low carb and kidney disease...

Hi betic,

I know some low-carbers produce ketones when reducing carbs to 30-50g daily. My diabetes consultant advises against ketones at all costs, but unsure of the science behind it all, here is a explanation of how kidneys are effected by ketones; it is a american article, but explains things well.

http://women.webmd.com/guide/high-prote ... rate-diets

Nigel

Hi betic,

There isn't a set figure for reducing carbs as such, you will find many members on the forum consume anything from 30g a day to 200-250g, sometimes more. Its all about what works for you, I reduced my carb intake cause I was often in double figures, and my control was erratic. Therefore, I started by trying to get away with the least amount possible, which for me was 50g of carbs, but even though I bulked my meals up with extra veg etc, I felt ill and lethargic. Some on very low-carb diets substitute carbs with extra fat, but as I didn't want to do this for health reasons, I slowly increased my carbs and I am eating between 90g-130g daily.

At this level I feel perfectly fine, maintain good blood levels, and my hba1c has come down by 1.4%.
The key to restricting carbs is testing, as much as possible at first so that you can see which foods cause spikes, and to write down this information and record all bg's. You say that on your present diet you have good bg control in single figures, this is good and must mean that you are slowly getting there. I too would ignore your dietician's advice, 12 rounds of bread a day could equate to 250-300g of carbs alone! :shock:

Try eating your fruit (apples) after your main meals, this way it shouldn't spike you the same. Just remember, keep an eye on your bg's, especially before and after you exercise. There is some good advice on another website for people like yourself who are sporty, its called 'runsweet' . I will have a quick look and post link for you.

http://www.runsweet.com/

Regards

Nigel

betic
If the dietician can't work out your diet, ask to be referred to one who works with athletes specifically, Rowers and the like. they are often your size.Or bigger 8)
Hana

This comes up quite regularly - and a search of this site will throw up a few discussions. You also need to do a bit of reading on the difference between being in a state of Ketosis (which is actaully desirable if you are trying to lose weight) and teh conditionion Ketoacidosis (definitely NOT desirable!)

I'm yet to find any real evidence of lo-carbing leadingto kidney disease. The theory (if you can call it that) is that increased intake of protein overworks the kidneys.

Like I said - no real eveidence of this. I'd be interested if anyone knows of any actaul cases of a lo-carb diet leading to kidney disease...

Hi Patch,

I only know by what I read in medical articles printed in newspapers and on the net. When I was on a course recently (DAFNE) there is a question and answer session with the diabetes consultant where you can any question at all. A young lad next to me, about 30 years old and a sports fanatic, didn't low carb but didn't use much insulin compared to what he ate, asked a question about protein to the consultant. This lad said he ate quite a lot of meat in his diet, said that he had a tin of mackerel most days for lunch, as well as a meat dish for his evening meal. Also said he would eat cold meats between meals when he felt hungry.

The consultant said that to much protein in the diet can place a increased strain on the kidneys, and as diabetics we are more prone to kidney disease than people who don't have the condition, so it was wise to limit your protein intake. The consultant said that protein was essential as part of a balanced diet, but not to consume to much. Atkins diet and such like was also brought up, but again he stressed the importance of looking after the kidneys, as on these diets they produce ketones, and for diabetics, ketones should be avoided.

Should you look at the link I provided betic, it explains things rather well, as I say only know what I have been told and read, I think we all have to make our own minds up, based on what is put before us. Although I trust those that I have close contact with, and many years of studying and experience, than what I read on the internet.

Regards

Nigel

Hi betic,

In diabetics, kidney damage tends to be as a result of persistently elevated blood glucose levels, rather than protein intake per se. However, anyone with existing kidney damage will need to be careful with the amount of protein in their diet.

As far as kidneys and ketones are concerned, I think you need to make a distinction between uncontrolled ketosis/ketoacidosis, and the relatively low level of ketosis normally seen on a very low-carb diet. I guess it really comes down to the age old argument as to what exactly you'd consider to be a safe/normal level of ketones.

If you do choose a diet that puts you in ketosis, then keeping an eye on your regular kidney function tests will help you decide what's myth and what's truth.


Best regards,
timo.

timo2 said:

Hi betic,

In diabetics, kidney damage tends to be as a result of persistently elevated blood glucose levels, rather than protein intake per se.


Best regards,
timo.

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Hi timo2,

I was just looking at profile, your occupation isn't listed, as you have made the above statement I can take it that you are medically qualified to dismiss protein as a factor in kidney disease, if this is so then I'll bow to your expertise.

However, should it not be the case and you are ruling this out on the bases of your own opinion, you may well want to think again before giving new members advice on subjects you know little about. You are quite correct that elevated blood glucose can cause damage to kidneys, as well as many other organs of the body, this I know to be a fact!

I am also not qualified to say yes or no, hence why I suggested that betic look up the information himself. I offered advice on my own personal experience, whereby on two occasions recently I have been in the presence of a highly qualified diabetes consultant, with many years of experience, who said that both high levels of protein in the diet and running ketones/ketosis are both damaging to the kidneys, more so in diabetics.

It is of no use to anyone to be given information/advice on assumptions only, it is far better not to reply to a post, or if unsure, suggest they ask for a professional opinion.

Regards

Nigel

Thanks, Nigel, I'll bear the advice in mind.

Have yourself a good weekend.

Timo,

Please, what ever you do, don't take it the wrong way!

If I came across brash, then I apologize........so you have a good weekend too!

Regards

Nigel

Hi betic,
I have only been on a low carb diet for about 15 months, my kidney function was good on diagnosis but far from deteriorating it has improved. Fergus who has been lowcarbing for around 10 years has seen his GFR improve from 89 to 105, this link will explain more about GFR.

http://www.renal.org/pages/pages/other- ... stages.php

It's also worth checking out Fergus's Newbies guide which also covers ketones.

viewtopic.php?f=18&t=7215

Regards
Graham

betic, from the perspective of someone currently under the care of a nephrologist, you only need to be concerned about protein intake if you ALREADY have compromised kidney function. eGFR is the scale used to measure this, and anything higher than around 85-90 is considered perfectly normal, so if you're there tuck in to those eggs and meat!

The exact point at which you need to start thinking about protein is unclear. It will certainly involve other factors, and will not be based on just one set of blood test results.

My eGFR went from 40 to 52 in just 6 months, but I'm not sure whether this was because I restricted protein intake (I was advised to eat no more than 2 eggs a week), or just had better glycemic and pressure control through this period. I suspect the latter, but an eGFR of 40 IS something to worry about. It's all about your own numbers.

It is one of the oddities that I have noted that if you mention cutting your carbs then it is assumed that you are also increasing proteins and fats – and it ain’t necessarily so!

Just looking at the Diabetes.co.uk website. Very good information about diets, the low-carb section is very well presented, as is the low-gi section, it evens mentions combining the two works well, which is very encouraging as I have been doing so for the last six months with great effect.

Did notice though, in the low-carb section it mentions what we have been talking about here, that of high levels of protein causing kidney disease. It says that 'there is medical research supporting links between high protein diets and kidney disease, gout and heart problems'. See for yourself:

http://www.diabetes.co.uk/diet/controve ... diets.html

Nigel

This has caused disputes as there is medical research supporting links between high protein diets and kidney disease, gout and heart problems.

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All the links that I have researched point to an exacerbation of pre existing conditions rather than a low carb diet( high protein/high fat diet) actually causing any of these conditions. Another good reason why you should always discuss changes of diet with your doctor before embarking on them.

noblehead said:

Did notice though, in the low-carb section it mentions what we have been talking about here, that of high levels of protein causing kidney disease. It says that 'there is medical research supporting links between high protein diets and kidney disease, gout and heart problems'. See for yourself:
http://www.diabetes.co.uk/diet/controve ... diets.html

Nigel

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Nigel

What is quoted is correct. However it only aggravates a pre-existing Kidney Disease. It does not cause Kidney disease. I have seen no evidence anywhere that this is not the case.

If you have some evidence that it actually causes Kidney disease other than anecdotal I would be interested to hear from you.

Ken,

Don't mean to correct you, but the sentence you have highlighted in bold, makes no mention of pre-existing kidney disease.

Should this be wrong, maybe it is worth contacting the administrator of the site to correct them on this, and change it to pre-existing, otherwise it is misleading people somewhat.

Nigel