My husband has chronic kidney disease 3a, diabetes, cirrhosis and heart problems. Lately he has had protein in urine 256, 6 months and it's not improving. He is supposed to be on Ozempic but it's extremely difficult to get, since June only one prescription and that was half strength one. He has put on weight, he does an hour a day on exercise bike. It's very difficult to get him not to eat foods that are high in sugar inbetween meals. I cook healthy meals from scratch, even freezing some, so when I'm not well, we still can have a healthy meal. Here is the problem, his nephrologist told him to do protein shakes, 3 a day with the occasional piece of chicken or bone broth. My husband agreed, but at home decided it was not for him. After many arguments, we agreed on 1 shake a day with very light meals, for 2 weeks, to kick start weight loss. Home cooked chicken with beans, cauliflower and broccoli, or just a couple of boiled eggs. I have done the same, just not the shakes, as it's too expensive, on a pension. So much conflicting advice on internet, my husband is always trying to argue his way into eating bad things. I have health problems myself, it's wearing me down. I know you are not professionals, but does anyone know what we can do?
Confused with Nephrologist advice - Kidney Disease
Confused with Nephrologist advice
what are you using for the protein shakes? Has he tried them? Is he okey with the taste?
I’ve been having a high protein fruit veggie smoothie daily along with high protein cream of wheat, an egg with extra liquid egg whites, and non dairy yogurt. I’ve been eating Siggi yogurt. Their nondairy has about 10 g of protein per serving. I have a toasted English muffin with the egg. That gives me some crunchy food daily.
As you can see, I’m following a low sodium, low fat, low carb diet overall. I also eat very little meat protein at this point. Eggs with liquid egg whites are the only non-plant protein I eat daily now. It took me some time to adjust to eating fewer veggies daily. But I had to to keep my potassium in check. I also drink chicken broth sometimes…
I find I feel best when I eat appropriately. That as well as trying to get to a transplant without dialysis are what motivate me.
I’ve been able to control my A1C without meds for over a decade. It took me three months to pull my A1C in check with meds. They pulled me off the meds at 6 months. That was over 14 years ago. Diet and exercise were key then and remain key now.
Keeping you and your hubbie in my thoughts and prayers. CKD isn’t easy.
Jayhawker
The only one the nephrologist said to use was optifast, we are in Australia, so not sure if it is available elsewhere. He doesn't mind the taste. It does receive no dairy on it, he also said no fruit or vegetables. We decided we needed some, so decided on green ones only. My husbands regular breakfast was 5 weetbix with sugar, milk and cream, and a daily chocolate bar plus biscuits and muesli bars. He has his head in the sand. You are doing well. It does need commitment. I stopped lollies and chocolate after my last stent in Feb, it's not easy. But to live properly, you can't eat what you want and get away with it. Thank you for your reply. Take care. Moni
Hey, what brand of cream of wheat do you use that is high protein?
I add protein powder to it. Here’s the recipe.
Ingredients:
3 tablespoons cream of wheat
1 cup almond milk (unsweetened)
1/4 cup water
1 scoop protein powder (I use pure protein vanilla protein powder)
1 serving diced oeaches
Directions:
1. Mix cream of wheat with almond milk and water.
2. Microwave on high for 1 minute.
3. Stir.
4. Microwave on high 1-2 minutes stirring every 30 seconds.
5. Mix protein powder into cream of wheat immediately.
6. Put diced canned peaches on top.
I like the vanilla protein powder flavor together with the vanilla almond milk. You could put any fruit you like on top. I’ve also put peaches ir blueberries on top.
This is 30g of protein with the pure protein protein powder. There are other protein powders option that may give higher protein OER serving.
I also have a high protein oatmeal recipe that is simple.
Ingredients:
1/4 cup steel cut oatmeal (quick cooking)
3/4 cup water
Liquid egg whites (I usually put in 1/4 cup)
1 serving no sugar added cinnamon applesauce
Directions:
1. Mix everything together in a microwave save bowl. Be sure the bowl is large enough—2 quart size is good.
2. Microwave on high gif 1 minute.
3. Stir.
4. Microwave in high gif an addition 1-2 minutes stirring every 30 seconds. This comes out at 12g of protein. You can add more liquid egg white to increase me the protein. I can’t have regular milk products but if you can you could put milk on it afyer cooking. That would add mire protein. I haven’t tried adding protein powder to oatmeal. But it would be something worth trying too.
Jayhawker
Got a recipe for a high protein veggie smoothie that you like that doesn't look (and taste) like ground up grass like the ones I've seen on tv? 
Reply just as you have time busy lady.
peach raspberry smoothie
1 cup frozen raspberries
1 medium peach, pit removed, slices or ½ cup frozen peaches
1/2 cup silken tofu
1 tablespoon honey
1 cup unsweetened vanilla almond milk
I’ve also made this with blueberries instead of raspberries.
You can add veggies to it. I like to add 1 medium cucumber peeled and seeded. Also adding some spinach would work. I’m not sure about celery but you could try it.
Very Berry Goodness
1 medium cucumber, peeled and sliced
1/2 cup fresh blueberries
1/2 cup fresh or frozen strawberries
1/2 cup unsweetened rice milk
Stevia to taste (optional)
I don’t use Stevia. I usually make this without any added sweetener. But if I wanted to sweeten it some, I’d use honey.
Also, you can add tofu to any smoothie to give it protein like the first smoothie recipe. I always add tofu to my smoothies.
Bahama Breeze
1/2 cup strawberries
1/2 cup pineapple
1 small orange, peeled
1/2 cup rice milk
Handful of spinach
This is for those who are okey with potassium levels. But it gives you an idea of how much spinach you can add for a single serving smoothie. Again I’d add tofu to make this a high protein smoothie.
once you get going with these you’ll be able to come up with your own recipes that meet your specific nutritional requirements. One more that has more veggies in it:
Watermelon Bliss
2 cups watermelon
1 medium cucumber, peeled and sliced 2 mint sprigs, leaves only
1 celery stalk
1/2 cup silken tofu
That’s all I’ve got…
Jayhawker
wow, these are great! Last question, what recommendation do you have for a good, but not too pricy smoothie machine?
I just bought a pretty pricy blender. I make heated blended soups in it too. But my friends like the following blender specifically gif smoothies.
Ninja Professional Blender $80 appt
Jayhawker
I'm sorry you're having a hard time getting your hubby to eat properly. My hubby didn't want to follow a proper diet for a number of years - seeking out buffets, bringing home all the wrong foods, etc. Then, he was finally asked to see a nephrologist who bluntly told him that he had 7 years to live if he continued his lifestyle. He suddenly "saw the light" and immediately started on a very low carb and sugar diet. Unfortunately, it came to late - he lost his kidneys about two years later and was put dialysis. My hubby was very upset that he wasn't warned sooner, so maybe your husband would respond to an honest assessment from his team too. It definitely made my husband change his ways. In my hubby's case, he was told to largely follow the Keto diet, a diet that limits carbs to 50 a day or less. It worked beautifully. He lost weight and lab numbers responded and improved significantly. Unfortunately his blood pressure suddenly skyrocketed and he was put on dialysis to control it. Intervention had come a little too late in his case. Your hubby may have time to turn his situation around. Perhaps you can call his doctor or accompany your husband when he sees his nephrologist and ask him/her to be frank and honest about the prognosis. Sometimes, those that are obstinate or in denial simply need a direct statement to put them on the path toward better health. As a spouse to a diabetic, I know what you're experiencing. It hurts and it's hard. Please don't forget to care for yourself when you can. And stay in touch!
I do go with him, as he can't hear properly but won't wear his hearing aids. Nephrologist said he needs to do a biopsy to diagnose it properly. My husband agrees to do all the things while we are there, he has convinced himself that doctor said diet only 2 weeks, but he needs to lose 20 kg fast. I explained, even on strict diet, you can only lose 1-2 kg a week. I'm sorry your husband found out too late. Maybe they should have been more strict on my husband years ago. He had nearly complete renal failure 2011, nearly lost him, he has come close a couple of times. Thank you for your reply. All the best. Moni
You could try a Nutritional Therapist to address all of his issues with healthy eating for weight loss and his medical issues. But tbh a proper one should only consider it if your husband is willing to comply - so sorry.
When you're addicted to food, its not always easy to change. I'm sure at some level he knows the dangers of what hes doing, but simply cannot stop. It seems to me that he needs help with his food addiction and not necessarily just dieting. But, what is important is that its has to be up to him. You cant do this for him and neither can the doctor. Is there any chance he sees a mental health professional? If he can,hopefully, he can gain some insights into how these habits developed and gain the motivation to want to change. Unless, he does this, anything you do will unlikely alter things.
Bless you for all your help, but you have to take care of yourself.
Aside from a mental health professional, do you have any access to a dietitian?? With all the medical problems present, it has to he difficult to make "happy" meals that will satisfy him. And, I'm confused over the diet advice from his nephrologist. Most CKD patients are trying to do low protein intake and instead his doctor said to do 3 protein shakes a day????
Wishing you the best if luck with this very serious problem.
I want to add that food can be such a stress reducer for some people and that's how some food addiction develop. Maybe a good approach would be if he could reduce some stress by other means. For example, not having to lose 20 lbs "right away" could change to losing 5 lbs by xmas may be a more realistic goal by finding new exercises or by eliminating only one or two favorite foods and not all of them.
I do now remember the liver dietitian saying to be careful listening to this nephrologist, he is a hospital nephrologist but also works at home. Yes, even the info on optifast says it's not for kidney disease patients. That is why we decided only one a day. It's hard as we have seen quite a few dietitians but they don't always have the same advice. Yes, it's hard to change a habit of eating, I do have to let go of what I can't control. Just, because of our bad health, we help each other, it's the only way of coping. Thank you for your reply. Take care. Moni
Listen to your intuition and stop the protein shakes and get another kidney doctor if you can. And as far as dietitians are concerned, it's best if they're certified "renal" dietitians. Still, I understand what you are saying about dietitians as a lot of advice they give do not always coincide with existing habits.
Listen, you and your husband can do this. GO SLOW. Its important to reduce stress over this. Your anxiety meter is very high. Set realistic goals,i.e. not 20 lbs right away or giving up all the "goodies" ar once. Instead of 4 breakfast biscuits, try 3 for a few days/weeks, then switch down to 2 a day. It's easier to deal with eating less than eating none at all. Cut down on the amount of milk and cream slowly. Easy does it. Rome wasnt built in a day.
Did you know that once you slowly reduce sugar, your desire for it starts to decrease. And, it's easier to struggle with eating a little less than eating none at all.
You have a treasure in being able to help one another. Just do it easier. Try to find new exercises instead of more of the same old ones. Try a new recipe if you can each week. And, most importantly educate yourselves via kidney classes and info provided by reliable kidney sites. This way you can advocate for yourselves and when a doctor advises 3 protein shakes a day, you can with confidence say "no way"
Good luck and keep us posted on what's going on.
I did say to my husband, it takes 2 weeks for your taste buds to adjust, but his way of thinking is, I have to go back to normal eating some time, so why bother. I told him, normal eating not an option for us both. Thank you for your reply. I might try for him to read all these informative comments. Take care. Moni
Diets to some people are punishment. It is all how you look at it. I am amazed how much protein he is consuming. I eat a very low protein diet, heavy in fruits and vegetables. Have been doing so for over four years now. My husband and I make our "diets" lifestyle changes that will help us and not be a punishment. All about attitude.
Sometimes to get someone who is in denial to see the light, you need to show him what the future holds. Go to a dialysis center and see how much fun they are. Talk to people who wish they had the opportunity to turn things around when they had a chance.
I know Ozempic is hard to get right now. Not sure why. But.... if you can get it, please have him use it. It is an amazing drug. My A1c was running over 9 at one point. Insulin was helping but.... not as much as Ozempic did. Starting on it last fall. My A1c has been 5.6 since last January. I also follow a good diet and exercise. It works.
Ozempic hard to get because of tictoc, some celebrities said it's great for weight loss, even trulicity the one I used to take is almost impossible to get, I adapted my diet because I'm trying to avoid insulin again, it's so difficult to manage, each brand only lasts 12-18 months before it stops working. For some reason even our gp is against fruit, but we did buy some yesterday, maybe that will help his sweet tooth. Thank you for your reply. All the best. Moni
I don't have a whole lot of help for you, but I can sympathize completely with the situation. My husband does not have kidney damage (so far) but denied his diabetes diagnosis for over a decade, until he finally went on medication . He thought that meant he could go ahead and eat whatever he wanted and the pill would take care of it. He came within a hairs' breadth of having to go on insulin before he finally changed his diet. It was a constant battle all the way. He also can't hear but won't wear hearing aids, and when he leaves the doctor's office he has already forgotten what the doctor said, though he agrees with all of it while he is there. Then he will tell me I didn't hear it right, even though he knows that I did, all to avoid having to deal with it himself. He has many health issues, and he's literally pushed my health down the tubes with his refusal to deal with anything. All I can say is do your best, and then leave him to it. I finally got to the point where I prepare meals that are healthy for him, and try not to fix anything extra to keep for leftovers, or he will eat that too. He's dropped about 20 pounds in the last year or so, finally. I've literally saved my husband's life 3 times in dire emergencies, and at the time he recognizes it ,but then he goes right back to his default of "You don't know what you are talking about". Just take care of yourself, do what you can to get your husband to eat properly, and then leave it up to him. It's his life, and if he wants to throw it away, you really can't stop him. Best wishes for you and your husband, and keep in touch here.
Wow, so similar, my husband forgets what he wants to, then miss hears things and hangs on to it. I don't want to police his eating, just need him. People who stay with us are amazed how simple we eat. No trimmings. Thank you for your reply. Take care. Moni
Depending on the type of hearing loss he has the hearing aids may be difficult. I have Sensio neural hearing loss and do wear hearing aids. However even though I know a person is talking I might have trouble following the conversation, even with my aids turned up. As for the food I can't help there as I've never been overweight and up until the CKD I could eat anything I wanted.
I had to lose weight to get on the kidney transplant list. I have been fat my whole life. Luckily I got on Wegovy before it became popular. It really takes away my hunger. I have lost weight by eating just one meal a day. I have an ileostomy ( I have no large intestine and poop in a bag) and can't get veggies and fiber. I didn't change what I ate so much as changing to just eating once a day. My endocrinologist says I won't lose more unless I get under 800 calories a day. I just haven't been able to do it since I can't eat low calorie foods like veggies. I lost enough to get on the transplant list and I've kept it off with the Wegovy. Would it be nice to lose more, sure, but since I've lost enough to get on the list I'm ok with just staying where I'm at. To lose more I'd have to stop eating any meals and just have sugar free jello or three granola bars a day.
I don't know why people keep suggesting those protein shakes as meal replacements. My transplant dietician wanted me to eat them since I was only eating once a day. They are very high in calories. She thinks I should be able to lose weight by eating 2000 calories a day and 30 minutes of exercise 3 times a week because that's what they taught her in dietician school 40 years ago.
My endocrinologist knows that is BS. Weight loss is way more complex than calories in calories out. ALSO it is a total myth that obesity causes diabetes. Every study shows the opposite. It is the genetic propensity for diabetes that causes obesity. Yes, losing weight improves diabetes, but the causal relationship is not what people think.
There are international shortages of Wegovy, Ozempic and other diabetes drugs that reduce hunger. There is very high demand because they are the first drugs to really work. Many rich people and unethical doctors that are prescribing for people who are not obese. It is supposed to only be for obese people, not anorexic actors who want to lose 5 pounds. There are also huge production problems with Wegovy so Dr. are prescribing it's lower dose version of Ozempic to non diabetics.
I went to the YMCA five nights a week for 2-3 hours. It doesn't help with the weight loss, but does help with overall fitness. I got Covid last month and haven't been back yet. I need to start going again. I'm 59 and post menopausal. Most everything we are told about weight loss is a LIE and not based in science. You can't exercise yourself skinny, especially if you have a super low metabolism like I do. You can only lose weight by starvation and you have to do it long enough to trick your body.
I don't know if Wegovy is even approved in Australia yet. It is the only thing that has worked to take away my hunger. The average weight loss is around 15% and you have to keep taking it for the rest of your life.
Thank you for your reply. My husband has done 1hr a day on exercise bike for 9 months, but he does reward himself. Even when he was on Ozempic he didn't lose weight. Lately his hip has gone, so mobility very low. We both stopped our antidepressants to aid our diabetes, meds don't have same impact on antidepressants. It is about cutting what you eat, the food pyramid has changed drastically. Gets us confused. With Google, it depends what questions you ask to what answer you get. Is it good ,is it bad? So glad you were able to lose weight, because you decided to take charge. Keep up the good work!! Moni
I didn't lose on Ozempic either. I didn't lose until I got up to the full 2.4 mg weight loss dose of Wegovy. Ozemic only goes up to 1mg. You have to start on low does and slowly increase to avoid side effects. Good luck
In Australia only Ozempic or trulicity are available. Our pharmacy doesn't supply for weight loss anymore but they very rarely get any, plus we are Regional area, so city centre would get more. Maybe one day.
When I was needing a high protein diet due to low albumin, my doctor wanted me to get 100 mg of proteins a day because he was concerned my albumin would get so low they would take me off the transplant list. Here are some high protein fillers that don’t taste like you are grazing.
Premium Protein (Whey Powder) - Mix with 8 oz milk. It has 39 Mg protein (including the milk)
Quest Bars - They have Chocolate Oatmeal and other tasty flavors - 21 mg/bar.
Hope that helps.
Regards,
Magdi
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