Hey guys. My dad is on his 3rd year of Hemodialysis. CKD stage 5. He's a 50 years old obese and is getting worse. It's like the dialysis isn't helping his body to get rid of his fluid intake. That is however, it is very difficult for him to limit his water intake to 1 liter per day because we live in a tropical country. He is also having problems on following a restricted diet which I think could be blamed on his mental vulnerability because he is obese. He's already weak so he thinks he needs to eat more to compensate. It's getting difficult for him to carry his own weight, has anyone experienced this? Because of this, he needs oxygen everytime he's on dialysis because he gets filled up quickly. I just don't know what to feed him anymore or how to help him. I just don't know what to do anymore. Any suggestions would be great help. Thank you.
How do you diet when you have CKD? - Kidney Disease
How do you diet when you have CKD?
First, thank for caring for your father; mine was also on dialysis many years ago. I'm thinking it would be helpful for both him and you to have a palliative care consult, it that is available where you live. Both of you need support. Blessings.
Thank you for your insight! Unfortunately, we have almost exhausted all our funds in order to support my dad. In my country, palliative care is a rare thing to resort to. But I understand the concept of your point. I might look more into it in the coming future.
This will sound cold and I don't mean it too but it appears to me the only one who can help your dad now is himself. We can't make someone else do what we think they should. Nonna had great advice in seeking palliative care if you can. Good luck.
Thank you for your jnsight! Yes it is very frustrating and it's taking a toll on all of us mentally, emotionally, and physically. I'm more than frustrated with him, I just always think of the fact that he has lost hope on recovering from CKD so he turns to food, so I really sympathize with him. He's my dad, I can't give up on him even if he's already resigned from fighting. But thank you, I also think the same thing.
I do understand what you are going through. My sister was the same way, morbidly obese, CKD, T-1 diabetic and COPD among other things. She could never give up on the food. I battle that too but seeing what it did to her helps me keep it under control, most days, but not all. Have faith
Sorry your father is having a rough time of things. I'm sure this is very hard on you.
Have you asked his Nephrologist for a referral to a Renal Dietician. They can help with weight loss and suggestions of a healthy diet for a dialysis patient.
You and your father may be able to get some advice from the dialysis team as well.
Best of luck.
Thank you for your suggestion! His treatments and hospitalization has already impacted greatly our savings. I will perhaps look for videos online on this.
Online and the public library are both great resources.
I have been obese all my life. The kidney transplant program wanted me to lose weight before they would put me on the transplant list. I have been working with an endocrinologist and have lost around 35 pounds. I take Wegovy, the newly approved weight loss drug that is basically a higher dose version of Ozempic, a diabetes drug. There are worldwide shortages of Wegovy. I was luck I was able to get it. It does reduce appetite. It also works by making eating painful. Luckily I don't get nausea or vomiting, but I do get terrible stomach cramping. I go to the Y 5 nights a week for 2 hours a night. Although the Dr. says that doesn't really help me burn calories but helps my heart and blood sugar and makes the transplant people happy. My Dr. indicates I won't lose more weight until I get my calories down to 800 a day. I eat once a day and am probably closer to 1000-1200 a day. I have a VERY slow metabolism, lifelong (59 years) genetic obesity, am post menopausal and am an insulin dependent T2 diabetic (due to CKD, they took me off my oral diabetes med and switched me to insulin). Losing weight is very difficult for me. I have found working with an endocrinologist to be much more effective that working with a dietician. My transplant dietician wanted me to eat 1500 calories, exercise for 30 minutes a day and still lose weight. Her advice was based on 40 year old myths about weight loss.
How does that work (a slow vs fast metabolism)?
It takes the same energy for a person with low metabolism to walk 100 yards as it does someone with high metabolism (all things being equal, like their weight, the speed they walk, etc). Over the course of a day and assuming their activity is the exact same, they will consume the same amount of energy.
Yet the person with high metabolism is said to burn more energy.
Where does the extra energy (created by the person with high metabolism) go - if they are using energy at the same rate as a person with low metabolism? Once food is converted to energy (burnt) the energy it has to "go" somewhere / do something. It can't just disappear.
I've always wondered about this
There is lots of research. Its a real physical thing. People who have trouble losing often have a low normal body temperature. They tend to be more still throughout the day and night. Internally, they process foods differently. There are unknown (to me) numbers of biochemical variables.
My dietician told me to eat twice as many carbs. Guess what happened, I gained weight. At least I could afford to, but I still didn't want to gain. I only went in for a CKD diet, not weight loss or gain diet.
I think an endocrinologist is best with your metabolic problems.
Good luck. I know you are very motivated. Have you asked about exercising every other day to fool your metabolism?
I beat myself up terribly if I don't go. I used to go 7 days. Now I skip the weekends and try to mall walk at least one day a weekend. Last night I only managed 1/2 hour. I wasn't feeling well. I got my COVID booster and a Hepatitis vaccine last week and am feeling punk. I just got my first ever cold sore at 59! I just learned it is a known vaccine side effect, especially when you are immunocompromised in the first place. What I really need to do is get over my fear of using the weight machines so I can try to build some muscles.
That's another.of those ones that I've kind of gone "duh?" to all my life. I know folk who'll put on a kg from eating a Mars Bar. Whereas I couldn't on weight to save my life. I seem to be like a Toyota Prius or something!
That is new information. I have always thought that eating more would mean that there would be more extraction, because of gaining more weight. So essentially putting more strain on the heart? How are you faring with exercising if I may ask? Are you not lethargic most of the time?
You provided some interesting info on Wegovy. Thank you!
I understand the struggle. I see it everyday with my dad. I have heard about ozempic but I am a bit apprehensive on how well my dad will take it. Because he regularly feels nauseous, lethargic and has stomach cramps for some reason. If it's not too intrusive, how are you faring with ozempic? My dad's doctor has also rejected him from operating on him, he was a conventional doctor. Given that the new kidney will most likely be affected by getting more strain than necessary due to his obesity, essentially being rejected and going to waste. Otherwise, other doctors will operate but there's is risk on rejection and resources being put to waste. We've also been quoted with anti rejection medications, 3 times the cost of what it regularly is because of his weight. But then again I do understand that the longer you are put on dialysis, the more complications may arise. It is a very difficult decision to make
They didn't say anything to me about needing more drugs due to my size. I even did a drug study to make sure the drugs actually got into my system since I have no colon. There is actually very little research on kidney transplant among obese. There are many irrational preconceived notions about weight. At 201 pounds it was the same as if I were 2000 pounds. They pick a magic number that ends in a 0 or is below a certain bmi. But these numbers are NOT based on any scientific research. I had to get under 200 to get listed. If I was a man I would not have had to lose weight. Also, if I were a man I could have gotten listed at Mayo. I couldn't even get an assessment at Mayo or the u of Minnesota because they have very low bmi cut offs. The talk of wasting a kidney on a fat person is quite disturbing. I and others like me are worthy of life.
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