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

Winnie53

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Ringi and bulkbiker, you are both misunderstanding the intent of this thread, in part because of my poorly worded OP.

Apologies.

My friend and I both prefer to get all of our protein from animal sources. That is not the issue being discussed here.

What I'm trying to learn is how to get some protein from plant sources to reduce the work load on the kidneys.

Her kidneys are very damaged. She only has 25% kidney function left. While lab test results will bounce up and down from day to day, the damage is not reversible. The goal is to not cause further damage.

In stage 4 CKD it becomes necessary to monitor sodium and potassium intake. Her upper limit is now 1500 g daily for each. Can't remember what her upper limit is for phosphorus. These levels are monitored closely because the kidneys are having a really tough time keeping these levels where they need to be for the body. If those levels increase too much, that can make things worse for her very quickly.

If either of you can find evidence that getting 100% of protein from animal sources within the context of stage 4 kidney disease, please share it here.

The goal is to stop further damage to the kidneys so dialysis can be delayed as long as possible. Once dialysis is started, average survival rate is 5 years.

For the last 2 decades or so, some patients have been able to significantly delay dialysis for years by reducing the work load on the kidneys with a specific diet and protein supplements designed for CKD.

Protein from animal sources is not a problem for those of us who have healthy kidneys. I do not yet understand why it's a problem for those with CDK. That said, those who use the CKD diet and plant based protein supplements are able to delay dialysis. But the supplements are very expensive. Not everyone can afford them. That's the problem.
 
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Winnie53

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Avocado is great for keto, but is problematic for CKD due to its high potassium content, so this is a food that needs to be limited.
 

Winnie53

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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)

You might feel differently if hospitalized with ketoacidosis due to that drug.

Phinney and Volek were and continue to be my go to researchers after starting the keto diet. I also follow Virta Health's work closely. I agree with you there.
 

Winnie53

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Okay, I just spent the entire day re-reading all the research I did in 2017 on CKD.

Animal protein is a problem for those who want to stop the progression of stage 4 CKD to avoid dialysis. For best results, the lower the protein intake the better, from plant sources, but this requires supplementing with ketoacid analogues/essential amino acids (KA/EAA) supplements.

Good news is that I talked with a woman who has CKD at that time, and she shared with me that Dr. Fung assured her that the low carb high fat diet would not hurt her kidneys. She stopped the progression of her CKD by doing a very low protein, mostly plant based diet and taking the KA/EAA supplements. Going to reach out to her this weekend to see how she's doing now.

Perhaps this weekend I can try to summarize what I've learned so far on a new thread in the Diabetes Complications sub forum.