How do I do low protein plus low carb diet?

HurricaneHippo said:

What’s the elephant in the room?

Am also confused by the age thing, I’m 35.

I don’t think they take BMI before they test anyone right?

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In the real world, an elephant would be difficult to hide or ignore in a room. It becomes erflinger obvious.

The standard kidney function test on eGFR does not alter for age, but real people find their eGFR reduces as they get older - it seems to be a fact of life, but I have not seen a simple explanation for this phenomenon apart from CKD so I am querying if that is actually a valid conclusion.

The doctor or nurse will weigh you and measure your height from which your BMI is calculated by the NHS software. It does not take into account any beer belly or waist measurement, so is not actually giving a result that represents body surface area,.

HurricaneHippo said:

Thank you I did the blood test as soon as I woke up after a fast so was probably dehydrated. Is it worth fasting before the test?

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So was this a home test that you sent away to a private company? Or a test at the surgery?

HurricaneHippo said:

Oh I see so if I was the “perfect” BMI, my GFR would be a “better” figure?

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I am just thinking out loud that maybe there is a simple explanation as to why old age seems to affect GFR and not actually be due to kidney failure as we age. Or even as we make dietary changes that affect body mass in ways that the BMI does not explain on its own. I am guessing here, so it is only a lemma, (i.e. not even as advanced as a theory). I would expect my blood urea figure to increase if my kidneys are poorly, not just creatinine and GFR. Also, my NO (Nitrous Oxide) should be elevated but that needs a different (blood gas) test that only a hospital can do

I'd be careful about assuming you need to eat less protein unless you've been diagnosed with severe kidney disease by a nephrologist.
The implication of eating less protein is that you will eat more fat (tricky without the animal protein that accompanies it) and/or more carbohydrate. Many doctors would say that eating foods which increase insulin resistance and hence make you more diabetic will ultimately damage your kidneys more than high protein.
High protein = 2g+ per kg body weight so you could start by checking if what you are eating actually constitutes a high level and if still concerned see if you can get someone to help you interpret those results remembering that 'normal' is a relative term relating to the mean average for a whole population and an apparent decline in your kidneys' health could be an artefact of how the test was performed. Only a specialist would know how best to interpret that with knowledge of how reliable the result was.
I am taking irbersartan (no obvous side effects) because I had some abnormal kidney function years ago in pregnancy/bad control phase but I don't worry about protein bearing in mind that I'd find it tricky to eat enough of it to get to 'high protein' levels! I am much more focussed on my blood glucose levels as a type 1.

In answer to a previous question regarding water intake affecting the result of the kidney test
https://jasn.asnjournals.org/content/19/6/1041

And to confirm that GFR is estimated in terms of body surface area, but the Lab uses a generic coefficient that is not individual.
https://ukkidney.org/health-professionals/information-resources/uk-eckd-guide/about-egfr

There are variants of the calculator that take into account sex (M.F) and ethnicity. Again these are fixed coefficients in the equations. There is NO allowance for age in the generic eGFR. The methods used by Labs for measuring creatinine differ, and it becomes a postcode lottery where results need to take lab location into consideration too. But the CKD stage limits are fixed nationally and are not local, so again there is room for error there. Renal function decisions do not take urea levels or NO into account at all it seems.

HurricaneHippo said:

Home test from a company called LetsGetChecked! By the sounds of it, it wasn’t a good idea…update above

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Thought so. The reason I asked was that I bought a private Vit B12 test from Medichecks (who generally have a good reputation). It came back as exactly mid range of the normal figures. I went to my GP and he said the ones you buy online can be unreliable. He tested again and I do have B12 deficiency.

HurricaneHippo said:

UPDATE:
I rang the GP and mentioned my eGFR was low and he said that can’t be right. He said eGFR blood test taken on 3rd August at the same time as my HbA1c was absolutely normal. He then asked me what company I used (LetsGetChecked) and the method used to take the blood (finger prick). He told me it’s rubbish and to ignore the results from LetsGetChecked!!!! He said my eGFR was fine on 03/08/2021 and last year 2020.

I think I should be relieved?!

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Phew! Yes that's one thing less to worry about, great news.

zand said:

Thought so. The reason I asked was that I bought a private Vit B12 test from Medichecks (who generally have a good reputation). It came back as exactly mid range of the normal figures. I went to my GP and he said the ones you buy online can be unreliable. He tested again and I do have B12 deficiency.

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Snap.

HurricaneHippo said:

Oh wow well lesson learnt for me!

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Me too

Oldvatr said:

In answer to a previous question regarding water intake affecting the result of the kidney test
https://jasn.asnjournals.org/content/19/6/1041

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An interesting if scattergun review.

Nothing very specific about anything.

Noting that the GFR bit mentioned "excess water" but didn't define it.
Here we hit the oft repeated question of "how much water is enough?".
The author seems to take the view that if you are not thirsty you are adequately hydrated.
Another view is that you can judge adequate hydration on the colour of the urine.
Light straw colour (or, I think, nearly clear - pick your straw) is said to show that you are adequately hydrated.

Personal experience.
If I drink only when I am thirsty my urine tends to be dark yellow.
If I make a special point of drinking an extra pint of water each day then my urine ends up almost clear.
If I have a couple of "clear urine" days before a blood test my eGFR seems to be better.

Anecdote not study, but I suspect that increasing water intake until my urine is more or less clear can improve clearance of "stuff". However drinking more that that (excess?) may not have any additional effect.

Anyway, I would welcome feedback if anyone else has managed to improve their eGFR by upping water intake for a couple of days prior to a blood draw.

LittleGreyCat said:

An interesting if scattergun review.

Nothing very specific about anything.

Noting that the GFR bit mentioned "excess water" but didn't define it.
Here we hit the oft repeated question of "how much water is enough?".
The author seems to take the view that if you are not thirsty you are adequately hydrated.
Another view is that you can judge adequate hydration on the colour of the urine.
Light straw colour (or, I think, nearly clear - pick your straw) is said to show that you are adequately hydrated.

Personal experience.
If I drink only when I am thirsty my urine tends to be dark yellow.
If I make a special point of drinking an extra pint of water each day then my urine ends up almost clear.
If I have a couple of "clear urine" days before a blood test my eGFR seems to be better.

Anecdote not study, but I suspect that increasing water intake until my urine is more or less clear can improve clearance of "stuff". However drinking more that that (excess?) may not have any additional effect.

Anyway, I would welcome feedback if anyone else has managed to improve their eGFR by upping water intake for a couple of days prior to a blood draw.

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My experience is the same as yours re the extra pint of water.

LittleGreyCat said:

An interesting if scattergun review.

Nothing very specific about anything.

Noting that the GFR bit mentioned "excess water" but didn't define it.
Here we hit the oft repeated question of "how much water is enough?".
The author seems to take the view that if you are not thirsty you are adequately hydrated.
Another view is that you can judge adequate hydration on the colour of the urine.
Light straw colour (or, I think, nearly clear - pick your straw) is said to show that you are adequately hydrated.

Personal experience.
If I drink only when I am thirsty my urine tends to be dark yellow.
If I make a special point of drinking an extra pint of water each day then my urine ends up almost clear.
If I have a couple of "clear urine" days before a blood test my eGFR seems to be better.

Anecdote not study, but I suspect that increasing water intake until my urine is more or less clear can improve clearance of "stuff". However drinking more that that (excess?) may not have any additional effect.

Anyway, I would welcome feedback if anyone else has managed to improve their eGFR by upping water intake for a couple of days prior to a blood draw.

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Interesting. The GFR is directly but inversely proportional to the creatinine value from the blood test. An improvement in GFR would mean decreasing creatinine not increasing it. Dehydration is one factor that seems to affect creatinine in the blood
https://www.medicalnewstoday.com/articles/320113#diet

This would imply that drinking water should indeed improve GFR. It is interesting that the article you reviewed actually seems to say that the opposite was noted in their trial data.
I.e
"Water ingestion can acutely affect GFR, although not necessarily in the direction one might expect. Using 12 young, healthy individuals as their own controls, Anastasio et al.[] found increased water intake actually decreases GFR. "

Actually, those of us that might suffer CKD might benefit from not just lowering protein, but also avoiding phosphorus from our diet.

Modern processed foods have phosphorus compounds added as flavour enhancers, preservatives and thickening agents. One major contributor that we may not know about is fizzy drinks. Many soda drinks used phosphoric acid, which not only rots teeth and guts but also stays in the body and builds up if the kidneys are underperforming.

From what I have seen, it is meat that is the main problem since it is packed full of creatine which is superb for building muscles, but the excess becomes creatinine which messes up the GFR. So reducing meat, especially red meat, and also apparently fish, in the week before a GFR test might help keep the surgeons at bay. Some vegetables also contribute to creatinine, so it seems Cruciferae such as cabbage, Brussel sprouts etc (the vegs with phosphorus in them) could also go onto the naughty step for that week (or permanently, as some will say)
https://www.mayoclinic.org/diseases...xpert-answers/food-and-nutrition/faq-20058408

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