Has anyone successfully lost weight with ckd? Has anyone tried baratric surgery to lose weight? My story in a nutshell. I was diagnosed with stage 3 ckd in January. At the same time I was seeing an orthopedic surgeon for hip and knee pain. A series of x-rays plus some sort of bone scan using radioactive material pinpointed my left hip as the root of my pain. I need a hip replacement, however, I need to lose weight before the doctor will do the surgery. The first ortho suggested I not listen to my pcp or nutritionist about a diet for ckd and eat as much protein as I could so I could lose the weight fast (I had lost 82 pounds on keto before the ckd diagnosis.) This guy would not give a specific amount of weight, nor the body mass number he wanted me to reach. I had a second opinion this week and he also wants me to lose weight, explained how much more difficult it would be at my current weight both on me and the surgical team. He wants me to lose another 75 to 80 pounds. I talked to my primary care doc and she talked about several methods and also said that if I tried one of the types of baratric surgery that it would help me lose that amount of weight. I am most interested in the baratric balloon that is placed in the stomach and can be increased or decreased as the weight management doctor feels is needed. I am worried about how this will impact my ckd and she said she didn't know but would do some research and that I should talk to the weight loss doc about it. I know I have to lose the weight, the pain from the bone on bone hip is horrible and getting worse. I am on morphine for the pain and it just lowers it to a bearable level.
Weight Loss: Has anyone successfully lost... - Kidney Disease
Weight Loss
I’m so sorry you’re in such horrible pain! I can’t even imagine what you’re going through. I’m also stage 3 ckd and I have been able to lose just over 30 lbs on a mostly plant based eating plan. It’s been very slow but I’m not perfect at making lifestyle changes. I do eat some salmon and no salt added tuna fish sometimes. The mostly plant based and low protein has also improved my kidney numbers. I was down to a few points from stage 4 and now am at 3a last blood work. I do eat legumes for protein and I eat eat cheese sometimes too. I don’t eat any beef or pork because it’s very hard for kidneys to process. I did learn something new to help in lifestyle changes and it’s to not focus on the end goal but to focus on making a good choice each meal and each day. I’m going to try to remember that and not pressure myself. I have more weight to lose. Please let us know how you are doing. We care. 🙏🏻
I too lost 25+ lbs on my prescribed CKD diet. The weight lost has levled off.
I did so well with Keto, but had to stop due to the protein being so bad for my kidneys. I worked with a renal dietician to work with a modified Keto diet with protein at 73 g a day. I was hungry all the time and that was not good. My last meeting with the dietician we looked at ways to keep me from being hungry. I'll meet with her next week for the last covered visit I'm going to email her some of the things I've learned about a renal diet instead of the modified Keto died. I had lost 82 pound on Keto, gained about 10 pounds back with the modified keto and working on a renal diet that I found. The dietician is checking in to my doctor requesting more visit and seeing if insurance will cover them. Sadly, I have so many conditions that the dietician thinks something can be requested and covered for one of them.
Hi Topaz,It infuriates me that doctors will not help patients of size. The fact you are living on morphine is very scary and not a good answer to your issue. My first suggestion is find another doctor. To lose as much weight as they want you to do in a slow and healthy way is going to be difficult for sure. The bariatric surgery is actually going to be faster for you. BUT and it is a big BUT, there are consequences. The balloon is not a recommended choice by the way because of the possibility of infection and other complications.
I hope you will take the time and go talk with a qualified bariatric surgery program that will be your support and not just out to make a buck. There is a lot of evidence that losing weight can help with CKD as well.
But being a person of size myself, I know how hard it is to lose and keep off weight. First of all, if you have done a lot of dieting, your body metabolism can be messed up. That is my issue. Second of all, the body knows that you are not feeding it enough and will quickly stop at a certain point and not lose more weight easily or at all. This is the issue with diet alone without surgery. The surgery changes not only the amount of food you can consume, but the hormones and other chemicals that make you hungry. You will lose weight rapidly. However, the complication of not being able to absorb nutrients afterwards is a BIG issue, especially for people with CKD. I am not going to go into it all. You need to talk to a professional.
One statement you made that really made me say CHANGE YOUR DOCTOR is that she didn't know the impact of bariatric surgery and CKD. And that she has you on morphine.
Here are some things I can suggest. Get off the pain meds as best as you can. Do not take ibuprofen as an alternative and if your doctor prescribes that, RUN from them. It has been absolutely proven that ibuprofen causes kidney damage.
See if going to a physical therapist can help improve your situation for now. Even in a chair, increase your strength by doing some form of exercise. Small dumbbells and resistant bands are a good way to help your metabolism and strength. The PT can help with this.
Ask for a referral to a renal dietician. You need to make a commitment to follow whatever they say though. Eating KETO or heavy protein is counterintuitive to CKD diets and can damage the kidneys further. I lost 30 pounds within 6 months of changing over to a renal diet, I have lost even more on plant-based, but it is very slow.
I also went to see a bariatric surgeon. I was turned down believe it or not. Too high risk. I am stage four and have other issues as I was also told I was too old. Not sure if that is true, but there it is. I wish I had done the surgery years ago when I was younger and healthier. Although I believe in the health at every size, the medical world does not agree. For people of very big size, this surgery can be a life saver. This is the most important part of what I have to say about diets and even surgery: YOU MUST BE WILLING TO COMMIT AND CHANGE YOUR LIFESTYLE.
I have several doctors for varying conditions. The first orthopedic surgeon is history. The current orthopedic is the doc who did my knee replacements and not only is a great surgeon, he is a very nice man. He explained that while he can (and did) do knee replacements on people with high BMIs, that he would have difficulty with the hip replacement because of all the tissue he would have to go through. He gave me a specific number, 75 to 80 pounds, and suggested I talk to my primary care doc about surgery and maybe diet pills. I went to my primary care who said that she wasn't well versed with the effects of surgery on CKD and she wanted me to talk to a baratric surgeon. I don't want any of the surgeries that take out part of your stomach or intestine. I am worried about side effects. All things that the baratric surgeon can answer. I'm fine with my primary care doc not knowing all the effects of surgery on ckd, she knows someone who does know the answers. She is having her staff set up a meeting with the surgeon. I hope it is soon because I am a worrier.
Have you spoken with a Nephrologist about the effects on your kidneys? A Neph is a kidney expert and can coordinate with your other physicians in your total care.
My ACL and both menesci went 2 years ago. They said i need a knee reconstruction. I was denied surgery from 3 drs due to my weight. Since it collapses bone on bone and I’m in such pain and utter disfunction, no exercise is possible. I spent a year in bed. I gained 80lbs. Not being able to move does that! I’m glad you got your knees done. I need two new hips, it’s the same thing—it’s painful, but they don’t work. I could no more use resistance bands than I could run a marathon, hips subluxe when abducting. I also am lucky to have adrenal failure and Cushing’s, true endocrine disorders that turn your metabolism upside down. I was on morphine for 10 years, got off it made me too weak. Only thing I can take is a strong muscle relaxer. When on opioids for a while neurotransmitters can backfire causing you to feel MORE pain. I am in less pain off them and wanted to make sure you’ve looked into that. It ain’t easy, but you’re in fine company ha ha!
I've lost a lot of weight with CKD. (At least 60 lbs, probably more.) I was diagnosed with Stage 3A in the fall of 2020. I went full freakout mode, very scared, very upset. I felt like it was a Catch-22, because I know obesity is bad for CKD, but losing weight too fast is also bad for CKD. I switched my diet completely to plant-based, very close to vegan, following the diet plan advised by Lee Hull in his book on kidney disease (more or less, I can't say I follow it 100% but I'm very strict about the plant-based part).
After I lost probably 20 pounds, I had one doctor tell me I should keep my calories up (so maybe I'd lose 1 or 2 pounds a month?) but I felt that was B.S. because I had already lost some weight at a faster pace but without any dramatic ill effects. But I complied and increased my calories for a spell.
It felt very VERY counter-intuitive as a fat person to have to force myself to eat more than I had an appetite for. Then I found this site: thegeriatricdietitian.com/k... and determined that at my current BMI (in the morbidly obese range), it was "safe" to lose about 4-5 pounds a month. That was actually not as drastic as I could have done. I looked at this online calorie calculator to tell me how many calories I should have at my age, sex, and weight, and for me, the calories they gave me seemed to work. calculator.net/calorie-calc...
It worked great! I've lost a lot of weight. I'm still obese but no longer "morbidly" obese and feel fantastic. I've lost enough weight now it's becoming a little hard to keep losing 5 pounds a month (because I don't want to go under 1200 calories a day) so I'm hoping to lose 3 pounds a month. My follow-up with my regular nephrologist showed that my GFR had gone up several points and my labs were all decent. My doctor was very pleased with my weight loss efforts and told me to keep doing what I was doing.
I don't know what your labs are or what your unique situation is, so I can't say my diet will work for you. I do urge you to see other doctors, because they all seem to have different perspectives, some which are clearly not helpful! (As with the doctor who urged me to eat MORE, lol.)
In my case, my GFR was in the 50s, I have no protein in my urine, and most of my labs (other than creatinine) are more or less normal, some a little on the higher or lower side but within normal range. I have no idea how my weight loss plan would work with anyone else. (I'm a middle-aged woman, and we typically struggle to lose weight. But here I am, losing weight! Praise the Lord!) I also should add that I don't exercise much—which I need to do—so being sedentary hasn't hindered the weight loss.
Anyway, it can be done. For me, plant-based made a HUGE difference. I stuffed myself with lots of veggies, prepared them to be tasty, and they filled me up so I wasn't always hungry. I've been very comfortable with this diet; never feeling deprived or starving. I also follow the "zig zag" diet, where you do 5 days with lower calories and then two "pig days" (higher calories) so your body doesn't start to plateau. As long as the average amount of calories for the week totals to your goal, you're good.
Since changing to a more kidney friendly diet following my diagnosis of 3b last year I've found it quite hard to keep weight on. When I first switched to plant based I lost about a stone quite quickly. I suspect this was mainly fluid due to my kidneys' not functioning properly (I had been constantly thirsty with a dry mouth and was drinking way too much fluid). Once the load on my kidney's was eased by eating a better diet and limiting salt the weight loss settled, but I have to eat more than I've ever eaten before to maintain my BMI at 21.
Please be so careful with any bariatric surgical remedies that are offered these days. They’re not exactly always based on improving one’s health and well-being. It’s more of a money-maker. I’ve heard some serious horror stories about almost all of them, bands, balloons, including the gastric bypass / sleeve. Remember that it is a business, and the end result is more often than not, irreparable, and in turn will wind up being indefinitely your problem.
A high protein diet is really not the answer for those of us with CKD. It’s really not the best for anyone actually. After a period of time, it can overwhelm our kidneys and ultimately, weaken their function. I often wonder if it was all of those years following a high- protein, low-carb diet for so long, that may have contributed to my kidney issues.
Ask your medical team, or a renal dietician about a low-sodium, more plant-based diet for the time being in order to the lose the weight quicker for the hip surgery. Incorporate a little more easily digestible protein like eggs and some cheese into your diet. Eat plenty of foods like celery, lemons, and add parsley to your salads and soups. These all have a natural diuretic effect. Drink plenty of water (speak to your doctor regarding how much daily, would be acceptable for you). Try to consume your heavier meals during the day when your metabolism is most active, and find some chair exercises to increase your cardio.
These all have proven to be successful tactics in my experience (when I stick to them, that is - lol). I hope you will find this helpful. Please keep us posted on how you come along! All my best to you, TopazForests! God bless. 😊👍🙏
I still use very low calorie 850 to 1200 Keto and cycle low carb Meditarian style just have to choose carefully what you eat and best work with a Dietician because your body might not work like mine. About the surgery it is a 5050 risk however I had read about some who were able to significantly reduce the rate of egfr decline while others had sevre side effects that ended up having to remove the stomache due to damage or cancer. There are also new drugs meant to control diabetes that could help not only with weight loss but a better arteries and heart health this in turn benefit the kidney as well ask your Dr if you can use it . Finally have you tried accupunture for the pain instead of taking pain killers which kills the kidneys
I have not tried accupunture, but have heard good things about it. It's frustrating when insurance won't cover it and you can't afford it. I have had chronic pain from my arthritis for years, which is part of the reason my primary care doc thinks I have ckd. So I had to go off all the arthritis meds and that caused the chronic pain to increase. I had been on NSIADS for the arthritis for more than 25 years. I am working with a pain specialist and he had me try a pain patch, which I loved. Because we didn't have time to wait for the insurance prior authorization to come in, I paid cash for the first month using GoodRX. The insurance denied it stating that before they will pay for the pain patch, I had to try two other meds. Morphine is the first of these. The pain specialist said he wouldn't prescribe any of the other meds. He is dealing with the insurance company while I try the morphine.
Ya it sucks when insurance does not pay. You can also try cold laser therapy as well I have chronic foot pain cannot walk for months I did cold laser and I could walk in a week. Cold laser therapy is covered by Medicare Medicaid too during physical therapy . You need to be careful with those pain meds it will destroy kidneys faster remember to drink as much as you can as per your Dr limit and try to move as much as you can move
I woke up suddenly one day and said out loud to myself…I’m addicted to sugar! That day I started a mostly keto diet. A year later I am down 70 pounds. No more diabetes and no more kidney issues. My fatty liver is now normal. My blood pressure is normal. My EKGs are normal. We can reverse the effects of the damage that SAD (Standard American Diet) does to our bodies. It takes discipline to realize that you are the only one who change you. I simply decided that I am the only one who can fix me. Every cell in our body dies off and is replaced by a new cell about every 3 months. Therefore we are sort of “made anew” each time. The challenge becomes…do you keep feeding yourself the same crap that has made you sick? Or, do you begin to feed each cell what it really needs for optimal health? It’s your own choice. I also try to walk a mile every day. Keto means no sugar. No grains…flour, oats, etc., so no breads or cereals. No potatoes of any kind. No more canola or vegetable oil. I only use organic virgin oil and butter. Lots of fresh leafy greens. No fruit except berries. I’ve gotten my life back, that’s the best I can say. Oh, and my doctors are amazed and thrilled at my results. The weight is coming off very slowly, but I’m okay with that. It took me years to pack it on, so I guess for it to come off slowly is okay.
All the best to you. Just remember this, it’s YOUR decision either way, and that NO ONE but YOU can change yourself by taking that first step towards better health. I do have to be honest here and say…. With God all things are possible and so He is with me on every step of my journey.
Good for you I had been on Keto and cycle with Meditarian for the pas10 years however I developed CKD stage 3 3 years agoSo the caveat is to prevent kidney damage you have to drink enough water and electrolytes and do a mostly vegetarian with very little meat and very little dairy or no dairy use olive avacado or coconut oil nuts as fats or cocoa butter nothing processed mostly fresh low carb fruits fresh veggies and fresh meat or fish. Also it is important to have cheat days where you can eat anything you like but best to carb load with all kinds of fruits and veggies and minimal junk food. Also remember if you use the ketostix to check for ketosis drink more water if it shows a darker color because it means dehydration aka possible kidney damage and not deep ketosis like most people think. Take care
Everyone has made great suggestions. I can't add only tell my experiences. At stage 3-4 I hovered around 345 lbs and 5 ft 7 inches. I was still quite active owning a farm and had 5 kids. I walked a couple miles daily, did mild weight lifting, exercise bike 3-5X a week. Within the first 2 years on dialysis I went from 345 to 280. Just by returning to work, being cautious with diet etc. I'm now at 184 but also now 5 ft 3 inches. Ì never tried any specific diet or actually limited my calories by counting carbs etc just better portion control and being more active. In 2004 when trying to get listed a surgeon told me I'd be dead within a year without gastric surgery. I found his statement irresponsible and ridiculous. He was at Mayo Clinic. I never returned to him. Everyone has their own way and nothing works perfect for everyone. Blessings
I'm sorry that you had to deal with a rude medical professional. In cases like the Mayo doc you dealt with and the CHI ortho I dealt with, I remind myself of this old joke: What is the person who graduated last in his (or her) medical school class called? Answer: Doctor. Regardless of how intelligent or skilled a doctor is, if they cannot relate to patients, it will hurt their practice. I keep getting surprised by doctors who do things like blame you for gaining the weight and saying if you cut out sugar and salt you could lose the weight. At the same time, they ignore the problem and allow it to continue.
I am on wegovy and went from 224 to 189 to get on the transplant list. I lost my colon and have an ileostomy so I can't have bariatric surgery. Wegovy has simar weight loss is surgery. I am lucky my insurance has covered so far.
I had bariatric surgery on 3/24 (vertical sleeve gastrectomy) after having had a total proctocolectomy in 2007 (with a j-pouch now) The gastric bypass isn't recommended for us but the sleeve is fine if all your other tests go well. I have lost 75 pounds (17 pre-surgery) been able to go off all of my diabetic & bp meds, and most astounding of all to me is that even though my diet is more protein than anything my egfr went from 56 in March to 97 last week! I can't get over how much better I feel in every way. I'm only sorry that I assumed not having a colon ruled this surgery out for me until last summer when I read an article from an ostomate who had the sleeve done..it would have been nice to have this tool which has been so helpful for me when I was 50 rather than waiting til 61..but I'm grateful in any case!
I had a total of 5 abdominal surgeries and now have a parastomal hernia no one will fix. I've had two temporary ileostomies while a straight ileal-anal anastomosis was healing. They couldn't make a j-pouch so they gave me a straight shot. After 3 years of hell I got a Barbie butt and permanent ileostomy. My CKD is from 30 years colon free with a high output ileostomy. The constant dehydration has killed my kidneys. Given my short small intestine and tons of adhesions no one will do bariatric on me. Also I live in a state with TONS of experts (Minnesota) - Mayo wouldn't even fix my parastomal hernia.
That's a lot. I've had 6 abdominal surgeries but fortunately none shortened my small intestine - I'm prone to adhesions so had several emergency open lysis sessions to relieve total obstructions. I'm just shocked at how well my kidneys have done. In 2010 I had an aki, complete kidney failure as a result of hypoglycemia in my sleep that left me in a coma for a couple of days due to a T2 med and skipping a meal (no one told me) and they said I would have to probably have dialysis if I lived which didn't happen but over the years I've struggled with caring for my kidneys - that I went from the 30s to mid 50s was good but seeing my last two results in the 90s is like a dream. I hope things will go well for you, you've clearly got a lot on your plate 🤗
I have added wegovy to the list of procedures and meds to talk about with the weight loss specialist.
Don't take this as a lecture, or advice for what you need to do. This is what worked for me, a type 1 diabetic with CKD. Also, I have specific information, because I am an engineer who needs to know exactly what I am supposed to be doing, not the typical vague stuff docs say like "eat as much protein as possible" or "based on your lean body mass". Just like you implied, you need to know what the goal is to know how to achieve it.
I lost weight (from 220 to 135 lbs) over about 6 months using a lower carb diet. The problem is that "low carb" and "high protein" are defined differently by different people, so I'll be more specific. At an eGFR of 20, my nephrologist told me to:1. Eat at least 1g of protein/kg of ideal body weight. He defined the body weight as your body weight at a BMI of 25 for your height. For me, at 5'2", that is 62g. He also said not to eat more than 1.3 g/kg. That would be about 80g of protein for my height. (62-80g protein/day for 5'2" female)
2. Limit carbs to less than 100g/day. I got a food scale (that shows nutritents in food) and counted the carbs in carrots and broccoli. As a diabetic, the stabilized blood sugar was very important to kidney function. I couldn't give up potatoes, so I would slice up one 1 inch diameter white potato every morning and eat that with 3 eggs. When I walk more than 20 min, my blood sugar drops, so I sometimes have to eat glucose tablets to counter act this. DO NOT USE CANDY to raise blood sugar if you are trying to lose weight. Dextrose is used immediately to raise blood sugar. Sucrose is half dextrose and half fructose. Fructose causes fat storage.
3. Worked my way up to walking 30 min/day, no matter what. That took me about 6 months. (I didn't have the joint problems, though, so you'll have to determine what you can do for activity)
4. Limit sodium to less than 1200 mg/day. I limited my sodium to less than 800, because that was easier for me.
5. Fat didn't matter, but the type of fat did. I was allowed to eat bacon, olive oil, coconut oil, butter, but no veggie oil or canola oil or margarine, because they are fake or overly processed fats.
6. No artificial sweeteners, because they are hard on kidneys. That includes stevia, and high fructose corn sweetener. There isn't much research on stevia, so it may or may not be bad. HFCS is so processed, your body doesn't see it as food, and can cause extra inflammation in the body.
With all of these rules, I could not eat any processed food. For the first month I was super strict. After that, I allowed myself to cheat one meal a week, so I could stay sane and not feel so deprived. Also, I ended up with low BP because my sodium levels were so low.
I think that telling someone with CKD to eat as much protein as possible is irresponsible without him talking to a nephrologist.
Good luck. Keep up your spirits!
Thanks for your information. Like you, I prefer detailed information. Right now I cannot do much exercise at all. My hip is in such bad condition that I cannot take a step without extreme pain. I can do exercise in the pool. I was in aquatic physical therapy until insurance cut me off. My insurance covers gym membership but the site we go to kept closing the pool and we (I drug hubby with me) would get ther and then no pool. The gym just opened a brand new site and we need to go check that one out.
I cannot take aspertame, saccrine, and one more without getting severe migraines. Stevia leaves such a horrid after taste for me. My husband loves it. Interesting how the same thing reacts so differently in two people. I do use sugar alchol products to sweeten items. I'll use monk fruit sweetner in my tea and will buy Keto granola with either erythiminol or xylatol in it.
The fired ortho is an idiot and when he kept pushing the eat more protein, I finally told him that following his recommendation for eating that much protein would mean that in a year, I would be on dialysis and not need a new hip. Then I said that it was interesting that he was refusing to treat a condition within his speciality but wanted to tell me how to treat another condition that was being treated by two other professionals. He is such a jerk.
I'm lucky to have a primary care physican who knows all that is happening to me and is basically my guide through all this. She may not know everything, however, she knows the doctors who do know everything. I have not had a bad referral from her.
You said "in a year I would be on dialysis and not need a new hip." Could you clarify or explain why not? Just trying to understand the rationale. Blessings
At a loss
Wondering about fatigue/body aches
Nearly Hit Stage 2
CKD Stage 2 and Keto Diet?
how to keep protein potassium and phosphorus low and get 2,000 cal/day? 
