CKD stage 3, proteinurea. High BP

[Pitva]

looking for advice from ckd patients with high BP and proteinuria who have successfully managed to stop the progression of the disease. Please elaborate your diet restrictions and anything else that you followed.

[Bassetmommer NKF Ambassador]

Just to be clear, you cannot stop the progression of CKD. You can slow it down. I did for over 6 years. Here is how: no meat, no processed foods. Whole natural foods. Lose weight if you need to. Low carbs, lots of veggies. If you are diabetic, follow the required diet and medications. Keep you BP stable and low if possible. Lots of water. And last but most important, get educated. Take classes, research info, there is a ton of info out there. National Kidney Foundation is the best and most accurate. Watch out for people saying they have a cure; there is no cure.

[Pitva in reply to Bassetmommer]

Thank you. So did your CKD eventually progressed to next stage? I am not diabetic. You mentioned low carb. Any particular grains that you consumed 3 times a day that filled your appetite? Vegetables alone don’t satisfy me so I need a grain (barley) and some dairy substitute.

[Bassetmommer NKF Ambassador in reply to Pitva]

not really..... rice once in a while. Small pasta rarely Oatmeal often. And yes, I went to almond milk.

[Pitva in reply to Bassetmommer]

thank you so much.

[Pitva in reply to Bassetmommer]

Hi, How did you manage to get calories to around 1500 in a day. Vegetables and almond milk won't add much calories. Small pasta may be 100 calories.Was it nuts/ coconut fat etc. Thank you.

[Bassetmommer NKF Ambassador in reply to Pitva]

who said 1500.... I did 1000 or less

[Merny5]

I have managed to maintain the progression by eating no red meat, very little protein from meat, abundance of veggies( only specific ones as I have Hyperoxaluria ) I avoid processed foods and drink a great deal more water. However, my bp remains elevated. ( around125-130 over 79-85 ish) What has your bp been and what does your nephrologist say is the target number?

[Pitva in reply to Merny5]

Thank you. my BP fluctuates between 124-139 systolic and in high 80’s diastolic during course of the day. I am on 10mg lisinopril-HCL morning, and half Metoprolol 25 mg tablet morning and evening. Haven’t talked about target number. First thing the nephrologist reduced the dose to half of lisinopril medicine as I think they added to the damage to the kidney. I also take Farxiga mg in the morning. I have been vegeterian all my life.

How do you satisfy the hunger? Vegetables don’t satisfy. Any specific grain for 3 meals of day? Any go to beverage? How much protein did you try restricting yourself to in a day? Thank you.

[Merny5 in reply to Pitva]

That is very interesting about the lisinopril. My nephrologist is the one who put me on 40 mg of that medication. I will have to ask him about it when I see him next week. To answer your questions, vegetables and nuts, satisfy my hunger, usually. I consume a few grains. When I do have bread, it is always Ezekiel bread. I don’t know exactly how many grams of protein I have per day but I would suspect it’s anywhere between 35 to maybe 55. i’m not sure but I think the danger is an animal proteins and not proteins from vegetables. Probably the biggest change I’ve made is that I drink anywhere from 70 to 90 ounces of water per day and I do not add salt to my food.

[Pitva in reply to Merny5]

Thank you.

[Pitva in reply to Merny5]

Hi, please note the response below from Attari11. He is taking rimiprill. I researched afterwards and came across this article that says -

"Ramipril was associated with the lowest incidence of all-cause mortality. Lisinopril was the least effective in lowering systolic and diastolic blood pressure and was associated with the highest incidence of all-cause mortality".

Here is the article for your reference.

pmc.ncbi.nlm.nih.gov/articl....

I have reached out to my doctor. You may want to check also.

[Merny5 in reply to Pitva]

Thank you so much for this info!!! I will bring this article along with me to my visit

[Pitva in reply to Merny5]

I did more research on Ramipril and noticed one study said it damages liver.

pmc.ncbi.nlm.nih.gov/articl...

I read more good reviews on Losartan. I have sent both studies to my doctors cardiologies as well as nephrologist and have asked for their advice.

Do let me know what your doctor prescribes.

[Merny5 in reply to Pitva]

I see him this Thursday and I will let you know. I have printed out part of the study that you posted to bring to him.

[Merny5 in reply to Pitva]

After reading the study, I’m not sure what to discuss about my Bp meds🤷🏻‍♀️

[Pitva in reply to Merny5]

at least lisinopril ain’t working. And the scientific study does not predict good result either. So surely news a change in medication. I read losartan is better but doctor can advice.

[Pitva in reply to Merny5]

below is the comment from my cardiologist -

<<

I would be very careful about reading information from the internet. Even research information that may be accurate and reliable might not actually apply to your situation. For the example, the first study is talking about outcomes in patient treated with ACE inhibitors as part of their therapy for heart failure -- which is a completely different situation then why you are being treated (for hypertension). Similarly, liver injury from an ACE inhibitor is incredibly rare and not something I have ever heard of. ALL drugs will have some very rare and unusual side effects if you look hard enough for them online.

I honestly don't see any particular reason for you to change from the lisinopril-hydrochlorothiazide combination tablet. But, if you wanted to switch, ramipril is also a very reasonable option and I think the risk of an unusual side effect like liver injury is extremely low. Ultimately, I would review with your nephrologist and you can mutually determine the best approach.

>>

[Merny5 in reply to Pitva]

Thank you! I appreciate you sharing this information!!

[Attari11]

Hi you haven’t mentioned your age i had protein-urea issue few months back slightly rise than after i am lose weight and exercise and lots of water no red meet eating fruits and vegetables than just got the results it’s back to normal coming down hugely no more proses food cutting salt

[Pitva in reply to Attari11]

I am 53. Got diagnosed stage 3 a year ago

[Attari11]

once you fix the protein leaking issue than you will stay stage 3 long time just follow the healthy diet many people’s has the protein leaking issue still on stage 3 on long time it depends how much protein leaking there is maybe other issue about the protein leaking stay positive you will find the solution

[Pitva]

thank you. Is there an approx. amount of protein you consumed daily along with any supplements that assisted in getting rid of proteinurea?

[Attari11 in reply to Pitva]

I lost weight 83kg to 63kg within 4 months more focus on running i just start taking omega 3 its really beneficial for the kidneys than i eat once a day mostly vegetables than drink berry’s mix with strawberries cranberries blueberries smoothies i only take very small tablet rimiprill 2.5mg i will suggest take omega 3 it’s really good for blood pressure aswell make sure you get epa higher amount for the bp yes i eat protein less not every day

[Pitva in reply to Attari11]

Thank you so much for giving us the name of BP medication. It's quite revealing that how this one is better then Lisinopril per below article. I have already reached out to my doctor. pmc.ncbi.nlm.nih.gov/articl....

Back to the diet, one usually needs around 1500 calories in a day otherwise, it would be fasting. You mentioned that you ate mostly vegetables once a day, then drank berry's mix. Vegetables and Berries have very less calories. 1) How did you increase your calories? Was some fat added? 2) Did you consume any grains? 3) I didn't understand what you meant about proteins. How much protein approx. amount you consumed during day. Thank you.

[Attari11 in reply to Pitva]

Yes i eat grains i mean i eat animal protein once a week small portion mostly salmon fish even i eat red meet some time as i said please add omega 3 if you want than i would suggest which one you should take than you should exercise running 20 mints make sure when you run you feel your body should sweat you will see your bp huge difference any more question feel free to ask did you take any axciety medication if not than you should it will also help your bp to come down

[Pitva in reply to Attari11]

thank you. Yes, please provide the omega name.

[Attari11 in reply to Pitva]

Hi here is the link amzn.eu/d/aWoUHAK

[WildIris]

I eat a fair amount of nuts and miso-vegetable soups with beans and about 2 spoons of plain yogurt, which are all fairly high in protein, plus the low amounts of protein in vegetables. I always put corn in the soup, because it is high in an essential amino acid that most veggies are low in. Essential means essential to eat, because the body can't make it.

I also take losartan for blood pressure, which is a drug that is beneficial for kidneys by blocking something called angiotensin 2 receptors, which seems to directly help the kidneys. This drug has even caused slight improvements in CKD in some people.

I also eat approximately a ton of blueberries, and I'm convinced they are particularly healthful, if you like blueberries, of course. I don't eat sugar or processed food except a tablespoon or two of hummus, (which I also really like.) Its important that you find foods that you really like that won't hurt your kidneys so you won't come to feel oppressed by your diet.

And drink plenty of water.

I never had proteinuria, but my eGFR has been all over the place, between 23 and 73, it's over 60 right now, stage 2 CKD, not too abnormal for my age, When the eGFR was 23, I had hemolytic anemia and joint pain from lupus and heart problems, then the CKD diagnosis was too much. I was inspired to change my diet; within a year or two, the lupus was in remission and my heart issues faded into the distance, though my BP does still creep up sometimes. So I still take losartan.

[Pepperthedog]

Hi Pitva

Despite eating no meat, little cheese, and only a little chicken once a week, I've had significant and increasing proteinuria for several years, but neither the renal consultant nor my (new) GP is concerned. I've been taking Candesartan, an ARB, for a long time; but there is some 2013 research suggesting Olmesartan is the best drug in this class for managing proteinuria: pmc.ncbi.nlm.nih.gov/articl...; more recent research suggests its also the best all-round ARB for kidney patients. link.springer.com/article/1... Might be worth checking out.

As I mentioned in a previous post, the addition of Empagliflozin is the first med in over a year of trying different ones to have lowered my escalating BP. There is some evidence that combining Empagliflozin with Finerenone may be even more effective.

[Pitva in reply to Pepperthedog]

thank you so much for giving the details of the medicines. I have started on Ramapril 2.5 mg today only and will see it over for next few weeks. If it does not work, will try yours. I am on Farxiga 10mg for protein urea and it has brought it down substantially. I would like it to be completely fixed so have started low protein diet around 30mg daily. I am trying to reduce any kind of load on kidney. I imagine our kidney is like a sieve and there are pores in it that are getting bigger and bigger with increasing load and so protein which has bigger molecule size is able to escape in those pores. If. It’s not fixed, slowly those walls will keep tearing down. I will check in 2 weeks in renal panel if diet change has had any affect. .

[Pepperthedog in reply to Pitva]

Apparently there can be a problem with combining meds from different classes, e.g. SGLT2 inhibitors (those ending in -flozin (including Dapagliflozin /Farxiga) with the drug class Angiotensin III Receptor-Blockers, which end in -artan. Together they may lower blood sugar too much, causing salt and water loss, which may result in side effects, some of which may be serious: mayoclinic.org/diseases-con...

Many of the meds for particular conditions can cause similar side effects, or even resemble symptoms of, the condition they're intended to treat. So if you take several, it can be difficult to know whether they're caused by one, by a combination, or by the condition itself.

I've been taking Candesartan for some years, and recently added Empagliflozin, which is the first med to have brought down very high blood pressure after a series of alternatives. I do experience side effects of the combination; but these started abruptly well before, after trying several different Calcium Channel Blockers a year ago (and since withdrawn): low blood sodium; dizziness; poor appetite; difficulty thinking clearly, at times confusion; and chronic diarrhea. So it's not clear either to me or the medics whether these effects are due to particular medications, the combinations, or the kidney disease progression.

I too have persistent proteinurea, which the renal guy doesn't seem bothered about, though there's clearly muscle wastage; and I've found yoga and walking helpful for both mood and fitness. I hope your diet is effective in reducing the proteinuria; if it is, it would be useful to know what's worked for you.