the curve forcing patients to seek out their own resources to maintain some kind of control of their future.
As an aside, there is a med-based research project for people (like me) with genetically-based kidney disease that I'm part of at Wake Forest University, led by Dr. Anthony Bleyer. They are close to finding a treatment for those of us who have been blessed 🙄 with sucky genes. For my particular mutation, they are looking at US descendents of a few families from the UK! It's fascinating and very hopeful. Perhaps they will find some genetic tweak about how the body processes protein, etc that will confirm Lee Hull's approach.
It's wise to be skeptical. The question, however, is what one does after exercising due diligence?
The science is the science, whether undecked by Lee (who lists it exhaustively) or the NKF. The place of ketoacids is the place of ketoacids in that science. And the potential benefits, such as they are, are the benefits. The NKF are now advocating the same low protein + ketoacid approach that Lee first did. (They might dither on whether a meatless diet or not, but given you can't eat meat AND run a very low protein diet at the same time ... 😉)
Prior to the NKF KDIGO 2020 guidelines (where the very low protein diet + KAA is first advocated by "medicine"), the previous guidelines were from 2012. Those 2020 guidelines are based on science as of 2017, so are already 5 years old news.
Medicine is very slow moving, so own research warranted. If you haven't the time to wait, that is.
Bear in mind also that the NKF themselves, in those guidelines, point out that it will take years for the recommendations in these guidelines to find expression down in clinical practice. Not least because there is no army of renal dieticians sitting around waiting to be deployed on the new 'early dietary intervention' front line. What renal dieticians there are, are down in the dialysis dept trenches and they ain't going anywhere fast.
You've got to train NEW dieticians. Which means you have to recruit students into yet-to-be created renal dietician courses.
Be skeptical, by all means. But not to the point of waiting 20 years for medicine to ketchup.
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I wouldn't criticise Lee for making money from supplying ketoacids. There is nothing wrong with making money from a discovery, last I looked. Sure, be skeptical as a starting point, but don't be handcuffed by it. The inability to move beyond initial skepticism is as bad as being suckered into buying magic cures by snake oil salesmen on YouTube. Uber skepticism (and I don't mean ride sharing) is the other side of the gullible coin.
It's not like the market is saturated with options (there was only one or two other KAA's on the world market, at similar prices to Albutrix,, last I looked). Lee has unique selling points seemingly based on a sound understanding he would never have obtained from the medical profession (for want of their understanding)
In the face of few options it seems to make sense to give yourself the best chance you can. For example: IF your BUN was running way outside range (like mine was) AND IF elevated BUN leads to faster CKD progression AND a low protein + keto acid diet brings BUN into range THEN that's a good thing.
You are a very good writer, make a lot of good points and I appreciate your response. I should say I had my transplant from a living donor last June so my sense of urgency is definitely in a different place. Also my kidney failure was due to a genetic mutation that programmed me for failure at a certain point in my life no matter what I did (although if I'd had DM or HTN or ate steak every day that certainly could have accelerated it). So that is perhaps why I was a little fatalistic and my answer reflected that bias. Also I'm an RN for whatever that's worth. I certainly don't mean to discourage anyone from looking for answers outside what you are given - especially since there isn't a lot of good news to be had with our diagnosis. And god knows I've brought stuff to my docs' attention many many times even developed a sort of reputation for that. All this to say, I hope you are right and I wish you the best of luck today and always.
By the way, there's registered dietician I started following on FB early in my disease called the Kidney Dietician because I found renal diet information so lacking and/or confusing. I messaged her about Lee Hull 's book and she had some very positive things to say. I will copy her response:
The Kidney Dietitian mentioned you in a comment.
The Kidney Dietitian
March 1 at 8:06 PM
I have heard of this book and that supplement! Ketoacid supplements like albutrix can be helpful for people with advanced kidney disease who are on a VERY low protein diet. But, should always be taken under the supervision of a dietitian. I think there is some generally good advice in there, but of course, it isn't individualized to YOUR stage of kidney disease or labs. It might be worth a read, but then make sure to double check with your dietitian if the recommendations make sense/are safe for you!
Yeah, the oversight of an RD is helpful - there's only so much you can know and it's best to have someone on your back to prevent a ball drop. My RD has me focused on getting calories on board so avoid muscle wastage. Apparently a very low protein diet would see muscles being used for energy production if the calories aren't available. This would be less the case were I short on calories but eating more protein.
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Water Consumption helps or hurts?
PKD 
eGFR around 60 normal??
Just found out 
