Yes, definitely

[PensacolaSharon]

Losing weight using a healthy diet (no Rx) and exercise can definitely improve kidney function. Btw, most people with ckd die from a heart condition before reaching dialysis necessity (90%). Healthy diet and exercise greatly reduces cardiovascular risks for 98% of people.

[userotc]

Indeed. Whilst the reason that weight loss should help CKD is likely more reaching, its effect on BP is probably key. This has been demonstrated by my dad in monitoring & plotting mum's BP over the past 7y, as reported in blog below which youve seen. As he states, maintaining sustainable weight loss "should aid her CKD which, whilst generally a progressive disease, can be successfully managed to halt or reduce that progression".

ocnutrihealth.com/blog/chro...

[GosportNancy29]

I have a dilemma, I have heart failure and am at increased risk of cardiac arrest because I have had one already. I also have stage 3 chronic kidney disease + type 2 Diabetes.

The dietary requirements for heart failure include foods high in potassium and the main dietary requirements for those with chronic kidney disease include minimising or avoiding foods which contain potassium.

The food selections I am looking at are opposites. So I have a choice of managing the heart failure OR the kidney disease.

My current thinking is that I prioritise the heart related issues and then wait and see if I am offered dialysis at some point

[Badger2024 in reply to GosportNancy29]

This is for your doctors to decide, not for you to worry about. Perhaps they need to discuss it together. I am also stage 3 CKD and my nephrologist told me that I don’t need to reduce potassium as my levels are fine. Yours may be too. Until you speak to your doctor I would continue to eat foods containing potassium

[GosportNancy29 in reply to Badger2024]

My health record on my NHS app was updated recently and I found out that my stage 3 CKD was diagnosed in May 2022 and my GP hadn't mentioned this to me. The dietary requirements for my health conditions contradict each other so I can't eat high-potassium foods for my heart condition at the same time as limiting potassium for my kidney issues.

Any decision about my health is down to me. I don't have a nephrologist as I have to be referred and my GP hasn't told me that I have CKF but it is included in my health history.

[Badger2024 in reply to GosportNancy29]

As you have been having a potassium-rich diet for thirty years for your heart condition I would just continue that unless your lab results have shown a recent rise in potassium to above normal levels. People with CKD often don’t have to reduce potassium until stage 4 and beyond. Sounds like you need to change your doctor

[PensacolaSharon in reply to Badger2024]

Agree on that. Look closely at lab results and aim to keep them all in a normal range. If you're not out of range on potassium, not going over, then there isn't going to be much if any effect on your ckd. This is true for all lab numbers. If you can keep them in normal ranges, ckd will not progress quickly. Cut as many exposures to chemicals as possible, eat organic produce, lots of it, because that benefits heart and kidneys. At stage 3, cutting out all processed food (bread, chips, crackers) will benefit you greatly.

[2023CKD in reply to GosportNancy29]

Always talk to your doctors ( kidney and heart) as your diet depends on your entire health picture.

If you have diabetes, high blood pressure, are overweight or have any other co-morbalities you may have other dietary restrictions

I am losing weight to achieve my recommended BMI for my age, height and frame size. I’m feeling better already there is a

I don’t have coronary artery disease or other heart issues that impact the kidneys and I have good blood pressure.

My doctor said the two most important things for me are:

1. Manage sodium intake. He said that it is key to manage blood pressure to prevent or manage coronary disease

2. Exercise an average of 155 minutes a week.

Walking is an excellent option, as is biking, or various other cardio options. It’s winter so I am going to the mall and walking 2-3 miles 3 times a week.

He said managing potassium or phosphorus or protein is not something that I need to worry about until later stages of the disease ( think when your kidneys are damaged to the point where they are not able to dispose of these) typically as you are closer to dialysis). Approximately when your GFR is less then 30

If I had diabetes I likely would need to be more diligent about sugar intake

I read multiple books and what I found is that often the information in the books say limit sodium, potassium, phosphorus and protein ( but don’t qualify for what stage) and lose weight if you are overweight/ over your BMI.

This lead me down a rabbit hole trying to find foods low potassium and phosphorus foods and trying to avoid eating them entirety.

Now I use an app to track my food intake and by eliminating salt and making more meals from scratch and eating more fresh of frozen l fruits and vegetables. I am noticing most of the time my sodium, phosphate, potassium and calories are within the RDA which puts me where I need to be .

My take away from my initial research….Choose your source of information carefully. Choose information by kidney doctors and if they are trying to sell a magic pill at a high cost move on. There are a lot of people monetizing those with kidney disease fears

A good place to start is the National kidney foundation website.

Besides monitoring your appropriate food intake, be sure to have your doctor check the medications and OTC supplements that you take, as some can be harmful especially NSAIDs.

For example taking OTC turmeric pills can cause kidney stones which should be avoided. I was thinking of taking them for inflammation.

Also if you gave a CAT scan let them know that you have CKD. The contrast that they inject in your bloodstream can damage your kidneys. Instead they will have you drink a kidney friendly contrast.

I spoke with a well respected kidney nutritionist and she recommended that I follow a heart friendly diet such as a Mediterranean / low salt friendly, heart friendly diet. Your recommendation may have some exceptions.

I am in the process of finding the best foods that work for me as I’m managing several different conditions that require different dietary choices. When in conflict heart and kidney trump others for me but thankfully many food choices are included in all subsets.

Start by eliminating or reducing processed foods, those with lots of additives and prepared foods.

In their place substitutes more fruit, vegetables and foods / beverages with low salt, sugar and additives. There are lists of things to avoid. Drinking water, tea or coffee are generally ok. Eliminate soda.

Track what you eat and drink to help manage the quantity od sodium you consume. You’ll be surprised! This will also help with your calorie intake.

I use a free app called Cronometer (it has an excellent database of foods if you are in the US) . It’s really helping me. It also tracks my steps via my watch/ phone and calculates my calories available real-time by subtracting my calories burned

There is also a free app called Yuka that scans barcodes of food and other products to tell you if it’s good or bad for you based on various factors including too much salt, fat, calories or toxic additives. ( I scan US labels so results may vary in other countries )

Avoiding toxic additives is important for kidney health.

FYI: I have stage 3B with a relatively stable GFR of 50-57 for at least 3 years. I was recently “diagnosed “, no one ever mentioned that I had CKD until it popped up on my chart a few months ago as a condition and I happened to notice it

After integrating a kidney friendly diet for 25 days it is becoming easier. I keep introducing new foods into my diet to find healthy options that I like.

Best wishes to you, it seems overwhelming at first but focus on the longterm outcome and work on making a positive change to your diet a little bit each day.

I started with the goal to introduce fresh fruit and vegetables a little each day and reduce my salt intake by substituting no salt or lower salt options.

You got this! Looking forward to hearing of your successful journey.

[GosportNancy29 in reply to 2023CKD]

My problem is that I eat a potassium-rich diet for heart health and have managed my heart failure successfully for more than 30 years. I get my medical advice from widely known kidney and diabetes specialists as my GP shows no interest in my health and has offered no advice in the 10 years I have been with his practice

The kidney-friendly advice contradicts the heart-friendly advice. I don't see a dietician as I haven't been told that I need a kidney-friendly diet as my GP didn't inform me nearly 2 years that I had been diagnosed with stage 3 kidney disease

[orangecity41 NKF Ambassador in reply to GosportNancy29]

I agree other conditions do play into CKD. Maye a dietitian would be help getting a diet designed for you. Moderation plays in to my diet. The CKD diet has fruit as a major item, but with my pre diabetes, another specialist has me cut back on fruit, so add more vegetables?

[GosportNancy29 in reply to orangecity41]

I'm just confused about the conflict relating to the advice on potassium. Advice for heart health is a potassium-rich diet and advice for kidney health is to limit potassium or avoid it altogether. I already understand basic dietetics as I have studied several courses in it. If I was seen by a dietician about either condition the advice would still conflict. I have cancelled all hospital and clinic appointments for the foreseeable future as I keep getting appoints to clinics too far away from home to travel to

[orangecity41 NKF Ambassador in reply to GosportNancy29]

Maye you can utilize video appointments for some of your Doctors. I do use this way for some appointments.

[GosportNancy29 in reply to orangecity41]

My GP practice doesn't do video calls. Occasionally one of the nurse practitioners calls me and once in a while one drops by to lecture me about one thing or another. Then I go back online and see what the specialists advise. I drew a blank because of the conflict over the potassium content of my diet and came here to see if anyone else has been in a similar situation

[Lezzers in reply to GosportNancy29]

Hi

I've been following your post as my husband also has HF & stage 3b kidney disease, & yes diet is really difficult. Have you been told to have a potassium rich diet? I've not seen advice about potassium rich diet being good for the heart as such, but a lot of the heart healthy foods such as green vegs, tomatoes, potatoes, bananas etc are high in potassium. A lot of people with HF, my husband included, has high potassium (heart meds often cause high potassium) so he has to limit his potassium intake considerably. Too much potassium can cause arrythimias as can too little, it can be really difficult balance unfortunately but we try to keep it at everything in moderation & just small portions of vegetables with our meals.

[PensacolaSharon in reply to Lezzers]

Let the lab results determine your dietary changes. You want those as normal as possible. If potassium is in target, it's not harming the kidneys. Also, potassium shortage raises blood pressure, and high blood pressure worsens kidney disease - that is a fact (actually 2 facts I suppose). Don't let people speculate and use you as an experiment to see if their guesses are right. Look for facts, supported by proper research, and follow those.

[Lezzers in reply to PensacolaSharon]

His diet is determined by the lab results, he has frequent bloods because of his health issues. When his potassium levels are too high, he has to stop certain meds & restrict potassium high foods. Once the potassium goes back into the normal range it's always still on the higher side of normal so we're careful about how much he eats potassium wise. He's not being used as an experiment, he's had potassium issues since at least 2008 so we're very well versed in his diet & potassium, he's never suffered with high BP, in fact his BP is always on the low side.

[GosportNancy29 in reply to Lezzers]

I just found this on the British Heart Foundation site, where I look for information as my main online source. This was in response to some recent research

"Tracy Parker, Senior Dietitian at the British Heart Foundation (BHF), said: “This research supports current advice that cutting down our intake of salt and eating more foods containing potassium can be the recipe for a healthier heart."

I don't need to see a dietitian about my question about potassium as this is currently widely recognised dietary advice.

[Lezzers in reply to GosportNancy29]

I think the word there is 'can' be the recipe for a healthier heart but that's not always the case. Yes heart healthy food is absolutely good for the heart if you don't have high potassium, if you do then unfortunately it just causes more problems such as dangerous arrythimias. Do you have regular bloods to check your potassium levels? You dont have to speak to a dietician though, because of his high potassium issues my husband was given a low potassium diet sheet to stick to, surprisingly even the way you cook some foods changes the potassium levels, sadly it is a very bland diet.

[GosportNancy29 in reply to Lezzers]

I just checked and my most recent test result for potassium was June last year and it was within range. That tells me it is safe to assume I can carry on eating my heart-friendly way with the Mediterranean diet combined with intermittent fasting.

[Lezzers in reply to GosportNancy29]

Absolutely, if your bloods are within range then you're definitely doing the right thing, the Mediterranean diet is widely recognised as the best type of diet for heart disease, everything in moderation. It was just the phrase 'potassium rich diet' that struck a cord with me.

[GosportNancy29 in reply to Lezzers]

It's semantics. The Mediteranian diet is potassium-rich so I think that's why the term Mediteranian diet is used. I doubt books on 'potassium-rich diets' would sell so well. When I was studying dietetics a while back, the Mediterranean diet came up top on the list of most helpful for general health and especially for heart health

[Lezzers in reply to GosportNancy29]

Indeed! There's no doubt the meditation diet is the best for heart health if it's suitable for your health conditions.

I do know that from a medical point of view the heart takes priority over any other conditions as obviously that's the most important organ in the body. I do remember being concerned about the damage to the kidneys caused by heart meds and mentioned this some years ago to my husband's nurse, she replied that the heart takes priority and that we can do things for the kidneys! And just recently because of fluid retention my husband had to have his diuretic dose increased which in turn hurts the kidneys more. His current nurse said that it was more important to remove the fluid and that sometimes you have to sacrifice the kidneys to do that!

[GosportNancy29 in reply to Lezzers]

I agree that the heart health should come first. I went into cardiac arrest when I was being treated for multiple organ failure. It could be that the kidney problems date back to when I was in hospital in 2016 and it's only become a chronic condition fairly recently.

[Lezzers in reply to GosportNancy29]

Quite possibly there's a connection there somewhere. My husband had a cardiac arrest in 1997 after a massive heart attack which left his heart seriously damaged. However he didn't develop HF until sometime between 2008 & 2012 and whilst he's had minor kidney disease for some years it only became an issue after he was very ill last year. His eGFR has now reduced from 60 to 30's within a year, his bloods a couple of months ago showed his eGFR to be 31, last week's bloods showed it had improved to 34 & yesterday's blood show 37. Still stage 3b unfortunately.Do you know what caused your organ failure? Was this due to acute HF?

[PensacolaSharon in reply to Lezzers]

Acute kidney impact, his egfr could continue to climb over time. It's not unusual to have a temporary kidney impact that recovers over time.

[Lezzers in reply to PensacolaSharon]

Unfortunately due to his ongoing health issues that not going to happen. The aim is to try & stop it getting worse though

[GosportNancy29 in reply to Lezzers]

Leading up to the hospital stay I had several colds one after the other and I'm only guessing here that it was having had too many viruses in the same few months might have caused a flare-up with the heart failure, and that caused the organ failure. I haven't had any follow-up to the cardiac arrest and the coma that followed. I only recently had it suggested that I might have sustained some brain damage. This was only picked up when I asked to see somebody at a memory clinic and they sent me to see a dementia neurologist

[PensacolaSharon in reply to Lezzers]

If your circulation is impaired, that also means less blood flow to kidneys which also worsens kidney disease. Guard your cardiovascular health.

[Lezzers in reply to PensacolaSharon]

Amongst other issues he has severe HF, unfortunately there's a limit to what he can guard. He's been told that the aim now is too keep him alive for as long as possible & that is a balancing act unfortunately.

[PensacolaSharon in reply to Lezzers]

I'm so sorry you and he are going through this. It's hard, I know.

[PensacolaSharon in reply to orangecity41]

Berries and tart apples like granny smith are great for diabetes. Now is the time to learn the "tricks". You can eat fruit after veges and protein, and it not raise your blood sugar a large amount. The order in which you eat different types of food can really help control blood glucose and stop spikes. High fiber veges first, then protein, fruit (or another carb you really want) last. Limit it to 1 indulgence last though in a reasonable portion size, because the goal is to not spike blood sugar. I track with a cgm, and it has helped me figure out ways to eat some indulgences with no blood sugar spikes.

[GosportNancy29 in reply to PensacolaSharon]

This is called 'food pairing' and I have shared links to this in my Diabetes group on social media. I have been practising food pairing since my diagnosis and it helps. I quickly found out that fresh cream eclairs don't spike my blood sugars

[orangecity41 NKF Ambassador in reply to GosportNancy29]

Good plan.

[Phillip46]

Thanx, and good to know, 77year old guy now wanting to see cardiologist, and forget about stage 4kidney disease. Really though thanx for the info and weight is normal and take several walks a day, due to my jack russell terrier.

[GosportNancy29 in reply to Phillip46]

I have successfully supported my heart failure and as the dietary advice for this and my chronic kidney disease conflict, I am going to continue with what I am doing and cross any bridges when I get to them

[Badger2024 in reply to GosportNancy29]

Sounds like you know what you’re doing. The fact that your potassium is within normal limits in your blood tests shows that you’re eating the right amount for both kidneys and heart