proteinuria help

[Radars]

can someone please help, I have had 2 urine samples and there is protein in my samples, what am I supposed to eat, everywhere I have read says to avoid potassium and phosphorus and protein, I also have osteoporosis and you need high protein, I have been using alpro soya milk and yogurt and they are high in potassium, I thought all alpro were healthy, it's getting so I don't know what to have, any help please, I think I'm in the early stages, any help please.

[Darlenia]

Hi Radars. I understand your dilemma - many of us in this community are in your predicament - coming to a crossroad involving competing health issues. Do you know the reason for the proteinuria? I see you have been diagnosed with prostate cancer - sometimes that can cause it. Sometimes, an infection like a uti can slough off cells (all cells have protein) into the urine. In my husband's case, he has diabetes so his urine always shows high protein levels. However, it's the sugars and carbs that causes that problem - essentially poking holes in his kidneys so they leak protein. So he has been directed to eat proteins in moderation (since they don't have carbs/sugars). He's also 75 so everyone also understands that seniors need to keep their bones functioning. At one point, my husband's proteinuria levels were very high post transplant. His transplant doctor put him on a stronger blood pressure med so his new kidney wouldn't have to endure the high pressure pounding causing damage. We are all so very different. I think this is good time to bring up your worries wit your doctor and see what he says. Chances are good that something can be done to address it.

[Radars in reply to Darlenia]

thanks, gp said the renal team think it was my high b/p that caused it,I also have osteoporosis which needs high protein, what are you supposed to eat, my gp never said about cutting things out ,they don't bother till stage 3,I have been using alpro unsweetened soya milk and yogurt for my osteoporosis and they have potassium so don't know what to do now.

[Darlenia in reply to Radars]

It seems that you might be in the very early stages of CKD. Generally speaking, diet restrictions aren't necessary at the early stages of CKD. Medication adjustments and so on can return things to a tolerable state. However, if restrictions are necessary, then regular monitoring via blood tests is required particularly when electrolytes such as potassium, sodium, and others are involved. Yes, other organs including your bones, have their needs too. The best you can do is simply call your doctor(s) specifically about about your dietary concerns and ask for guidance.

[Radars in reply to Darlenia]

thanks, so I will be ok still to take alpro unsweetened soya milk and yogurt for my osteoporosis.

[KeturahAudrea in reply to Radars]

Radars, you should check your insurance to see if it pays for a nutritionist visit Medicare pays for 2 visits per year you said you’re 76 so you should have Medicare schedule an appointment with a renal dietitian

[ShyeLoverDoctor]

Consult a renal dietician. Also don’t diagnose yourself with CKD until a doctor has.

[userotc]

Youve not indicated the level of proteinuria and that matters. My mum (aged 69, CKD stage 3 for 14y) has had proteinuria for several years but her nephrologist is quite unconcerned at its level as has remained at <1g.

She follows Nutritional Therapy (NT) which is likely less restrictive than a renal diet and more holistic for general health, so considering the increasing risk of other health conditions eg osteoporosis and sarcopenia. She has moderate protein which has been reported as over-played for CKD (links available).

NT also helped her reduce her BP a few years ago to the extent she's weaned off medication and is drug-free 🤞🤞.

[Shedman]

These things are complicated - various causes.Mine was due to blood cancer creating misshaped immunoglobulins.. it improved after treatment, but some scaring remains.

I have found that high oxalates worsen my proteinuria - so I avoid almonds and spinach, as two of the highest sources.

I take a few supplements, most days.. one is a combined calcium, magnesium, vitamins D and K2 - this is an excellent combination for bone health. The UK Cambridge company, is igennus, sometimes cheaper via bank holiday special offers (3 for 2, etc), sometimes via Amazon.

Another relevant supplement I use occasionally, say if my appetite falters, is their hydrolysed beef protein powder (they also sell a vegan version).

It has no noticeable taste - can add a spoonful to instant soup or even to coffee.. immediately adding 20g of amino acids to my protein intake.

I hope this helps.

[Radars in reply to Shedman]

thanks, which milk do you take I have alpro unsweetened soya milk and yogurt but I have read that's a bit dodgy for proteinuria, I need it for my osteoporosis, I have read that silk almond unsweetened is best, I will have to research on that, I think it will be better when I see a renal dietitian, I know you aren't supposed to have a lot of protein, I have got some whey protein powder but the nurse who did my ecg said don't use it, it's all confusing.

[Shedman in reply to Radars]

I have very little milk - there are many sources of calcium, and bones also need magnesium and vitamins D and K2I choose vegetables with low oxalates: sprouts, peppers, cabbage, broccoli, cauliflower, peas.. these do supply calcium.

I do eat some yoghurt and some cheese, even a little cream.

Protein intake is a matter of measurement - generally it isn't likely in trad English diet to eat excess.. whey powder could make it easier, but I think whey powder is complicated, with other issues, where my suggested protein powder is quite safe within protein restriction levels..

For instance, this link from JAMA gives precise guidelines:

jamanetwork.com/journals/ja....

(See image)

Problem with almond milk for me, is oxalate level.. but I'd want to examine the long ingredient list quite carefully.

Jama (linked) screenshot showing detail on recommended protein intake in stage 3 ckd.

[Radars in reply to Shedman]

it was a long read so I am only 8st and have osteoporosis how many grams of protein a day would be better for me is tuna in spring water ok.

[Shedman in reply to Radars]

8stone is 52.8kgThe image as summary is easier to take in.What stage is your ckd?

Suppose you look at 1g/kg/d, that would be 53g protein per day.

I avoid tuna due to its high mercury content (mercury level in seas has risen greatly in last 50 years)

I'm not sure the protein source is necessarily the topmost worry - start by calculating (estimating) how much protein your current diet gives you per food and per day. List them.

Then you are better enabled to swap one ingredient for another, as and when you have a better idea.

Obviously you need all essential amino acids - 10g of whey protein is unlikely any problem.

Pea and bean protein, combined with grain protein gives essential amino acids.

[Radars in reply to Shedman]

I think I am stag1 proteinuria ,I have always been taking alpro unsweetened soya and yogurt for my osteoporosis, I know they have potassium in them but i have to help my osteoporosis, i have had 2 zoledronic infusions.i have to have some calcium even if it's not safe for proteinuria,

[Shedman in reply to Radars]

Per my first reply: take a look at igennus calcium & magnesium, which includes vitamins D and K2 - no magic formula, but I'll bet your doctors haven't mentioned K2?It's a good formulation.. could cover ~50% of your calcium intake needs, with advantages of correct ration magnesium and vits D + K2 to see minerals deposited in bones..

The other thing to find out about is some exercises to do at home to aid mineralisation/density of bones: typically weight bearing exercises, also muscle toning exercises.. nothing dramatic, but likely different to base living regime.

I'll search on here for osteoporosis exercises..

Well done - I see you already asked:

healthunlocked.com/boneheal...

Do you know your vitamin D blood level?

K2 is mostly v low in standard UK diet.. Japanese get lots via Natto (fermented soy bean product), which is also source for most vitamin supplement K2. It isn't vitamin K(1) associated with blood clotting, instead works with vit D to see mineralisation of bones, rather than calcification of arteries.

[Radars in reply to Shedman]

thanks, I already take 1000iu d3 and k2-mk7 I go for a walk 30mns 5 times a week and do light Weights, is that ok

[Shedman in reply to Radars]

That's great. (You've been doing your homework 🙏)

What was your last vitamin D blood test result? - if you have one.. (1000iu might be fine or low, depending on blood level .. it can be hard to raise suitable level)

How much K2?

Do you take any magnesium?

Calcium : magnesium ratio ( 2 : 1 ) is one aspect.

Just to complicate..

Vitamin D is somewhat synergistic with vitamin A;

Eating some liver from time to time (100g = 7 days RDA .. maybe 10 days given your weight) or taking (standard formula, eg Sainsbury's large store only) ACE+Selenium, which contains RE (retinyl ester, aka vitamin A) for a few months each year, may be a good idea.. (NB beta carotene is not vitamin A)

Any symptoms? Dry eye. Teary eyes in windy weather. Dry/eczema/psoriasis skin ailments. Poor night vision or odd artefacts: bright light aversion. Slow clearance of viruses, eg common cold etc ?

(NB. NHS mostly doesn't notice vitamin A matters.. there's history behind this.)

[PecanSandie]

You seem most worried about your osteoporosis. You should talk to your doctor about taking one of the drugs that helps (reverses) osteoporosis.. They are not always great for the kidneys but some are better than others. I am taking Ibandronate (Boniva) and it has so far no effect on my kidneys. I was starting to develop osteoporosis and by taking this drug it reversed it into mild osteopenia. I take it once a month on an empty stomach with a glass of water and then fast for one hour. (Not too bad).

[Radars in reply to PecanSandie]

I have had 2 infusions of zoledronic acid.

[PecanSandie]

Has it helped? Do you get annual Dexa scans?

[Radars in reply to PecanSandie]

yes it has helped me to how I was,I will probably have another dexa scan after my last infusion third one in April, then it will probably be prolia if my kidneys aren't too bad,

[PecanSandie]

That's good. There is a strong connection between kidney disease, high blood pressure and osteoporosis and I still haven't figured out how it works because the food that you would eat for one condition is not necessarily the food you would eat for the other. I just stick to what I like and what makes me feel good which is the Mediterranean diet. No salt. Limited sugar. It kind of works I guess.

[Radars in reply to PecanSandie]

exactly what I have been struggling with what's good for 1 is not good for the other, calcium is not good for proteinuria but I need it for osteoporosis and potassium which I am finding it hard to control, and just recently I have noticed bubbles in the toilet bowl when I pee. that's not good.

[PecanSandie]

Osteoporosis is a disease but proteinuria isn't (it's a condition). If I were you, I would continue eating yogurt and things that help grow bone (don't forget your weight bearing exercises!) and just be careful too lay off salty things (that is my downfall) and sweets and stick to dainty portions of meat (I no longer eat red meat).

[Radars in reply to PecanSandie]

thankyou, I think you are right I will start my alpro unsweetened milk again and alpro yoghurt, or my osteoporosis will get worse,I will tell the renal team when I see them, oh I also have no testosterone because it hasn't recovered since I finished treatment in 2016,for prostate cancer.

[WildIris]

In long term studies of CKD patients, getting plenty of protein has the best longevity and well-being outcomes if your eGFR is at least 40. As your eGFR gets lower, a little less protein is a little better for you, though if you have osteoporosis, you should probably continue to take plenty of protein. The notion that restricted protein is best for CKD came from the fact that kidneys do the work of processing protein without the knowledge that protein is vital for optimum health.

You did know that you only need to restrict phosphorous and potassium if your blood test indicates they are too high? So, check your blood work in reference to continuing your high potassium foods.

You're asking the right questions. If you're still confused, bring your test results and your normal or favorite food intake list to a renal dietician.

[Radars in reply to WildIris]

thanks, my gfr from a blood test last October was 101 but there was protein in my urine sample, my gp sent me a text saying that the renal team think it was my high b/p that did itand she would discuss it with me in the new year, I have some whey protein powder that I dare not take my serum potassium level normal 4.4mmo/L,I haven't a clue how to restrict my potassium and phosphorus ,from what I have read on here people are leeching veg and all kinds of different things I am not a chef, I have been using alpro unsweetened soya milk and yogurt for my osteoporosis, but that's not good for proteinuria it's all confusing.

[AlBolt]

I have the same problem and I eat vegetables and little chicken and fish. Red meat is very bad for kidneys.