What is the impact of plant based diet on y... - Kidney Disease

Kidney Disease

6,554 members2,656 posts

What is the impact of plant based diet on your GFR

Knobbs profile image
Knobbs

Hi everyone

I am 55yr old female. Diagnosed in March. CKD 3b. My GFR hovers between 32 and 36.

Other conditions- hypothyroidism, resulting in high cholesterol

On meds for hypothyroidism, cholesterol and high BP

I am thinking of changing to a plant based diet. Have you changed and have you seen an improvement in GFR?

What are you eating for protein? Anyone including chickpeas in their diet?

19 Replies
Bassetmommer profile image
BassetmommerNKF Ambassador

HI Knobbs, I went plant based in February and in April had labs drawn and my GFR went up 2 points and my creatinine went down. I am due for my next draw and we will see if this trend continues.

I have a very low amount of protein in my diet. It is only 10% of my diet which is 32 grams. I have a hard time keep ing at that level because it is so low. I get enough protein from the various things like broccoli, pasta, the wraps I use for lunch to worry about adding beans. I have included them occasionally.

My best advice is see someone who specializes in renal diets, plant base to help you figure it out. It is worth the money.

My lipid panel, cholesterol and so forth was the best I have ever had.

One change was B12 was low. I added Bragg Nutritional Yeast to my food and that should help with bringing that up.

BTW, I feel the best I have felt in years. Well worth the effort.

Try making small changes. It is easy that way to change over. I do not miss chicken and even eggs any more. Cheese...that was hard for me. So I have been trying plant based cheese products......yuck!

Knobbs profile image
Knobbs in reply to Bassetmommer

Thanks for taking time to share. I am seeing a renal dietician on Tuesday. I have however learnt that the real experts with practical tips are the people with CKD, hence the question. The only animal protein I am consuming at present is chicken fillets - about 2x a week and maybe 1 egg every 2 weeks. I think I might manage plant based approach. All the best

Skeptix profile image
Skeptix in reply to Knobbs

What you're told by a renal dietician will really depend on the paradigm the dietician is operating according to.

A lot will also depend on whether you believe doctors/dieticians are up to speed on the latest science and approaches. Or, assuming they can be up to speed in principle, is the one YOU are attending up to speed?

On the National Kidney Foundation website, you'll see general patient info and tips on meat consumption. Use thinner sliced turkey in a sandwich, for example. It's the same kind of info-lite I came across on the Irish Kidney Foundation website.

But if you dig down on the NKF site you come across the science. Take this presentation dealing with pre-dialysis patients. The link below then scroll down to Guideline 3: Protein and Energy Intake

kidney.org/professionals/gu...

(note: 0.8g/kg protein is the recommended daily intake for a healthy adult. 0.6gr/kg is low protein diet for us CKD-ers, it's considered sustainable without supplementation. 0.3g/kg is very low protein diet which would need supplementation)

First some research conclusions are cited regarding an "ordinary" low protein diet (which would include meat). That's ca. 0.6 g/kg protein intake per day.

ESKD/death: beneficial effect of protein restriction (OR 0.62; 95% CI 0.39 to 0.98)

QoL: scores for general health and physical status improved significantly after protein restriction

Improvement in serum lipid profile

Dietary protein intake can effectively be reduced

Dietary intake can be used as an index of adherence to the diet

Protein restriction had no effect on eGFR, serum albumin level and anthropometrics

Uncertain effect on serum phosphate levels"

Now this is good! A 0.62 OR means the odds of ESKD/death with a low protein diet are only 62% of the odds of ESKD/death were you to stick to a 0.8g/kg diet. But look at what happens if you go VERY low (plant) protein + ketoacids. This is a plant based 3gr/kg protein diet + ketoacids in other words.

"ESKD: two newer studies show positive effects of protein restriction + KA (RR 0.42, 95% CI 0.22 to 0.78); evidence from older studies unclear effect on ESKD

Could help preserve renal function in stage 3 to 5 CKD (1 study in PD also indicated that eGFR was preserved)

Could decrease serum phosphate levels and improve markers of bone metabolism (calcium, PTH)

Had no significant effect on serum albumin levels and nutritional status (SGA and anthropometrics)

Effect on BP inconclusive

Could improve lipid profile

Protein restriction + KA can effectively be achieved

Dietary intake can be used as an index of adherence to diet"

0.42 RR?! In other words, the risk of ESKD/death is 42% that of the other group. What other group? Well the low protein diet group, is what.

In other words: low protein (including meat) is a helluva a lot better than an RDI protein diet of 8g/kg. But plant only protein + keto is a helluva lot better than a normal low protein, part meat based diet.

Do you notice "could help to preserve renal function stage 3-5"? Preserve means doesn't decline. Or doesn't decline as fast.

This means that you shouldn't wait until you're down at the bottom of the barrel before you start tackling your disease. You might have more wiggleroom at 3 than 5. But you need to get on the case: if you are 40 years old and stage 3 you've nothing to be hanging around for.

-

See what your renal dietician recommends. Cut out meat altogether and go low protein + KA? If that doesn't come up then you at least ought to ask them the question, why not?

"But if a very low plant protein + ketoanalogue diet has risk ratio of 0.42 vs. a low protein diet, why are you putting me on a very low protein diet?"

Or you might find as I found: you're told by your nephrologist to go easy on red meat and cut your meat portion size. In which case, get a new doctor

SkiingSailor profile image
SkiingSailor in reply to Skeptix

Very well put !

Marvin8 profile image
Marvin8 in reply to Skeptix

Great post!

Wow, Skeptix what an awesome reply! You are so very well versed in our shared issue and finding/using the relevant, up-to-date scientific evidence from trusted sites. That is a tremendous way to role model the “educate yourself” tool so necessary to CKD patients!

I really only licked the notion off Lee Hull's book. He dug up this kind of research and more and it turns out the NKF list the same stuff.

I was more noting the fact that there's a lag between the latest research and practice on the ground. Your nephr or dietician could be way behind the times. My nephr doesn't even appear to want to manage my blood pressure!

Point being: you need to lead the charge. Or figure out how to trust a professional without leading the charge!

Knobbs profile image
Knobbs in reply to Skeptix

This was very insightful, thanks. Saw dietician. Made a decision to go on a plant based diet. She is sharing meal planner with me next Tuesday.

Skeptix profile image
Skeptix in reply to Knobbs

Am trying the v. low protein + keto myself. It's a 4g protein + 4g keto mix.

Hard to keep the protein down to that level. Like salt, there's protein in everything!

Skeptix profile image
Skeptix in reply to Bassetmommer

I feel your pain regarding cheese. It's only 3 weeks or thereabout of no meat and I can't say I'm pining for it (although I did find myself lashing an off cut of my son's ham sandwich into my gob with some relish this morning).

But shopping down in the supermarket for fake cheese (a.k.a. vegan cheese) was distressing. All those lovely cheeses: soft, hard, Dutch, English, smelly and not so smelly.

The vegan variety was buried up in the top right hand corner - I had to stand on my shopping basket to reach it! In amongst the muck called vegan cheese I have found one that is pretty impressive it must be said. Hope springs eternal

When I was diagnosed almost 4 years ago, my GFR was at 32. Since then I've had it as high as 65, but more importantly I've averaged 50 since the diagnosis. As I mentioned to you in another thread, I haven't been on a plant based diet, and I hope I don't have to go that way. I do eat mostly veggies and I include a small chicken or turkey breast, a small piece of fish along with a plateful of veggies. I spoke to a Renal Dietitian shortly after my diagnosis and after looking at my lab reports and letting her know my preferences we developed a diabetic, kidney-friendly meal plan that has worked well for me.I no longer eat at restaurants because I can't control the prep and cooking process and frankly, I think I'm better off since I can easily do what they do in their kitchen for far less money.

Be sure to bring a list of all your medications with you when you meet the RD and if possible, bring a schedule of when you take the meds. The reason for this is that some meds interact with food in a negative way and some others require you to take them just before or after a meal. When my RD and I scheduled my first appointment she advised me to bring all of my meds and we went over each one and the interactions with other meds, foods, and which ones were not recommended for someone with kidney disease at certain stages.

If you'd like to check that out yourself go to drugs.com and look for their MY MED LIST feature. Enter all of your medications and when you are finished you'll have a complete list of your meds and the interactions with other meds, food, and it will make a difference.

Please ask your friend to contact a local kidney transplant center or contact UNOS to find out how to provide a non-directed living kidney donation. There are guidelines transplant centers must follow when accepting kidneys for transplantation. I was just told by my transplant nephrologist that GFR must be 20 or lower to qualify for a transplant. At my transplant center they generally won’t transplant until GFR is 14 or lower, Stage V.

Jayhawker

Kidney disease's condition is irreversible - this means the deterioration will continue. Any intervention is temporary. I was diagnosed with kidney disease 30 years ago - I went from 1 nephrologist to another until I found the right partner to my journey 14 years ago. I stayed with him and he manage all my kidney administration - mix and max of meds (I had other conditions, I don't take ANY med without his approval), lifestyle, health (he use a dietician - there are plants that affect the kidney adversely(, medical check up (no invasive tests), etc. The purpose is to protect the kidney - above all else.

10 years ago, my eGFR was in the low 20's and creatinine at mid 200's. He managed to extend my kidney's effectiveness (with 1 year more to spare, if I want it) until we decided it's time to do a living transplant two months ago. He is now managing my new lifestyle and ALL to make sure the benefits are maximized.

The point is - find the RIGHT nephrologist (and by right, I mean - one who will answer all your pertinent questions). He will be your partner in your journey. Do not self analyze or self medicate (very dangerous). Take all the advises and feedbacks to your RIGHT nephrologist - he will give you the right options (after all, he is the expert)

Examples: I was not allowed to take any vitamins - they could affect my other medications. No Chinese medicines, no kidney supplements (useless), no full medical check up (some could be invasive), I was taking sodium carbonate, Velphoro, a tab that breakdown sugar, etc in the last one year before surgery (now all discarded) - they protected the kidney until my scheduled living transplant surgery.

Good luck - remember that stress only adds to the kidney deterioration. Embrace your condition and Prevent/Prepare.

Thanks for feedback. I am very careful not to take any other than meds prescribed by the nephrologist

Mr_Kidney profile image
Mr_Kidney in reply to Knobbs

You can take meds from other physicians, just make sure that they are aware of all of your health issues and always, on each visit, provide them with an updated list of all medications, even any OTC that you are taking.

The science behind going to a whole food plant based diet is clear ( see above) . On a personal level I can vouch for it as well. I was diagnosed in Nov 2020 , read Lee Hull’s book “ Stopping Kidney Disease “ and went wfpb straight away. By April this year my eGFR had gone from 51 to 73! Ok, so it’sa bit of a hassle at friends houses ( take my own sometimes) and night end up with the occasional salad and chips in some restaurants ( won’t be going back, and now check menu and ring up first) but on the whole once you get 20 recipes in your sights it’s pretty straightforward and fun ! My husband is following be default as I do all the shopping and cooking and many of the meals have received high praise ! Good luck with it abs I hope it raises yours too. I don’t hold out any hope for your GP advocating wfpb, s as making you well by diet doesn’t seem ( in the U.K. and USA at least) to be their aim.

I have yet to meet my nephrologist but but far it appear that nothing affect my GFR, something I want to discuss with my nephrologist because I think that this steady number is/was deceiving. Prior to be told that I had kidney issue it was at 64 while I was eating ~150g protein/day and working out up to 10 times per week. Dropped to ~80g/day and the GFR stayed the same. Last test slightly dropped to 52 (from 64-70) but could be caused by the added exercise.

I have been eating a bit more vegetal protein than before and it appear to have had a positive effect on my BUN but it may have been caused by the surgery .. which may or may not have been successful -I am awaiting a MAG-3 scan to confirm that. AFAIK I was/still suffering from hydronephrosis, orignially caused by crossing blood vessel and it's unclear whether that kidney is blocked again, have no function left or give a false impression of being blocked on a T-Scan.

The other thing that changed is the quality of the protein, last year I was eating lots of egg, grass fed milk and sardines while now I tend to eat lots of almonds, steel cut oats and sometimes lentils. A bit of everything else too but right now they are my go-to protein, I still eat beef a few times a month in moderate quantity.

Overall I feel better but I may have felt just as good reducing the amount of high quality protein to be the same that I am absorbing right now. For me the advantage of the plant based diet is that I get more fibers and I tend to not eat enough potassium. At least for now. One negative I have is to be moderately mindful of balancing my protein whenever I eat lentils because I could see a few symptoms of being too low in protein building over the course of a few weeks. I also need to take a cal-mag more regularly.

Hi Knobbs, i am here to tell you that you have the power to improve your kidney function. I am a registered nurse and after I found that I had an elevated creatinine (1.85) in February of 2020, I did my own research. The most striking factor I found was that animal proteins are hard on kidneys. I now eat whole food, plant-based and avoid meat, fish, eggs and cheese. This change in diet has returned my creatinine to baseline (1.03) in this relatively short time, and it will hopefully continue to improve. I also do aerobic exercise most days and avoid NSAIDs, processed foods, salt and fat. I have learned that too much fat in the diet is harmful to the endothelial cells in the vascular system, which includes the kidneys. My physician is impressed with my progress. A good place to start is to watch the Forks Over Knives documentary and YouTube videos of Dr. Neil Barnard. Take charge of your kidneys and don’t rely on physicians alone - there is a wide variation in their knowledge base on this subject, and I say that as the wife of a physician!

In answer to your question about protein in plants, Dr. Barnard has a quick video on YouTube about it. I didn’t realize this, but there is protein in fruits and vegetables and as long as you eat a variety of them, along with whole grains like brown rice and legumes like chickpeas, you will get plenty of protein. As for supplements, a B12 and Vitamin D supplement are recommended.

One last note - you will see an improvement in your cholesterol numbers with a plant based diet. Guaranteed.

Best wishes.

Thanks for the feedback🤗. Really appreciate this.

You may also like...