Stage 4 Chronic Kidney Disease: How are you getting your protein needs met?

[Winnie53]

My friend has stage 4 chronic kidney disease (CKD). How are you getting your protein needs met?

Animal or plant based protein?

Is any one here taking the protein supplements specifically designed for CKD?

How is your dietary and supplement approach working for you? Have your labs stabilized, improved, or worsened over time?

What I'm trying to figure out is how to get adequate protein of 50 g/day doing the keto diet without causing more damage to the kidneys.

My friend has type 2 diabetes, began injecting insulin 20 years ago, needs to gain better control of her glucose levels, and needs to lose weight to qualify for a kidney transplant.

Any information would be most appreciated. Thanks!

Edited to add: If you are diagnosed with CKD or are knowledgeable about CKD, its diet and supplements, I'd love to hear from you here or privately. I'm still learning and need your help.

 

[LittleGreyCat]

I have stage 3 CKD according to the numbers.
At the moment I an avoiding NSAIDS and seeing if I can cut back on Metformin, but not restricting protein.
Mind you, my eGFR seems to have a mind of its own.

I think Keto can make the numbers worse; not sure if this truly indicates the level of the problem because I don't think the recommended numbers take account of the keto diet.

 

[Winnie53]

Thanks LittleGreyCat, yes NSAIDS are bad, bad for kidneys. I wasn't sure about using the keto diet for CKD, but I'm finding reports that patients are using it and stabilizing their labs. Can you tell me a little bit more about why you think keto would not be a good choice?

So many aren't diagnosed until stage 3. Hope you're able to stay there.

With stage 4, not sure how to get adequate levels of protein intake. Wondering if animal protein becomes a problem at that point, or not? Don't know. Hoping others here can share what's worked and not worked for them.

 

[LittleGreyCat]

Thanks LittleGreyCat, yes NSAIDS are bad, bad for kidneys. I wasn't sure about using the keto diet for CKD, but I'm finding reports that patients are using it and stabilizing their labs. Can you tell me a little bit more about why you think keto would not be a good choice?

So many aren't diagnosed until stage 3. Hope you're able to stay there.

With stage 4, not sure how to get adequate levels of protein intake. Wondering if animal protein becomes a problem at that point, or not? Don't know. Hoping others here can share what's worked and not worked for them.

Sorry, I wasn't saying that keto wasn't a good choice.
I keto, keto, keto.
I was saying that this may skew the figures a bit and make the numbers look worse than they are.

 

[Winnie53]

Thanks for the clarification that you are using keto. That's encouraging. Can you tell me more about how your lab test are effected?

 

[LittleGreyCat]

Thanks for the clarification that you are using keto. That's encouraging. Can you tell me more about how your lab test are effected?

They seem to vary between about 55 and 85 for no obvious reason.

 

[Winnie53]

So that level is bouncing up and down? Which lab test are you referring to? eGFR?

 

[bulkbiker]

Any information would be most appreciated. Thanks!

Yes its in mice but hey might be interesting..,

I presume you have pointed her at Dr Fung?

Not sure why you think plant protein would be better than animal?

https://www.livescience.com/35630-ketogenic-diet-reverses-mice-kidney-disease.html

 

[Diakat]

@WuTwo and @Mel dCP can probably answer or point you in the right direction.

 

[Winnie53]

Thanks Diakat.

Bulkbiker, yes, I've looked at everything I can by Dr. Fung, but he's silent on use of animal protein for patients with chronic kidney disease. And I am aware of Dr. Berry and DocMuscles using the keto diet with animal protein for their CKD patients but stage 4 gets dicey. This is not well known, but CKD patients have been treated successfully with plant based protein supplements for decades. They work, but are very expensive.

Any further direction you can be provided would be most appreciated.

 

[bulkbiker]

Thanks Diakat.

Bulkbiker, yes, I've looked at everything I can by Dr. Fung, but he's silent on use of animal protein for patients with chronic kidney disease. And I am aware of Dr. Berry and DocMuscles using the keto diet with animal protein for their CKD patients but stage 4 gets dicey. This is not well known, but CKD patients have been treated successfully with plant based protein supplements for decades. They work, but are very expensive.

Any further direction you can be provided would be most appreciated.

So far as I'm aware plant based proteins are far less bioavailable than animal based ones. But that's about the sum total of my knowledge.
I would however recommend taking anything published on "nutrition facts" with a very large bucket of salt.

 

[Winnie53]

@bulkbiker I'm still figuring out how this works, but as kidney function declines it becomes increasingly important to lessen the work load on the kidneys. Potassium, phosphorus, and sodium intake need to be limited. Kidney function is only a quarter of what it once was.

According to an article by DaVita...

https://www.diabetes.co.uk/forum/th...g-your-protein-needs-met.165485/#post-2077849

"our bodies only need about 46 (for women) to 56 grams (for men) of protein." "Half of your protein should come from high-quality sources that provide all the essential amino acids (e.g., eggs, milk, poultry, seafood, red meats, soy)." They also recommend low fat. No idea why.

So the question is, where do you get the other half of your protein needs met? I think that's where the protein supplements for those with CKD become helpful. But...they are very expensive. Not everyone can afford them.

I don't know much yet, so am learning as I go...

And yes, I have no interest in using Michael Gregor, M.D. as a resource. He's not helpful and confuses diabetics who are seeking help. I can't begin to tell you how many people who follow his guidance come to me genuinely concerned that I'm harming myself by eating animal sourced protein. Telling them there is no one "right" diet and what works best for me and what works best for them is likely different, they continue to be genuinely concerned for me despite having good health markers moving in the right direction. Thankfully, my kidney health is excellent.

 

[LooperCat]

I don’t have kidney problems, and I don’t eat meat, so I aim for 90g plant protein a day, as it’s less bioavailable.

 

[LittleGreyCat]

Thanks for the clarification that you are using keto. That's encouraging. Can you tell me more about how your lab test are effected?

They seem to vary between about 55 and 85 for no obvious reason.

 

[Winnie53]

@LittleGreyCat I'm assuming you're referring to your eGFR. I'm also confused as to why your numbers vary so widely. If I come across an answer for that in my readings, will come back here to share that information.

Thank you all for your sharing your knowledge and experience here. I didn't know plant protein is less bioavailable. Good to know.

If anyone here on this forum has chronic kidney disease and wishes to share their experiences, publicly on the forum, or privately, I'd be most grateful to hear from you.

 

[ringi]

"Half of your protein should come from high-quality sources that provide all the essential amino acids (e.g., eggs, milk, poultry, seafood, red meats, soy)."

Does that mean at least half from high quality sources?

I have seen reports of kidney functions improving with great BG control. Hence the high fat in LCHF may be important for anyone with kidney functions issues.

 

[Winnie53]

Yes ringi, half from high quality sources. Using keto to gain better glucose control and to lose weight is part of the plan.

 

[ringi]

Personally if I had this problem I would go for 100% protein from high quality sources and be very careful about the types of fat, eg top quality fully traceable extra vegin olive oil etc. There are times when keeping 100% to the "Art and Science of Low Carb Living" book is justified.

There are risks, but a SGLT-2i may also be worth talking to a consultant about. (I would wish to be testing blood ketones at least once a day to quickly detect DKA due to the increased risk from combined very low carb and SGLT-2i)

 

[bulkbiker]

I concur with @ringi
Why only half from high quality sources why not all?
Using keto and meat will provide enough then fat to top up the rest?
Avocado etc..

 

[ringi]

Avocado is risky as they contain protein.