Alkaline based diet

[cafelover]

Has anybody tried an alkaline-based diet? And if so is it better for you and your kidneys? I get confused by what I read some say go alkaline others do not..hmmm I know one thing for sure too much acid is not good for your body... But I also know another thing for sure trying an alkaline diet is not easy... Would appreciate some input thank you!

[Hidden]

Frankly, I haven't heard any mention of an alkaline diet. If you haven't asked for a referral to meet with a Renal Dietitian please do. If you are having trouble finding one, I previously mentioned going to eatright.org and in the upper right corner of their home page, you'll find a Find an Expert button and click there. Put in your zip code and you should be able to find a few names to contact to get you on the right track. If this alkaline diet was a good deal I believe it would be on all of the sites that offer suggestions for those with CKD, like the National Kidney Foundation, American Association of Kidney Patients, and the American Kidney Fund.

[orangecity41 NKF Ambassador]

Here is a link to article from Davita on alkaline diet. It cautions to check with your dietitian before you enter into a alkaline diet. davita.com/diet-nutrition/a...

[Marvin8]

Look at your serum CO2 first. If it's at the high end of the range, you wouldn't want to go on an alkaline diet.

[steve680]

Basically, any diet which cuts out meat and dairy (vegan) is going to be more alkaline than a diet which doesn't, but as you mentioned it's going to be harder to follow. Some "experts" say that alkaline diet is better for your kidneys, whereas some "experts" say any protein is bad for your damaged kidneys. In fact, there is a "very low protein" diet which the author claims can slow down the progression of CKD. This book was written by a nephrologist and it recommends supplementing your diet with amino acids so that you're not malnourished.

The issue of how much protein you should eat, and what kind of protein (plant vs. animal), are two controversial issues among the "experts". The only thing I can say for sure is that kidney disease is still not well understood and no one person has all the answers. I would err in the direction of an alkaline diet (vegetarian or vegan), as opposed to an acidic diet (meat and dairy), as we know the kidneys don't do well in an acidic environment.

I also wouldn't trust DaVita's web site's information on diet as they have shown in the past that they have a vested interest/bias in getting people on dialysis and staying on dialysis. For them, dialysis is just a big money-making business, and they have even been fined by the US government (FDA I think) for several unethical activities related to dialysis (which were not in the patient's best interest). There are better sites for a kidney-friendly diet, IMHO.

To answer your question, I did notice an improvement in my BUN when I did go vegetarian, but I found it too difficult to only eat vegetables for protein. And it didn't slow down the gradual rise my creatinine. I'm on dialysis now and am planning to get a transplant. Post-transplant I will most likely continue to eat lean meat in small amounts to get adequate protein.

I will say that most nephrologists will tell you to avoid/limit the amount of red meat you eat since there was a study which found a correlation between eating A LOT of red meat and people winding up in dialysis. However, now the thinking among dieticians that I've talked to think that it's OK to eat red meat as long it is grass-fed meat. This type of meat has a lot of Omega-3s which are supposedly good for you.

I used to eat a lot of red meat, but I wound up on dialysis because I was a binge alcohol drinker. Alcohol is also acidic and for some people (such as myself) seems to cause severe inflammation in the kidneys, which is not good for kidneys that are already in a diseased condition. Alcohol causes weight gain and can make you type 2 diabetic. Alcohol can also make your blood pressure harder to control. Unfortunately, this didn't become clear to me immediately and bad habits/addictions are hard to break. I eventually did stop drinking, but is was a little too late.

Most information on CKD says that it's OK to be a light drinker, but moderate /heavy drinking is not recommended. I just want to stress that unless you can limit yourself to ONE drink a day, then I would stop drinking altogether and get help if you can't. A lot of heavy drinkers don't think of themselves as heavy drinkers, so I would discuss any drinking with your doctors to get a second opinion. Unfortunately, kidney disease is not very forgiving of any bad habits or lifestyle. Im not saying this applies to you; just something to be mindful of as you may not get a second chance to fix things.

[Gauvian in reply to steve680]

Hi Steve680, thanks for your reply, i’m recently diagnosed 3b and although i have (managed) hypertension, the nephrologist is baffled as to why i have the disease at 58 years old. I drink a few glasses of wine everyday (since many years) and i asked him if it was that and he said no. But reading your reply has made me think again. I’ve tried stopping several times, everyday its like ‘i’m not gonna drink today!’ But i always do. Living in france red wine doesn’t seem to count as alcohol! Did you stop yourself or have help? Thanks and good luck with getting your transplant.

[Bassetmommer NKF Ambassador in reply to Gauvian]

Gauvian,

There is a glass of wine or two or drinking a whole bottle. We have wine glasses that hold only 3 oz. When I do have wine, it is one or two of those totally. My nephrologist said that it was fine and we do not have wine every day.... matter of fact it seems less and less often now. Wine can be good for you, but too much is hard on the liver and kidneys and it can dehydrate you. If stopping is not in the cards, then try to cut back. Some tricks to help with that is put less and less in the glass if you do not have small glasses. When you finish a glass, then switch to water in the glass. Sometimes the activity of drinking is more the habit than the product. Do you drink in social situations to have something to do with your hands, for example? Is there a specific time you have wine?

You will be surprised as how it does effect your BP also.

[Gauvian in reply to Bassetmommer]

Thanks for the reply Bassetmommer. I always try to cut back, but once i’ve got the taste i just want another glass! Its a very habitual thing, i drink wine with my dinner (sometimes lunch too) when i’m on my own as much as if i’m in a social situation. I’ve tried all the tricks - limiting myself to one glass, not drinking during the week, but come 6pm all those resolves go out the window! I only have this about the red wine, other alcoholic drinks don’’t have the same ‘pull’.

I’m really trying not to drink as from today as i shall be seeing my nephrologist 5 june and will have new blood tests done so I’’m feeling quite stressed about it which doesn’t help the attempt to stop drinking!

[Sammi_n_Munk in reply to steve680]

Gosh, Steve, thank you for sharing some of your background, and that bit of DaVita history. I didn’t know all that about DaVita. Now that I do, I’m a little ashamed of all of the times I recommended them to others in this forum. Whenever I went on their site (DaVita.com), they seemed to offer so much kidney-wise advice and tasty-sounding recipes. I’m glad I read your very informative post. I appreciate that. Once again, thank you very much! Please do take good care of yourself and stay well. All my best to you. God bless. 😊👍🙏

[Hidden in reply to Sammi_n_Munk]

The DaVita website regarding recipes is a great source of nutrition information. As I have said all along, none of the recipes listed should be taken as is. Depending on your specific numbers from your blood draws you should make adjustments to tailor the individual recipe to meet your needs. This is one of the things you learn when you initially work with a renal dietitian. That does not apply to just DaVita but any recipe should be tailored to meet your requirements. We are not all the same.

[orangecity41 NKF Ambassador in reply to Hidden]

Agree Mr K. I use some Davita recipes and tailor them to my diet requirements. One size does not fit all is what am learning on CKD. I also use Davita for diet planning and tracking to make sure I am staying on my prescribed diet limits and requirements. So far my eGFR is improving.

[Hidden in reply to orangecity41]

Way to go, OC. Another thing to watch for is any slight drop in GFR and a slight increase in potassium, or phosphorus. That's why I track all my lab values on a spreadsheet.

My new PCP wants me to bring it in at my next appointment to show her how I set it up and if it would be beneficial for some of her patients. I'm glad I have it on a flash drive.

Keep up the solid tracking of hour numbers.

[steve680]

I stopped myself when one night I did tripped and did a "face plant" on the sidewalk as I was walking (stumbling) home from a bar, and hit my head on the sidewalk (which also broke my nose). I tried to get up, but fell down again and hit my head on the sidewalk again. I could feel the blood running off my face, and so I decided to just lie there and "chill". Between the force to my head and a high blood alcohol content, I passed out. I was on the sidewalk for about a half hour when someone found me face down on the sidewalk and called an ambulance.

When I got to the ER, they found I had alcohol poisoning and some of my numbers, like potassium, were dangerously high (6.7). I was immediately given something to get the potassium down. The doctors also took me off an ARB blood pressure medicine I was taking at the time which they attributed the high potassium to. Coincidentally, my nephrologist (that I didn't like) was working a shift at that ER room that night.

I didn't think I even had that much to drin that nightk, but that it had somehow snuck up on me. I found it hard to stop drinking in a bar environment once I got started. I spent three days in the hospital and went through alcohol withdrawal, which included a couple of episodes of rapid heartbeat. A doctor at the hospital also indicated that alcohol was responsible for my kidney failure. Never found out why he said that as they didn't do a kidney biopsy. It had been a few months since I had seen my nephrologist and my GFR had dropped from 14 to below 10. A few months earlier I had normal potassium. So, I sort of felt lucky that I had tripped that night as I discovered the high potassium which is undetectable (no symptoms) and could have been fatal.

The ER doctor believed that I had fallen because I lost consciousness and so sent a report to the DMV which caused me to lose my driver's license for six months. I had to go through various heart tests and wear a heart monitor for two weeks to get my license back, even though I was not driving a car at the time of the incident. Eventually, I got it back, but it was a real pain to lose it in the middle of winter (and a wet winter at that). I became a good customer of Uber for a while. I tried to explain to the ER doctor that I fell because of the alcohol and didn't lose conciousness until after I hit my head on the sidewalk (twice), but he didn't believe me. He only knew that I was found passed out on the ground. I never wanted to go through an experience like that again, so I resolved to stop drinking after that night and never had another drink. My kidney function improved a little after I stopped drinking, but it never completely recovered. I stayed stage 5 and eventually would up on dialysis.

[Gauvian in reply to steve680]

Wow what a story steve680 well done to you for stopping the drink. I wish you all the best with getting a transplant, thanks for sharing the info.

[steve680]

Thanks, I appreciate that.

Kidneys do weird, unpredictable things. For 6 years (2006 -> 2012), my creatinine was stable at 1.7 even though I was a moderate to heavy drinker.

In 2012, I stopped drinking all together and my creatinine improved to 1.39 (almost stage 2).

In 2013, I started drinking again due to being in a stressful job, and the creatinine started to rise a little bit.

A year later (2014) my creatinine was 1.5, and my nephrologist told me not to worry because creatinine can fluctuate. I didn't attribute it to the alcohol because my creatinine had been stable when I was drinking.

A year later (2015) my creatinine was 1.7, and again my nephrologist told me not to worry because it was still stage 3 and creatinine fluctuates. My nephrologist also indicated he only wanted to see me once a year.

A year later (2016) my creatinine was 2.6, which for me meant I was now STAGE 4. I cr*pped my pants; so did my nephrologist. My nephrologist told me we could do a kidney biopsy but it wouldn't change our treatment plan (supposedly), so I passed. I didn't want to get jabbed by a big needle if I didn't need to. He ordered some new labs and he told me I was passing a lot of protein in my urine, which is a bad sign. Three months later my nephrologist retired. I was turned over to a new nephrologist but he didn't request I come and see him, but he continued to renew my prescriptions. I had a treatment plan, so I didn't see the need to someone, but after about 18 months, I requested an appointment.

I saw the new nephrologist and he ordered new labs. It was now 2018, and I found out I had "progressed" to stage 5. My new nephrologist said that there was nothing he could do to help me, and he wasn't going to try. He refused to order a kidney biopsy as he said it was pointless at that point. My only options at that point were dialysis or transplant. All of a sudden, I felt like I got sucker punched. How did this sneak up on me?

Well, all I can say is that this is how the disease progressed in my case, from almost stage 2 to stage 5 in five years. I often wonder what the outcome would have been if I hadn't resumed drinking in 2013, i.e. what would have happened if I had stayed sober. Unfortunately, I'll never know. Hindsight is 20-20.

I probably sound cynical, but you need to keep in mind that you and only you are responsible for your health - nephrologists are not paid based on the outcome of their patients; they get paid by the visit. One would hope the nephrologist would care about their patients, but that hasn't been my experience. You need to request appointments and lab work, even if your nephrologist doesn't.