Managing Chronic Kidney Disease: the Acid/Base Balance Approach

[Tomitoons]

I am a 70 year old biologist with some medical education as well. I recently had a radical nephrectomy due to Renal Cell Carcinoma. My post operative blood chemistry changed dramatically w my eGFR dropping from 70 to 38 with corresponding somewhat dramatic increase in Creatinine, Phosphorus and Potassium levels.

I got the book, "Stopping Kidney Disease" by Lee Hull and have to say, his book is a excellent text on a wide variety of subjects related to Chronic Kidney Disease (CKD) including, and perhaps most importantly, his discussion of Potential Renal Acid Loading in relation to diet management. It's a rather scientifically detailed book which requires some understanding of basic biochemistry and human physiology but if you can get past that challenge, the book is a wonderful explanation of the key factors affecting kidney function and how you can use diet management as a means of controlling, indeed slowing down the onset or progression of CKD. Lee discusses all of the key minerals (P,K,Na,N,Ca,Mg) that play a part in kidney function and how they combine to influence the performance of glomerular filtration, ammonium secretion and other important roles the kidneys play in helping to maintain body health and the maintenance of normal serum pH levels....

Lee's primary focus is on the relationship between foods that are more acidic (meats, fish, cheeses, nuts, some grains and beans) and foods that are more basic (vegetables like broccoli, asparagus, onions, or fruits like blueberries and apples) and the impact these different food types have on blood pH. His assertion being the importance of using alkaline (basic) foods to offset and moderate the effect of acidic foods on blood pH and the positive effects this dietary approach has on kidney health, especially when faced with CKD. He also discusses related topics such as the value in consuming foods high in polyphenols and antioxidants and other beneficial nutritional components.

Ultimately, Lee favors a largely plant based diet with little (or no) protein from most meat and fish sources, especially red meats (and he backs up his assertions with up to date research from refereed medical journals). He argues that there are unique amino acids in meats that ultimately contribute to acidifying the blood and further elevating creatinine levels. Plants alternatively lack some of the amino acids that meats have and so the plant proteins essentially place less stress on the kidneys in terms of filtering out waste products. Less stress, the healthier conditions for the kidney to function and the slower the progression of CKD.

Definitely worth a read if you can get your hands on a copy!!

[Bassetmommer NKF Ambassador]

Hi Tomitoons,

I have not read the book. However, I have done a lot of personal research and worked with a renal dietician and my nephrologist. The University of Rochester Medical Center, who I was affiliated with, has a whole program on plant based diet and the impact on the kidney.

I have not eaten red meat since 1986. However, I was consuming large portions of chicken and turkey everyday. I was diagnosed with stage four in April of last year. I have since cut down to a 3 oz portion of chicken maybe once or (rarely) twice a week. I was also eating white fish, and I am no longer because of the potassium. I have Psoriatic Arthritis which causes high uric acid. At one point, my level was almost 11. By switching up my diet to mostly plant based, using natural products only (homegrown veggies and herbs and homemade foods and meals) I have maintain my renal levels, improved my metabolic levels, and lost almost 38 pounds. However, I do take sodium citrate to keep my acid levels down because diet alone for me will not do it.

[Raji838 in reply to Bassetmommer]

Tomitoons info opens up a whole new field, it's mind boggling to understand vegies n fruits, do you have ready reckoner for them incul pH .

[JimVanHorn]

Hi Tomitoons, I am not as informed as you but I can share some things. I was told on Christmas Eve that I no longer have prostate cancer. Last August my creatinin level was 5.1 and I needed for prepare for dialysis. I now have a left arm wrist fistula. I also became careful of my kidney diet. My creatinin came down to 4.6 with plenty of daily water. Then my doctor prescribed Sodium Bicarbonate Tabs 650 mg 2 in the morning and 2 at night. He told me this would change the pH of my blood and make it easier for the glomerulous to get rid of acidic substances. He explained the blood has zwitter ions the keep the pH at a certain level, but this would help the blood get rid of acidic ions. My creatinin is now 3.7 and I may not need my fistula. So when I get rid of my heart disease and diabetes I'll be good to go!

[Rene70 in reply to JimVanHorn]

Hello good day! How much water did you or you were allow to drink?

[JimVanHorn in reply to Rene70]

I drink 1/2 gallon daily = this includes all liquids. Now you must ask your nephrologist because as your GFR changes so does your water intake. For example if you are on dialysis your water intake is greatly reduced and when you are in stage 3 your water is increased to get rid of impurities in your blood. You must check with your doctor.

[Rene70]

Yes this is true my name is Rene70 I am in Indianapolis and I have seen a nutritionist at st. Vincent's Hospital she spent two hours with me going over a diet and it was the vegan diet and based on the information that she gave me and your information it is confirmation I am already at Stage 5 see my doctor yesterday he explained to me that we need to go vegan and we need to sip water if we need to... to keep off a dialysis right now my creatinine levels have dropped just a teeny bit I am at 13.2 functioning but I'm praying and believe in God that I can least get it back up to 20 so I can stay off of dialysis but I'm going to continue to do the plant based diet because I've also heard that people have been on dialysis and had to come right off a dialysis because the kidneys started working again also weight loss plays a factory 2 I'm 5-2 212 pounds and I'm wanting to lose a lot of weight so I can get this blood pressure under control which they are controlling it with medications now but I want to be able to do it naturally I am very active now have a personal trainer feel great and I'm going to continue to do what I can do thank you for the information

[Lgriffis in reply to Rene70]

Hi Rene70, I am looking for a Nephrologist in the Indianapolis area. Are you happy with the care you are receiving? I'm having a hard time finding a doctor that will be on my team so to speak. I have tried to get reviews of doctors in the area but there is not much info out there.

I am currently in stage 3 ckd. I brought myself, with no help from my Nephrologist from stage 4 back to stage 3b. Any help would be appreciated!

[Trill]

This book came up with its title in the headline, and was promptly removed! Leaving a few of us who had seen it to chat amongst ourselves. I bought a copy and am in the middle of reading it. I am Stage 3a. I wonder if you can tack it on to your title so that the existence of this book can be made more widely known?

[Carosuz2016]

Thank you! I receive newsletters from Lee Hull . I will see about trying to get a copy of his book! Thanks again.

[Beachcomber49]

I, too, have been following Lee Hull's research and receiving chapters of Stopping Kidney Disease in the months leading up to its publication. The book is available online from Amazon in print and electronic formats. Yes, it is heavy on research, citing many recognized medical journals and scientific studies, but Tomitoons is correct in stating careful readers will be able to derive a great deal of useful information on how to lighten the load on our stressed kidneys. Lee is hard at work on a cookbook now, as an important adjunct to making the plan work. I recently discussed some topics from the book with my nephrologist and she has now acquired her own copy, after alerting me to the improvement in all my important lab result numbers, save one -- GFR is down one, but it has been just three months since I quit red meat entirely and six weeks since discovering the very low protein diet. My kidney issue is related to excess use of NSAIDS and my goal is to ward off dialysis as long as possible with diet and exercise.

[KidneyCoach NKF Ambassador]

Wonderful news. I also have a copy of the book and found it highly informative for those not yet on dialysis. Once on dialysis protein is removed through the dialysis procedure/treatment itself and it may be necessary for some to review their diet to allow for more protein and avoid low protein levels which can in turn impact nutritional levels, anemia and more. Once on dialysis I highly recommend the book "Help, I Need Dialysis!" How to have a good future with kidney disease. The authors are Dori Schatell and Dr. John Agar (Australia). It is one of the most informative and easy to read, understand book I've yet seen regarding ESRD, dialysis, working, SS and more. So many resources provided. It can be purchased through "Medical Education Institute (MEI)" or HomeDialysisCentral.org. Shipping appears to be free through March and cost of book is just $6 at the moment. It does cover chronic kidney disease stage 3-5. Both Dr. Agar and Dori Schatell advocate for a more patient empowered treatments and patient centered treatments. Check it out for yourself. Blessings

[Bassetmommer NKF Ambassador in reply to KidneyCoach]

Here is a link to a sample of this book and when you open the PDF, there is a list of classes here kidneyschool.org/mods/ which are free whahoo great information

[Beckett24]

Hi, Tomitoons. I was the one who initially put up the post on Stopping Kidney Disease which got removed. I am glad I am not the only one excited about this great, new book. I do have a question though, maybe I did not read the book carefully enough.

To offset the more acidic foods with the alkaline fruits and vegetables, do the fruits and vegetables have to be eaten at the same time as the more acidic foods or can they eaten before or after the more acidic foods that same day? Thank you.

[Raji838]

This is great news and ground breaking. Nuts! Well that's surprising ism regular on them. What about green French beans are they ok, I'm regular on them as well, n it keeps my tummy in order. Thanks so much, so one should now watch serum pH as well, oh one more for the labs. Thanks a lot.

[JimVanHorn]

I believe the amount of potassium in fruit and vegetables is more important than the pH of the food. Also the amount of fruit sugars should be considered, because all sugar is sugar. I am diabetic as well and have to watch fruit intake, also read a kidney diet with no dark soda drinks, potatoes, tomatoes, nuts, raisins, bananas, oranges, black beans, bran, granola, chocolate, bacon, ham, sausage, hot dogs, lunch meat, or canned meats.

[Bassetmommer NKF Ambassador]

To all: No one diet fits everyone. That is why you should see a renal dietician who can map out something specifically for your needs and medical conditions. For example, diabetics can not eat a true renal diet because of the carbs in white bread, pasta and rice which is recommended. Some people cannot eat legumes, especially lentils and beans because of the high potassium and phosphorous. And fruit, as Jim said, is high in sugar and not really good in large quantities for anyone. Fad diets can be dangerous for kidney patients. Truth: sad as it is...weight loss is best when done slowly and with a lifestyle change, not a quick fix diet.

[YorkieMom1 in reply to Bassetmommer]

Hi, Have Questions & didn’t know better way to reach you. This is not meant to be reply to the post I am writing on. I have been on Procrit for almost 16 weeks since the first of the year. Initially it was 10,000 units and more recent weeks it is 15,000 units. My hemoglobin has not gone up at all and in fact was down last week from November December 2018. I really feel we may be assuming the kidneys are the total cause of anemia when it is in fact caused by something else also or different. I have made a second opinion appointment with a teaching hospital. I don’t know if this was the right thing to do and do not want to offend the doctor who’s care I have been under for nearly 6 months but I don’t know what else would be a better choice. My hemoglobins are at 8.4 now and were 8.6 in December and up to approximately 9.0 for nearly 6 weeks of January and February. Those hemoglobin results are from weekly tasks and the injections have also been weekly. You always give such great advice and information in your replies. I would appreciate anything that you have to say about this, good or bad just hearing your thoughts. Thank you so much! Yorkie MOM.

[Bassetmommer NKF Ambassador in reply to YorkieMom1]

Hi Yorkie,

I sent you something in your profile. But as far as determining your blood levels, I am not a doctor and don't play one on TV. lololo.... So I cannot really speak about the blood levels.

I would agree with your thought about getting a second opinion. Doctors sort of expect that when something might be beyond their specialty. And if your other doctor gets upset, it would make me rethink them anyways. Besides, it is YOUR life and health you need to worry about, not their ego!

At one point my hemoglobin was 8.8. I do not know why and they didn't do anything special about it at the time. I was at stage 3 at the time. What ever was going on passed and it came up and currently passes between 10.5 and 12.6. I was taking OTC iron. I stopped when I had a diverticulitis attack. So we will see next month how things are.

Talk soon.

[RhenDutchess123]

Hello Tomitoons....your post was very informative ...My Kidney decline was diagnosed as Fibrillary Glomerulonephritis....can you tell me if the book has any info on this peticular CKD....thanks

[YorkieMom1]

Superb description of book I am reading! WELL worth the cost.

[mentormaker]

Tried to bring up Kidneyhood.org today but the website "was taken down by the Author"