Low sodium, low protein diet for kidney health?

[rosarugosa]

Does anyone have any experience with this type of diet? It seems like a lot of the good healthy foods that come to my mind are high in protein - or at least the kind of foods that one might build a dinner around are high in protein. Or can one eat high protein foods but just limit the quantity of protein, e.g. large pasta serving with small portion of shrimp, large salad served with small portion of smoked salmon, etc? This is new territory for me.

[JaneV2.0]

Kidney health? I've read more than one study lately that show a moderate protein, high fat, low carbohydrate diet can actually reverse renal disease. This makes sense to me because it's insulin resistance that kicks off most of the co-morbid conditions associated with type 2 diabetes, including poor kidney function. Increasing carbohydrate intake is a sure-fire way to worsen insulin resistance.

Here are a couple for you:
http://www.ncbi.nlm.nih.gov/pubmed/16774676
In this abstract, a patient with type 2 diabetes reverses his kidney damage with a low-carb diet.

In this one, researchers have success with a ketogenic diet:
http://www.medicalnewstoday.com/articles/222845.php

ETA: Here's another quote from Michael Eades, MD:
"The idea that protein damages the kidney is a myth. It’s the elevated glucose that causes the damage, the protein leak is the effect.

Dr. Michael Eades weighs in on the subject:
http://www.proteinpower.com/drmike/supplements/thiamin-and-diabetic-nephropathy/

An excerpt: "Diabetic nephropathy is most likely caused by the toxic effects of too much sugar in the blood and is helped, and even reversed, by careful control of blood sugars. Despite this common knowledge, many unenlightened people continue to treat the condition by limiting dietary protein instead of focusing on the continuing damage caused by elevated blood sugar. In order to keep caloric intake up, what do people substitute for protein? You got it. Carbohydrates. And since dietary carbohydrates become blood sugar fairly quickly, they end up damaging the kidney more than the protein they are replacing."

Note that the studies and commentary above refer to diabetes-related kidney health.

[rosarugosa]

Thanks, Jane, it looks like there is some interesting stuff here. For clarification, DH just had one of his kidneys removed. So he doesn't have kidney disease, but we want to take really good care of his remaining kidney.

[JaneV2.0]

I know someone who's lived with just one kidney--in excellent health--for decades now. The only medical advice they got, as I recall, was to drink plenty of water. Personally, I wouldn't go the low-protein, low-sodium route because I believe both are crucial nutrients and because I believe the information I cited above. It seems the best thing you can do for your health in general is to keep your insulin levels low and stable and limit inflammation.

[crunchycon]

Hi there - I'm one of those one-kidney wonders (had it removed nearly 2 years ago). As long as your DH's urine is not showing excess protein, he should be in good shape. I agree with the advice to drink plenty of water; I eat a moderate amount of protein, and make sure I don't have a huge amount in any one meal (IOW, I won't be having a BIG steak any time soon); that type of meal overloads the poor kidney. As far as sodium is concerned, I just avoid (or eat only occasionally) salty items like chips, crackers and cured meats, and read labels pretty religiously. It is amazing how much sodium is in processed foods - high sodium is as good a reason to avoid them as any.

[rosarugosa]

Thanks Crunchy, thanks Jane. That is reassuring because it sounds like we don't necessarily need to switch to a radically spartan diet.

[treehugger]

Thanks, Jane, it looks like there is some interesting stuff here. For clarification, DH just had one of his kidneys removed. So he doesn't have kidney disease, but we want to take really good care of his remaining kidney.

Your husband has probably already been told this, but it's also a good idea to avoid NSAIDs (ibuprofin, aspirin) and any other medication that is processed in the kidneys (I believe most/all drugs are either processed by the kidneys or the liver), so as not the stress the remaining kidney.

I only have one, after having donated one so my husband could get one (now, he has three! but two of his are really lame), the stay hydrated and avoid NSAIDs is the only direction I got. Oh, and avoid full-contact sports. So, no football or wrestling. Aw, shucks.

Pre-and during dialysis my husband had to severely restrict his potatssium and phosphorus levels, but he doesn't any more. Now, his only restrictions (other than avoiding NSAIDs, like me) are related to his anti-rejection drugs and not specificially his kidneys.

Good luck!

Kara

[JaneV2.0]

Thanks for posting that, Treehugger. Ibuprofen and Acetaminophen should be used carefully--if at all--by people in general.

[rosarugosa]

Thanks, Kara - we did not know this. He was told to avoid these drugs for 10 days before surgery, but my understanding was that this was just a pre-op thing to avoid excessive bleeding during surgery.

[domestic goddess]

What guidelines did you get from your dr. or nutritionist? The usual American diet is generally too high in protein and sodium, and these generally should be moderated to help reduce the incidence of other diseases, too. I use very little salt, and find it difficult to eat out and find something that hasn't had the whole salt shaker poured into it.DGD1 saw a box of salt last night and was very impressed by the little spout in it for pouring, and I suspect many other people are, too. But do get medical advice before restricting too much or not enough. Restricting too much will mostly make life harder on you than it needs to be; too little won't be effective. If there doesn't need to be a severe restriction, you can probably get by with eating your usual diet, but smaller portions of protein, and not adding salt when cooking or at the table. Then you can fill in the gaps with fruits and veggies. And cookies...lots of cookies. Or just call Paula Deen (not really, but I'm not kidding about the cookies-lol!!).

[crunchycon]

Oh, and avoid full-contact sports. So, no football or wrestling. Aw, shucks.

Kara

Yeah, my roller derby career is over, sorry to say.:~)

[JaneV2.0]

"The usual American diet is generally too high in protein and sodium.."

How so? A lot of us think the American diet is generally too high in carbohydrates (and Omega-6 oils), leading to widespread insulin resistance. If you change macronutrient ratios to minimize protein, you'll likely add more grains, sugar, and starchy vegetables--especially since flawed science and the Food Pyramid have made us so fat-phobic. Protein isn't optional; it's necessary--especially as we age--to build healthy tissue (including bone) and to keep our immune systems functioning optimally.

http://www.meals.com/Meals-Tools/Protein-Calculator.aspx

And recent studies suggest salt intake is not a problem for most of us:
http://www.nytimes.com/2011/05/04/health/research/04salt.html

[treehugger]

Yeah, my roller derby career is over, sorry to say.:~)

Roller derby, that's a good one! I will switch to using that (instead of football and wrestling) when people ask me what I had to give up along with my left kidney.

Kara

[mira]

I'm a one-kidney person too. Well, 1.23 kidneys... I had an awful infection a couple years ago that ravaged my right one down to 23% functionality :(

The renal specialist did not give me any special dietary guidelines and when I asked him if there were foods I should avoid, he said no. But I have learned that I can suffer pain in the weak kidney when I consume too much sugar, too much alcohol (I have maybe one drink per hour, if that) or caffeine, or even if I drink an excessive amount of water (which I once did in order to keep a lower UTI from spreading to my kidney... oops). So it might be beneficial to limit those things, since they make the kidneys work harder.

The solitary kidney will grow to accommodate its new workload, but your husband should find that he does not have to dramatically alter his lifestyle. Apparently any reduction in functionality or problems develop extremely slowly (I am not looking forward to this!).


There is some good information on having a solitary kidney here:
http://kidney.niddk.nih.gov/kudiseases/pubs/solitarykidney/#what

[rosarugosa]

Thanks, everyone, this is all very encouraging. I am always so touched at the way I can ask a serious question on these forums, and people I have never even met will be so generous with their time and mental energy in giving such well-considered responses.
Kara, You also made me realize that I should be attentive to my own kidney health in case I am ever called upon to be a donor. Healthy kidneys would ultimately benefit both myself and the recipient. If that never comes to pass, no harm done, right?

[leslieann]

Wow, Jane, thank you for the protein calculator. I think my intake is pretty good, especially since I have to focus on protein with my low carb aspirations but I didn't realize that a mainstream source would think I needed so much. For some reason, I have a hard time using personal experience as a yardstick ("I feel better when...").

rosa, my DSD (15) has kidney disease. Much to my dismay, nobody has ever told her anything much about diet except to avoid processed meats and overtly salty foods. As it is, she is a classically "picky" eater who lives on wheat and cheese (so much for sodium intake) and an occasional piece of fruit. She is doing very well, apparently, and is followed very closely by her medical team, so I guess its all okay. There are social consequences of not eating many different foods, but she hasn't experienced many of them, as pizza seems to be a socially acceptable food for any meal among her peer group.

[JaneV2.0]

According to a study a couple of years ago, thiamine in therapeutic doses can reverse (diabetic) kidney disease:
http://www.news-medical.net/news/2008/12/08/43893.aspx

Starchy, sugary carbohydrates deplete B-vitamins as well as wreaking pancreatic havoc in general.

[Suzanne]

While not directly kidney-related, the study linked below found that people needed to eat 78 grams of protein a day to maintain lean body mass, and notes that the US diet recommendations of 46 grams for a woman and 56 grams for a man might need to be revised upward.

http://www.huffingtonpost.com/2012/01/04/protein-body-fat-diet-_n_1183516.html?ref=mostpopular

My FIL died of end-stage renal failure caused by diabetes. His nutritionist told us to cut his potassium intake down very hard.

[treehugger]

Kara, You also made me realize that I should be attentive to my own kidney health in case I am ever called upon to be a donor. Healthy kidneys would ultimately benefit both myself and the recipient. If that never comes to pass, no harm done, right?

While I certainly advocate working to maintain and improve one's health, that's an interesting way of looking at keeping body parts healthy that I had never thought of. Sort of like the book Never Let Me Go. I felt a personal calling to donate a kidney to my husband, and though I have a good friend who donated to a stranger, I don't know if I ever would have felt the pull to donate to someone other than my spouse or close friend or relative. It's a moot point now, so I can't even guess at whether I would have ever done it or not.

I am definitely not donating any more organs. But, I do donate blood every 8 weeks and I have to remain healthy to do so.

Kara