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The kidney Dr. is back being interviewed by DadVIce
Re: Low Protein Diets etc. : youtube.com... - Kidney Disease
Re: Low Protein Diets etc.
Written by
RoxanneKidney
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So not a Lee Hull/vlpd/keto fan then!! Whilst strong suggestions for ACE or ARB (as you suggested earlier), conflicts for my mum with the video include:
Her kidney function is increasing not decreasing
Her BP is consistently very good
Her weight is now OK at ~63kg
Home urinalysis doesn't indicate protein (but lab tests eg 24h collection, do).
That sounds good. As long as she feels good and her labs are good. I had ordered the supplements and sent them back today. I was scared to use them even though my renal dietian suggested them????????Glad your mom is feeling better.
Thanks but no her labs aren't good (as per previous communication between us). eGFR and serum creatinine steadily improving eg eGFR latest =76 so in stage 2 territory.
But serum urea stubbornly >50% over normal max. And urine data continually worsening. I've concluded due to single kidney.
She generally feels OK albeit with some intermittent muscle weakness/insomnia.
What supplements. I thought you'd opted for drugs?
PS hope the £15 that I recently spent on Lee Hull book not wasted! Video would say so.
Your renal dietician okayed them? I know KidneyRD.com appear to approve them and Ketorena (and they are board certified RD's).
Your renal dietician say she's checked them out (by way of constituents, etc). Seems strange that a doc would approve something 'off the web' so to speak.
My renal dietian directed me to Hull's site. But as I stated before, I'm not sure they know anymore than we do with our research.
Yeah, but us and our research don't amount to a hill o' beans in any court of law. But an RD recommending some supplement "off the web" willy nilly??
When the population they are recommending this too have a progressive, deadly disease??
I'd have supposed this ripe for a lawsuit in the land that single handedly invented litigation for everyman!!
I had ordered Hull's supplements. But I sent them back. But some people obviosly benefit from them.
Hey Roxanne.
I started out on this video but quickly found myself getting irritated by the slow pace of information delivery, guffaws n' knee slapping and sweeping generalisations. 
From about 10 minutes worth of watching, the messages being given were:
- low / very low protein diets are presented as some kind of fad washing around the internet. Not appropriate for 99.9% of the CKD population. Some doc whose written a book says its not required. Low protein diets are controversial. Etc.
- the doc in the video has a book to sell
- keto analogues "empty your wallet"
- only 1 in 100 of CKD3 patients end up at end stage.
-
Low and very low protein diets are given a triple AAA recommendation for application to early stage CKD by the NKF. Reading the GRADE method used for assigning rating (rating 1A) indicates that if you are NOT running stage 3 populations on such diets then you better have good reason why not. The GRADE ratings are couched in sobre language but roughly translate as 'its a no brainer'
I started into reading the 2020 NKF guidelines from start to finish but fell asleep. But I did manage enough to glean that the guidelines are the result of a serious, serious evaluation of the body science. I think thet referenced 15,000 papers and distilled what that science had to say.
This video (thus far) stands four square against the guideline of the NKF (as well as against Lee Hull on the matter of at least low and very low protein diets).
Keto acids cost between $4-6 a day. That is hardly emptying your pocket, especially since you'll be saving on meat . Dialysis sounds like it would cost you (never mind the State) a tad more than that. Ya gotta speculate to accumulate!
Given KA supplemented diets are now a mainstream recommendation, healthcare systems ought to be stepping in, not only by way of paying for KA's on public health but by evaluating the KA's on the market (currently only 2 that I can see). KA price ought to tumble, given the economies of scale and competition but until then, if they are kidney preserving then they are as cheap as chips.
1:100 CKD ending up at end stages of the disease. This I truly doubt.
You watched through, I guess. Is there anymore substance of the argument against low and very low protein, given the NKF guideline? Do they explain why the NKF got it wrong and this doctor got it right?
Actually this doctors book is quite good. But, the information he gives on medication (and what I have seen on this site) further encourages me to stay as far away from medications as I can, even if I die sooner. Cause taking one med then ends up with at least a couple more prescriptions to manage the disasterous health effects of the first drug. And, then there are bad side effects to the other meds, which require more meds etc. So, the drugs may give you another 2 or 3 years, but they will be years steeped in absolute misery. But, this is my take... In fact, I would not be dying of heart failure and CDK if it were not for doctors prescriptions in the first place. IF ONLY I had taken other means...
Oh, by the way, in this doctors book he only is advocating about 46 to 55 grams of protein a day, so not much different than Lee Hull and others.
I know right. Good point. As far as the protein goes the average person over eats it. 50 grams a day is enough for anyone.b
We can probably agree that : Considering a person without CKD only needs about 50 grams of protein a day, people eat way too much, and the meat is especially hard for the kidneys to process. If we have Ckd and are leaking protein, it makes sense to cut back. This doctor repeatedly says the protein is bad news. I guess the question is how much should one cut back. A low protein diet is really only slightly less than what we should be eating, and a really low protein diet is 20-30 grams. That only is counting meat and tofu and beans or nuts, but I don't count any grams of protein f I'm veggies. I'm not finding getting adequate protein and issue. As far as most stage 3 not making it to End stage that is because most will die of heart failure, I guess. I think the confusion comes from the fact the most people eat way to much protein to begin with, so cutting back really feels limiting to them. But if I were to eat really low protein, less than 20.. I would take supplements. Again I only could the grams of high protein food. And limit those, but the others add up, So I feel fine.
I suppose my issue was the likes of their dismissing very low supplemented diets as wallet emptiers and supposing 1:100 CKD stage 3 CKDers arriving at end stage.
That kind of stuff generates serious credibility issues to my mind. They might be right on some points or not so wrong on other points but the takeaway for me is being as contra the science as they are. Without the science (to my mind) we are left relatively rudderless.
Some folk in the US tend to present as lot more whizz bang / high five! / "Your dang tootin', ya'll" than we do on this side of the pond. And so, the finger quickly got to hovering over the eject button when I sat down to watch. Once they began on the contra-science that was it: Auf Weidersehen Pet!
He did seem to but he does qualify it with there are people who are losing protein. They know it is an indicator of mortality.
My dietitian has ruled out tofu and beAns and nuts. Because I’m diabetic I’m supposed to eat 5 times a day. I’m not getting enough calories. My intention is to maintain my weight but I’m losing. Any assistance with diet? I’m not a cook.
What'd the dietician say to your losing? Surely their job is to give you a plan that doesn't result in your losing weight?
I just spoke to the Dietician. She’s away but she called me. She gave me some alternative proteins sources, suplena which can increase my calories. And she said I could try beans and peanut butter. I see her in two weeks and I’ll show her my labs.
I thought she probably ruled out Tofu because it is high in potassium, but then, so is peanut butter.
Good point but we do need some potassium.
Yes, we do need some potassium. But, I would prefer to get it from a food that is not inflammatory such as Tofu. Peanuts are very inflammatory.
Sorry, but I disagree with your renal dietician. pcrm.org/good-nutrition/nut....
There are multiple studies to the contray.
Most of the food I eat doesn’t taste good so I’m not eating enough. Any cookbooks? 68 years old and never really cooked much.
We need to sell mixes etc. that are kidney friendly. Like bread mixes and etc. Things without additives and salts etc. if I couldn't eat tofu and bean, I would probably be pretty darn thin.
But I would like to go to the grocery store and find something that was good for us.
besides the usual veggies and fruit.
I try to take recipes that I like and elimate the salt and reduce sugars and find ways to make them healthy. There is a lady on youtube to cooks vegan called Pick Up Limes...she has tasty recipes. healthy. there are recipes for vegan burgers and other dishes. If she adds salt, just remove it.
Me too. Every morning I get on the scale and it is a struggle maintaining weight, especially when your dietician says 195 carbs and 50 protein is your limit. But, you can have all the fat you want, so make a list of possible fat foods. For me cream cheese is a staple, cheese sauce on my morning cauliflower is a no brainer. I guess olive oil poured on your green beans is another possibility. I eat six times a day and need to average about 350 calories per meal to reach 2,000 cal/day which I need to maintain weight. I juggle my metformin and glimiperide trying to stay in range. Find im hypoglycemic at 3 am. Need to cut back my evening dose, I guess. Who cares where your carbs and protein are if one is wasting??? It is a real balancing act. Wished dieticians focused more on calories for preventing wt loss.
Did he/she say why? Do you have gout or something too?
No gout
Just spoke to her. She gave me information on a supplement I can take called SUPLENA and said I could try beans and peanut butter in moderation. And we would review labs. She’s away this week. I see her in two weeks. I’m going to do another 24 hour urine but I’ve been on Bactrim and I want to wait until it’s out of my system because I understand it can increase your creatinine.
A lot of peanut butter has high sugar content which I'm sure you know and I've read that peanut were harder for kidneys to digest. I eat a few nuts a day, but almonds, pecans, etc. Just a few. . Some beans are less starchy than others, but portion is key like you said. Wonder why no soy? Keep us posted. What meds do you take? Lisinopril raises creatinine, but better be worried about protein in urine number and not creatinine.
Not on Lisinopril but I take 12 different medications for different illnesses: cholesterol, blood pressure, diabetes, asthma, bipolar 2, tardive dyskinesia..
Yikes that's a lot to keep track of! You are right not to want to add one more med.
I would gladly add another medication if it delays the progression of CKD..
The latest best are the SGLT2 inhibitors. For diabetics as well.
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