My 66 y.o. husband has a Gfr of 53 and 15 to 30 protein in urine. He was first diagnosed 19 months ago and Gfr has changed very little. His PCP tells him to drink more water, lower sodium intake and get tested annually. He went to a Nephrologist that told him to drink less water (no more than 50 oz. daily), lower sodium intake and test annually. Neither doctor seemed concerned at all. We consulted a dietician who said to limit potassium, phosphorous, sodium and protein.
Now we have seen videos and posts stating that an all plant diet, along with protein supplements and alkaline, will reverse the kidney disease progression.
If he continues with a balanced diet with low sodium, potassium and phosphorous, is it possible that the progression will be slow enough to last the rest of his life without the extreme change that an all plant-based diet would bring? We realize that every case is different.
I can understand your confusion - different advice from different specialists. It would be most useful to know what your hubby's underlying condition is that is prompting the kidney situation and then adapt a diet to take that into account. You see, kidneys rarely break down on their own - usually there's something driving it like diabetes, high blood pressure, autoimmune conditions etc. It seems that all three professionals agree that lowering sodium is a good idea. So, if your hubby's exams (and labs) show that it's only high blood pressure that's a problem, then lowering the sodium and related should help outcomes as well as the proteinuria situation. However, if your hubby has diabetes then reducing carbs and sugars along with the salt would be most helpful in stabilizing matters. As far as protein is concerned, most people will generally eat "fins and feathers', but stay away from red meat. Protein is another complex substance important in preventing anemia , etc. This said, please don't do anything without the approval/direction of a professional who has taken a good look at his labs and exams. The renal diet impacts important electrolytes needed for proper body functioning including heart health. It really should be by prescription only. Please don't forget that you also have your own dietary needs. Removing salt from both of your diets may not be wise - doing so can make one pass out as happened to me as a caregiver to my hubby. Labs drive everything. Hope this helps!
Thank you very much for your reply. Another confusing thing is that no one knows why he has Kidney disease - no high blood pressure, no diabetes, no family history. Looking back on his last 20 years of labs, his Gfr has been consistently low at each age level. All other labs look good, including sodium and potassium.
Again, we appreciate your reply, especially your comment about his own dietary needs.
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One more note - we stopped eating red meat (which was always infrequent) when he was diagnosed 19 months ago. We know that some things cannot be explained, but just want a plan for going forward.
There's so many recommendations about diet and kidneys that a lot of people are left confused. What helped me was to remember to diet to my labs and my medical conditions and not anyone elses. Good luck and stay in touch.
That's very interesting! GFR is influenced by exercise and hydration. Wonder if your hubby is heavily into exercise and/or drinking lots of water? I'm just making wild guesses. Or maybe there's there's something else underfoot...who knows, right? Wish I could come up with something, but I'm not a medical person. But do take a good look at your hubby's prior labs and check to see whether his GFR is trending downward rather fast. It's often the history of GFR that's meaningful, but GFR going downward is also part of aging too. We're lucky if our organs last beyond the century mark. Hmm.... If the data and trend troubles you, I think I would ask another neph for a consult. You definitely deserve answers to your questions.
I know that it is confusing. He does not exercise, but is active with working on his classic car and other hobbies- not strenuous. He used to drink a lot of water, as well as a lot of Pepsi. No more Pepsi at all and 50 oz. of water daily. He is tall, 6'3", which the nephrologist says is a factor - tall would equate to more muscle mass.
We will just have to trust that God will give us direction in His time.
Hmm....your hubby isn't taking in much water at all. The average daily amount for men is at least 64 oz. (some say 125 with food), and your hubby is very tall and active. Too little water generally lowers eGFR. I'd ask my primary doctor to rerun labs in a few weeks. Our primary accommodates us quickly; yours will probably do the same. You may well have answers sooner than later. Blessings!
It could simply be age-related. At any point did your husband take NSAIDs or other drugs, if so how often? Also, excessive alcohol may cause kidney problems. But as you already know diabetes and or high blood pressure are the main culprits. Did your husband have a complete kidney ultrasound? That is usually one of the procedures that a doctor will order when one is first diagnosed. But it is not uncommon for CKD not to have a cause that can be pinpointed. Good luck and do not take anything that you have not checked out with his Nephrologist.👍
Thank you for the input. My husband has never taken NSAIDS or other drugs, nor does he drink alcohol. He is physically fit and otherwise healthy. He did have a complete kidney ultrasound which revealed normal sized kidneys and a large cyst on his left kidney. The neph and urologist are not concerned about the cyst and said that it is not the cause of CKD. they will repeat the ultrasound annually.
They also found a very small cyst on one of my kidneys during my last ultrasound in March. When I first got the results on My Chart I freaked out a little because it was not there on my first ultrasound but after talking to my PCP and Nephrologist was told by both that it was nothing to worry about and no treatment was needed.
I am surprised about limiting the water. My Nyphrologist has me drinking water all day to clean out my kidneys. I have followed the plant based diet pretty much and lots of oatmeal and my numbers have gone down. I am still 3aCKD but with better blood test. Everyone is different so I wish your hub the very best. This site helps to throw out questions.
Thank you. We are also surprised about limiting water. We went to two nephrologist. the first said 30 to 50 ounces per day. the second said maximum of 60 ounces.
I am just as surprised as everyone else here about limiting his water intake. All I’ve ever heard is to drink a lot of water to make sure the kidneys are being flushed well. Did the nephrologists explain why to limit the water intake? Have you ever heard of DadviceTV? It’s a pretty interesting website created by a guy who found out he had stage 5 kidney disease after having a heart attack, and was told he would be dead within three months if he didn’t go on dialysis. He dove into researching CKD and everything he could do to prevent going on dialysis. He brought his GFR up to stage 3b since, and has many videos on CKD diet and exercises. He also said that the US doesn’t seem to be as proactive about the disease as other countries. It’s another option for CKD info that I thought I would share with you. Best of luck to you and your husband. Btw, what classic cars is he working on? I love doing that too.
Thanks for your input. I really don't understand limiting water, but that's what two nephs told us. We have just recently started watching DadviceTV and love it! My husband recently sold his 1959 Triumph TR3A and bought a 1957 Corvette project car. It will be a longterm, multi-year project.
‘57 Vette? Now I’m jealous! You should find out from those two Drs. why they want to limit his water intake. I think we all would like to know what the reasoning behind that is.
Its hard to predict the course of kidney disease, especially if you don't know the cause. There are people on this forum who have delayed the progress of kidney disease for years with diet and a good attitude. Nephrologists and books will tell you you can't reverse kidney disease, though a fairly new family of drug (Farxiga being one) may be able to improve it some. Overweight, I recently learned, can be a contributing factor to kidney decline. Proteinuria tends to be a bad sign, but if his eGFR hasn't changed in 19 months, that's a very good sign.
He should avoid particular drugs, like NSAIDs and certain anesthetics-that info is available on the internet. There are usually alternatives that don't harm kidneys. Fevers, particular Covid, may cause setbacks, which may or may not be temporary.
As for the kidney diet, a lot of people go completely vegan, eat lots of fruits and vegetables, plenty of water, but you still need protein, which the kidneys have to process, to feel well. There is a protein supplement, Albutrix, which uses magnesium instead of nitrogen as the protein backbone, which the kidneys do not have to process, but it is expensive. Exercise and anything that improves general health is good.
you say protein where can you get that from iam eating the white stuff of the egg with beans since it comes from animal i dont know if iam getting the proteinuria worser or it s good to eat it with the vegetables teas and water of course and changed the milk for almonds or cocunuts water it tastes almos t the same and good
my eGFR was 57 when Dr. informed me I had CKD. I have no underlying health conditions either. I went on line and found great diet advice at Mayo Clinic and NKF websites. I targeted the food items that I learned were problems. For me it was Diet Coke, ice cream and potatoes. I completely eliminated them, cut down on salt and replaced the Diet Coke with water. 90 days eGFR is 73. Good luck on your journey.
Thank you for your reply. Your situation sounds similiar to my husband's. Thank God that you have improved! So far, my huband has not improved after major diet changes. However, he hasn't gotten worse!
I was diagnosed at stage 3 , five years ago. At that time my egfr was 36. I was 65 yrs old at the time. I was diagnosed with high blood pressure when I was 19. My doctors feel that high blood pressure was most likely the cause in conjuction with age. My blood pressure is now under good control with meds along with a 12 lb weight loss. Over the years my egfr has fluctuated to as low as 27 when i had covid this past winter to higher than 60 two years ago. i'm now at 47 at last lab tests in may. I talor my diet to my labs and do not see a renal dietician. Anything regarding diet i have learned from davita and other reputable sites also this forum has been very helpful. Tomorrow i go for updated labs. I have my fingers crossed. EGFR will fluxuate for most people. But stability is the key and that is what Nephrologists are looking at.
I'm glad you posted this. My wife went through the same situation where her GFR was fluctuating depending on what drugs she was taking as well as diet. She was down as low as GFR=39, is now at 77, and has fluctuated between those numbers over the past few years.
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Congratulations on her improvement. Best to you and your wife on this journey. My husband has never been on any medication - not even over-the-counter, so we cannot make any changes in regard to that. We hope for stability to continue.
My wife's case is complicated. She has multiple medical issues that directly and indirectly affected her kidney function. She had her left hip joint replaced in 2015 and then her right hip joint started hurting around 3 years ago. She had several appointments to get it fixed but kept getting sick and having to cancel. To curb the pain, she was taking a lot of Ibuprofen which we know is bad for kidneys. She was also on a BP med Hydralazine. I got her in to see my Neph and he told her to stop taking Ibuprofen and took her off Hydralazine, said they were both bad for kidneys. Then in January of this year, she was DX with multiple myeloma which also affects kidneys and this was probably going on for a while. She has been getting treatment for that and it has helped with kidney function. I've attached a list of her GFR over time and you can see the fluctuation. I would have to say that I don't think diet played any part in her GFR because she/we have not really changed our eating habits over the past few years.
Not sure but , so much conflicting info out there.
But it would not hurt to try mostly veggie diet for a while like 6 months to a year ( with small amount of meat .) Then get GFR done again .
Make sure you are drinking PURE filtered water .
Low salt ,low sugar, low Potasium, low Phosphorus.
*** You will have to look up the veggies and fruits.
DeVita has a list of 12 healthy veggies on their website .
Some that are healthy for other people, are NOT healthy for people with kidney disease.
For example potatoes, spinach, tomatoes too high in Potasium limit these or do not eat .
But Cabbage ,Red bell peppers, Broccoli, are Good very healing for kidneys .
Berries and cherries are very good.
But orange juice, oranges, and raisins are NOT.
Peaches are fine .
But not apricots.
I made lists of good and bad fruits and veggies and hung it on the kitchen wall for months . Now I have committed to memory.
So that when I go food shopping ,eat a restaurant or go to a friend's for dinner, I know what to eat and what to skip.
** One last thing that I feel is very important ,I buy veggies and fruit ORGANIC as much as possible . The reason is that I feel my poor kidneys do not need pesticides like Round-up going thru them .
You may want to find a Dieabetic and Kidney disease certified Nutritionist and go talk with her for diet ideas also .
Not everybody has high potassium and high phosphorous. So the fruits and veggies you mention as bad for kidneys aren't necessarily bad for all CKD patients. We all have problems with animal protein of course.
Here is something else to research...TMAO. It is my understanding it results from gut bacteria forming TMA from animal protein then the liver forms TMAO from it. It is a risk factor for CKD and a biomarker. I use lactobacillus GG with animal protein in a meal to prevent gut bacteria from forming TMA. Always consult your health care provider before using any supplement.
Since he's always had a low eGFR for his age for many years, maybe he had some kind of kidney injury long ago, but its been stable??
The eGFR formula is: 175 × (Serum Creatinine) -1.154 × (Age) -0.203 × (0.742 if female) × (1.212 if African American) "The equation does not require weight or height variables because the results are reported" normalized to averages.
Serum creatinine tends to be higher for men and African-Americans and older people, so the formula compensates for that. Creatinine is also higher after exercise and eating a lot of protein and lower after drinking a lot of water. Don't know what my point is here, I was just wondering.
An acute injury makes some sense - maybe that's the reason for the low, yet stable eGFR. You mention a formula for eGFR. The new eGFR standard no longer includes racial data and I think distinctions also are no longer made re males and females. I've read reports that both are considered no longer relevant or significant in diagnoses Some labs, however, still produce data with that info. Here's the new table: kidney.org/kidneydisease/si...
We thought about the possibility of an injury. However, we cannot think of a time that would have happened. Also, it would have had to have been 20 years ago at least. We have labs as far back as that. Wouldn't it have recovered by now? We went to two nephrologists, and neither has any answers for him. We will be repeating the labs and follow up with a neph in October.
Kidneys don't recover. Ask the neph, obviously. The injury could have just been a harmful drug he took for a little while, like a NSAID or something for pain. I got tinnitus 50 years ago from an expired antibiotic, and still have it. Just saying.
It seems youve had some conflicting advice from medics etc so I hope not to add to it. My mum's almost doubled her eGFR to ~60 in recent years without guidance from her nephro and she follows a Nutritional Therapy protocol rather than a dietician, for key reasons.
Also a recent scientific paper opposes the commonly held view on reduced, dietary protein but I wont send it in case it adds to your confusion - unless you ask.
My husband’s previous nephrologist (now retired) had a degree in nutrition in addition to her medical degree. She advocated a plant-based diet (vegan). It took him several years of resisting her before he agreed to it. But as soon as he did it his numbers stabilized. We have been following a vegan diet for 4 years. We have a new nephrologist who says a vegan diet is “too hard” but always remarks on how stabile my husband’s numbers are. I don’t think he credits the diet but we do. We had occasion to consult a dietitian (my husband also has Parkinsons) and she says every conference she goes to on kidney disease recommends a plant-based diet. She said the kidney’s have to go through 2 steps to process animal protein, but only one to process plant protein.
To tell the truth, it was hard enough for me at the start to figure out plant-based meals that i didn’t pay as much attention to the potassium, sodium, magnesium, and other food salt issues in a CKD diet but even with this his numbers still stayed stable. It’s a hassle at first, but you can find lots of vegan substitutes these days. (Trader Joe’s is great) Now i have lots of menus that we like and are plant-based.
Eating out can be difficult but we’ve found Thai restaurants can always work. They will substitute tofu in any dish and in anything (except Thai coffee or tea) they use coconut milk not dairy.
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