Low calorie diet

[milo_miller]

I am at stage 2 CKD. My Gfr is 78. Since I am just diagnosed, I dont have enough information about hove to arrange my diet. I am also diabetic. It makes the situation more complicated.

To manage my diabet also well, I am planning to be on very low calorie plant based diet.

This could make my kidney situation worse?

[Darlenia]

Hi Milo-Miller. I feel for you. The underlying cause for your kidney damage is likely your T2D (assuming this is your form of diabetes) and is often referred to as Diabetic Kidney Disease (DKD). Diabetes is fueled by glucose produced by sugars and carbs (which turn into sugar). High glucose levels stiffens, clogs, and then shuts down tiny blood vessels everywhere - eyes, feet, kidneys, heart, etc. If your kidney function is threatened, your labs will reflect that - creatinine, BUN, etc. You'll notice that high glucose levels often limits the ability for kidneys to process protein, so high protein levels are the result. It's notable that the diabetes diet targets the instigator (glucose) whereas the renal diet targets the end result (protein).

Diabetes is exceptionally stealthy. It takes a decade or two for diabetes to show its hand. Once organs are damaged, the situation can't be reversed but you can certainly stop it from advancing. The most effective treatment is to put diabetes in its place - drop the weight, take carbs and sugars out of the diet, and implement exercise. My hubby chose to "control" his diabetes through medications (including pills and insulin) and so on. My hubby eventually lost his kidneys, went on dialysis, and now has a transplant. His mom chose not to go that route and immediately changed her lifestyle and lived well into her 80s without needing any treatment. Two different people, two different choices. Sadly, diabetes is so common today that people simply accept it without realizing outcomes. Doctors should be candid and direct. A bright spot in your health in your eGFR. It's at 79. You have the time and runway to halt the progression and be able to lead a wonderful life. Your nephrologist and/or primary will help you in this - either by taking charge of your diet or sending you to a dietitian. I wouldn't wait. The diet should be a blend of the diabetes and renal diet with a heavy focus on the diabetes diet. They can be odds with each others - many renal diet items have exceptionally high sugars and carbs, e.g. grapes, rice, potatoes, breads... - always be mindful that, in diabetes, sugars create the problem and will damage you. With this awareness, becoming a label reader is essential. Taking action will give you purpose and control - and help remove the fear. Sending you all the encouragement in the world for your success!

[milo_miller in reply to Darlenia]

Thank you very much for your encouraging reply. There is something I want to ask since you didnt mentioned it. Your hubby’s mom was diabetic too? And she managed to live till her 80s with CKD?

[Darlenia in reply to milo_miller]

Yes, she was a diagnosed T2D who kept her glucose levels below the levels for medication. We're not sure if his mom's kidneys were affected. We do know kidneys do gradually decline over the years. Then, we also have two kidneys - a spare. (My hubby's eGfr with his single transplant is around 50.) So you likely will have a long life ahead if you stop the glucose assault on them. My hubby's family has a long history of family members with T2D - many enduring blindness, amputations, and more. His mom literally tended to her own mom and watched her die from kidney failure - a horrible experience for her. When she was told to go on medication for diabetes, she immediately said no. She dropped her weight over three or four months, watched her food carefully from then on, and never needed pills or insulin. Her son, my hubby, could have done the same thing but chose to simply go to doctors and take the pills and eventually insulin. He started the medical journey in his 40s, the same decade that his mother sent diabetes away by her own good decision making. My husband finally faced reality when his nephrologist (Asian background) sat him down and pointedly told him he had 7 years left to live if he continued his lifestyle. Under our primary doctor's direction (with the nephrologist's agreement), he immediately limited his carbs and sugars. His lab results dramatically improved, but the intervention came late to stop the collapse. He won his fight against diabetes and got off all diabetes medications while on dialysis a few months later. Our adult children are aware of the family history, are mindful of their labs, and are now taking steps to keep it far away (no longer drinking surgery colas, no potato chips, etc.) It's truly a lifestyle decision - a situation that lies completely in one's own hands if one either has or is getting close to having T2D.