PRAL/DAL/NEAP and CKD. You on an acid trip?

[Skeptix]

Does acid this figure in your/your docs CKD management?

Whilst rooting around on the National Kidney Foundation I searched against all the above terms and got "Your search did not produce any results, please try again"

Potential Renal Acid Load/ Dietary Acid Load / Net Endogenous Acid production. The nature of our diet determines acidity of our blood.

Lee Hull signposts the science indicating that an acidic diet is damaging to CKD burdened kidneys. And that to halt the march downwards, we need to switch to a more alkaline leaning diet. The aim being to be alkaline, not acidic.

Meat, eggs, dairy (surprise, surprise) is highly acidic (along with many non meat fruit and veg). It can very well be that one reason why the science points towards a very low (plant) protein diet + ketoacidanalogues as kidney-sustaining, derives from the fact that such a diet is low acid.

What do folk think of acidic as a factor to be managed?

[Bassetmommer NKF Ambassador]

Oh Skeptix, You are on to the other major "new" findings in renal diets. Yes, acid levels can be harmful if too high. Too alkaline also is not good. My uric acid levels were terrible and that is from having Psoriatic Arthritis. I passed multiple kidney stones, and had three large ones lodged in the kidney. I was eventually put on allopurinol and sodium citrate to lower my levels of uric acid and the stones dissolved and I haven't had one in years. Also switching to no meat, eggs and dairy is another factor. I have not eaten red meat since 1986. And so, that was not a renal factor for me.

[Hidden in reply to Bassetmommer]

Very good information. One additional item I'd add if you have high uric acid is Gout. The Arthritis Foundation has some excellent advice on Gout and CKD.

[Skeptix in reply to Hidden]

Bloody hell, my brother in law has gout. Onto the sister with diet news so!

[orangecity41 NKF Ambassador in reply to Bassetmommer]

I too am taking alopurinol due to high acid but have not been told I have gout.

[WheresNaldo in reply to Bassetmommer]

How do you you keep your uric acid levels low? I’ve been dealing with gout for nearly two months. I also bought Lee Hull’s books and have been vegan for two months. Thanks

[Bassetmommer NKF Ambassador in reply to WheresNaldo]

Hi Waldo,There is a lot out there on Gout diets. And if you read those, it will help. things to watch for are purines. You can Google that too. My issues are not from food but from the Psoriatic Arthritis which makes the same issues as Gout, but...not the same cause. So I am on medications to help. Many doctors start with sodium bicarbonate, yup: Baking Soda. But I could not tolerate it so I use a solution medication. Everything needs to be run by your doctor.

[Jayhawker in reply to Bassetmommer]

I’m on sodium bicarbonate too. I take 4 650mg tablets a day. I’ve also shifted to a modified vegetarian diet as per my renal dietician’s guidance.

This dietary shift has improved my BUN data specifically. It also improved my eGFR some over the first few months (ie, eGFR went from 13 to 15 over the first few months as I shifted my diet). My eGFR then stabilized for about 12 months with eGFR of 15.

So, the primary benefit I got from the dietary changes was BUN improvement. It was just a very modest improvement in my eGFR.

Over the past 4 months (several years later) my eGFR has shown a more substantial and unexpected improvement. This improvement is definitely NOT tied to dietary changes. My nephrologist believes it is due to better fluid management; in short, he thinks I have been chronically, severely dehydrated. So with better fluid intake, my eGFR has risen to 21 as of my April labs. I have new labs this coming Wednesday. We’ll see if this improvement holds for the next few months.

Jayhawker

[Skeptix in reply to WheresNaldo]

Won't the vegan doit do it for you. If you stay off acid veg too?

Sodium bicarbonate = salt though prob not an option?

[Skeptix in reply to Bassetmommer]

I must tell my wife about this. She had some small kidney stones pass and said it was worse than childbirth. She's terrified of them. Will give her then benefit of my own non acid diet musings! Cheers

[KidneyCoach NKF Ambassador]

Yes it should be well managed. A more alkaline diet is generally healthier than too acidic. Moderation in all things. As always check with your doctor.