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Preventing Kidney Failure Through Diet

Given how vascular our kidneys are, it should comes as no surprise that animal protein, animal fat, and cholesterol are associated with declining kidney function (microalbuminurea—loss of protein in the urine), which can be an early warning sign for not only kidney failure, but also heart disease and a shortened lifespan.

July 13, 2012 |
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Images thanks to LadyofHats via Wikimedia Commons and avlxyz.

Transcript

Our kidneys are highly vascular organs. That’s why they look so red inside. Afterall, our two little kidneys have to filter through our entire blood supply and as such receives about 20% of our cardiac output every time our heart contracts. And so if the standard American diet is so toxic to the blood vessels in our heart, brain, and pelvis, leading to heart attacks, strokes, and sexual duysfunctionwhat might it be doing to our kidneys?
 Researchers at Harvard recently put that question to the test. Thousands of women and their diets and their kidney function were followed for a decade. What they’re looking for is the presence of protein in the urine, known as microalbuminuria. There’s not supposed to be any protein in our urine. The whole point of our kidneys is to keep the good stuff in your blood and get rid of the bad. It’s supposed to hold onto protein and if it doesn’t, that’s a sign our kidneys are starting to fail.
 There were three significant risk factors for declining kidney function in these women, none of which come as a surprise given that we’re talking about clogged and inflamed blood vessels: “Specifically, diets higher in animal protein, animal fat, and cholesterol may be associated with microalbuminura—failing kidneys.” No such association was found for plant protein or plant fat.
And microalbunuria is kind of a canary in a coal mine telling you something is definitely wrong with your blood vessels. “Microalbuminuria and modest decrements in kidney function are powerfully associated with subsequent overt kidney disease, cardiovascular risk, and all-cause mortality, meaning a shortened life-span. “In summary, diets lower in animal protein, animal fat, and cholesterol may be protective" against this kidney damage.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Serena

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger
  • Michael Greger M.D.
    • HemoDynamic, M.D.

      Are you Kidneying me?

    • HemoDynamic, M.D.

      When I was in high school, I remeber being in the gym bathroom and seeing that many of the guys left behind foamy urine.  I always wanted to be like them–muscular, strong, foaming pee.  No matter what I did or ate I couldn’t get foamy urine.  I was actually embarrased that I couldn’t leave bubbling urine in the urinal.  I thought I was unmanly! 

      I now realize that proteinuria was probably the cause and usually not a healthy sign.

      Crazy what we imagine as being healthy when we are young.

      • editor d

        Wow interesting info. I was wondering why my urine no longer foams up since the vegan switch. Thanks.

      • editor d

        So on further “research” and some of my own testing. :) Frothy or foaming urine is not a good indicator of proteinuria.  It’s really more about how the urine stream hits the water and bubbles it up.

        • HemoDynamic, M.D.

          Sorry I haven’t replied sooner but I just got back from Farms to Forks Immerision at Pie Ranch in Pescadero, CA.  It was fantastic!

          Anyway, you are correct that “foaming pee” is not a good indicator of proteinuria, but I am not talking a few bubbles here (yes I can make foamy urine by urinating at a specific angle in a toilet).   ;-O    But I’m talking about foam like you would see on the ocean sand (See Below).  ;-} 

          Well OK maybe not that much but see the next pic showing a foamy urinalysis (Below).

          The individuals I were describing had foamy pee (albuminuria/proteinuria) that would stay for a long while.

          Here is some scientific evidence showing increased proteinuria with high Protein diets:
          http://www.ajcn.org/content/90/6/1509.long#T3
          “Adherence to the diet was also assessed by measuring urea nitrogen (BUN on your labs) excretion in the 24-h urine sample, which was significantly higher in the HP (High Protein) diet phase than in the NP (Normoprotein) diet phase. . . “ (Table 3).
          http://www.ajcn.org/content/90/6/1509/T3.expansion.html
          Here is a statement and link to Proteinuria from the National Institutes of Health:
          “What are the signs and symptoms of proteinuria?
          . . . Large amounts of protein in the urine may cause it to look foamy in the toilet. . .”
           http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/

          Maybe those kids pee’d at a certain angle or maybe they had significant proteinuria, all I know is . . .

          Plants Protect and Animals Annihilate the human body.

          Go Plant Strong!!!!!!!

    • SJ M.D.

      Very interesting (again). Another reason to go plant-strong. You dont want kidney-failure, no steak is worth that.

  • Thea

    Is there a problem with this video or is it just me?  When it gets to about 3/4 of the way through, the video goes black and looses the control buttons.  I’ve tried to watch it twice and get the same result.

    • SJ M.D.

      No problem here

      • Thea

         Thanks for letting me know.  I tried a third time and still have a problem. I’ve been able to watch all the other videos, so hopefully this will be a one-video problem for me. 

        Thanks again for the reply.

    • Michael Greger M.D.

      I’m so sorry you’re having trouble Thea!

      Which browser and version of it are you using?  Is your browser version up to date? You can upgrade any browser version here.

      Have you tried clearing your browser cache and cookies?

      Have you tried using the browser with all extensions or add-ons disabled?

      Do you have third party cookies enabled?

      Do you have JavaScript enabled?

      Have you upgraded Flash recently or are you using the latest version?

      Do you have another browser you can try?

      • Thea

         Dr. Greger:  Thanks so much for taking an interest.  I did some more testing last week and had problems with all sorts of videos on this site.  So, it was definitely a problem with my computer.

        Happily, when I checked, this morning, all of a sudden, everything was working fine.  So, I will put this down to a temporary problem with my system. 

        Sorry to bother everyone with it.

  • Therandey

    Excellent!  How we can in all good sense keep mistreating our bodies with toxic animla protein is beyond me.  Education is the key.  Thank you Dr. Gregor for providing short, compelling videos that will in 2 minutes  or so change the paradigms of the honest- hearted seeker of nutritional wisdom.

  • Dr J

    Dr.G,I do read (a bit) about the “goodness” of the occasional egg,and did indeed make an vegetable fritatta this very morning! Any words of wisdom/chastisement for this nomeat eater?  Dr.J

    • HemoDynamic, M.D.

      Dr. J I do not speak for Dr. G but read below Groovy Vegans post and mine above  to Editor D.

      A little bit of research will show you the “badness” of the occasional egg.   Maybe you should get Dr. Gregers new DVD.  The very first thing he talks about is the detriments of Eggs.  They are equivilant to smoking!!!

    • http://www.DonForresterMD.com/ Don Forrester MD

      I can think of no good reason to eat an egg. From a health stand point Dr. Greger has done 43 videos that mention eggs. See the video on eating a single egg… http://nutritionfacts.org/video/egg-cholesterol-in-the-diet/. Beyond cholesterol there are chemicals both natural such as arachidonic acid see http://nutritionfacts.org/video/chicken-eggs-and-inflammation/ and  unnatural such as PCB’s see http://nutritionfacts.org/video/food-sources-of-pcb-chemical-pollutants/. Additionally there are infective agents of which the most well known is salmonella see… http://nutritionfacts.org/video/total-recall/ or the less well known retroviruses see… http://nutritionfacts.org/video/carcinogenic-retrovirus-found-in-eggs/. Going beyond health you might find of interest the impassioned speech on the other reasons not to eat animal products see Phillip Wollen’s 10 minute video, Animals Should be Off the Menu, as part of an ethics debate recently in Australia… see http://www.youtube.com/watch?v=uQCe4qEexjc. Finally of course there are plenty of options to eggs. It’s not like the eggs have “quality” protein after all the essential amino acid profile of eggs is almost identical to broccoli or asparagus… Dr. John McDougall’s excellent three articles on protein in his newsletters dated 12/2003, 4/2007 and 1/2004. After viewing these sources I like to imagine your “practical wisdom” level will be somewhat higher. For a great video on Practical Wisdom see a video by the the author of a book by that name, Professor Barry Schwartz on our loss of wisdom on TED.com.

    • BPCveg

      According to the website of ‘The Academy of Nutrition and Dietetics’, which is self-described as the world’s largest organization of food and nutrition professionals:

      “eggs provide our bodies with protein, iron and lutein”

      Furthemore, the Academy recommend using egg whites abundantly in place of egg yolks to keep total daily cholesterol under 300mg.

      • Toxins

         Eggs have been consistently shown as harmful on this website. The amount of lutein found in a spoonful of spinach is equivalent to 12 eggs, and all the nutrients found in eggs can easily be found in plants. Don Forrester does a good job if linking up the videos.

        • BPCveg

          Toxins, I appreciate your comment. Let me explain where I am coming from: I am both dedicated vegan and a PhD scientist (in the field of biophysics)…I am already convinced of the benefits of a plant-based-diet and do not eat eggs.

          The problem I have is that the science of nutrition is a vast subject, so vast that anyone can select articles from the literature and make virtually any argument that they want. Some of the articles selected may not even be reproducible.  

          What seems more valuable to me the scientific concensus process- which ideally should be based on the views of a majority of scientists in a field and based on the totality of evidence — this minimizes the likelihood of bias. Now, “The Academy of Nutrition and Dietetics” is, according to Wikipedia, the largest organization of food and nutrition professionals in the USA with close to 72,000 members, most of whom are registered dietitians. How much closer to a scientific concensus can you get? 

          So, if eggs are equivalent to smoking, as Hemodynamic suggests, then why is the scientific concensus telling us otherwise? 

          From a rational laypersons perspective, who is more likely to be correct: one MD who selects articles from the literature to create videos for a website promoting veganism (and is capable of changing his opinion from one year to the next) or the largest organization of professional dietitians in the world?

          • Toxins

            I am aware of your strong support of a plant based diet which is why I was a bit confused in your comment. It seems the position of the The Academy of Nutrition and Dietetics is only looking at the nutritional profile of eggs, ignoring what other harmful side effects eggs may entail. Also, the fact they mention eggs as a good source of lutein tells me that there are probable corporate influences within that community, as lutein is abundant in the plant world in far greater quantities and this piece of information is conveniently left out when eggs are being supported. They are also ignoring other outside evidence showing harmful outcomes with the consumption of eggs which I am I am sure your well aware of. The fact that we have cardiovascular and stroke experts and researchers such as David Spence and Jean Davignon explaining the damage that entails with the consumption of a single egg makes me wander if The Academy of Nutrition and Dietetics are even aware of these harms.

            In regards to egg whites, although true they are a good source of protein, this is possibly the only positive statement that can be made of it. Here is some evidence of a major component of egg whites, Methionine, possibly causing human harm.

            1. Egg whites are high in the amino Acid Methionine. Rice has 14 times less of this amino acid and beans 7 time less. When one consumes Methionine in a large quantity (like that found in egg whites), it is broken down into sulfuric compounds. these sulfuric compounds are buffered by the calcium of the bones. the result, over time, is osteoporosis and kidney stones.
            http://www.vivalis.si/literatura/6a00.pdf

             2. Cancer cell metabolism is dependent upon methionine being present in the diet; whereas normal cells can grow on a methionine-free
            diet feeding off other sulfur-containing amino acids.
            http://www.ncbi.nlm.nih.gov/pubmed/14585259
            http://www.ncbi.nlm.nih.gov/pubmed/12416254

            3. Insulin like growth factor is raised significantly by Methionine. raised levels of IGF-1 = accelerated aging/tumor promotion.
            http://www.ncbi.nlm.nih.gov/pubmed/12176673
            http://jnci.oxfordjournals.org/content/92/18/1472.abstract

            4. Sulfur from Methionine is known to be toxic to the tissues of the intestine, and to have harmful effects on the human colon, even at low levels,
            possibly causing ulcerative colitis.
            http://www.ncbi.nlm.nih.gov/pubmed/9448181
            http://jnci.oxfordjournals.org/content/82/11/950.abstract

            It seems the weight of evidence for even moderate use of eggs and egg whites is harmful despite what nutrients may be present. Again, I understand your a plant based advocate as well, I am just trying to get my point across that perhaps The Academy of Nutrition and Dietetics is solely looking at the nutritional profile of eggs in making their judgement of its use.

          • BPCveg

            Toxins: thanks again for providing valuable information. I think you are correct about “corporate influences within that community”.  It seems that the A.N.D. may not be unrepresentative of the scientific concensus on nutrition.

            By the way, according to the wikipedia page on methionine, sesame seeds, brazil nuts and soy protein are also highly concentrated sources of methionine, albeit lower than egg whites.

          • Toxins

             Indeed, food sources are listed here
            on the USDA database.
            http://nutritiondata.self.com/foods-000084000000000000000.html

            Soy protein isolates and egg whites seem to be the biggest source, this soy protein is a soy protein concentrate and reaching harmful amounts in normal soy foods would be more difficult to achieve. Soy protein isolates have been shown to increase IGF-1 significantly as well.

          • Thea

             BPCveg:  I appreciate your comments since I think it is important that we always employ critical thinking when trying to make sense of the world.

            However, in this case, your thoughts do not make sense to me.  Here’s where I’m coming from:

            Remember the video on the Tomato Effect?  It shows how scientific consensus is not always about the science.  I fully believe that the Tomato Effect happens all the time today, because it is human nature.  It is not just a silly occurrence that happened in the past.

            Furthermore, it seems to me that a Tomato Effect is exactly what would likely be going on concerning the topic of eggs and the people in the Academy you mentioned.  It seems far more logical to me that those people would stick by what they learned in school whether current science continues to support that view or not.

            More than just sticking by their early education, there is a *strong* cultural bias for those esteemed individuals to not see the science for what it is when it comes to eating animal products.  Dietitians are going to be as strongly influenced by their own desires to continue to eat animal products as anyone else in our society.  It takes time to not just educate so many people, but to change their biases.  (In the mean time, you and I can look at the latest science and act now.)

            Even more, I doubt that all 72,000 members directly validated their Academy’s statement on eggs.  I would bet that a very small committee of people who fancy themselves experts came up with the statement and then everyone else quotes from it rather than doing the research themselves.  That seems to be the way large organizations like that work.  They outed themselves when they talked about lieutine.  As Toxins pointed out, that one bit right there makes it suspect that they were looking at the science at all.

            I would suggest that the purpose of this site is to show the science whether or not the body of the scientific community has caught up.

            Finally, it is not just one study that Dr. Greger picks out of the blue to support a particular view-point.  Skip any one study you want.  The point is that there is study after study after study that supports Dr. Greger’s big picture.  I can’t imagine how anyone could watch all 500 videos and honestly believe that Dr. Greger hasn’t done a very good job of properly representing the “body of evidence”.  As an example, I remember Dr. Greger saying in one of his videos something like, “People often accuse me of picking and choosing studies.  I don’t.  I challenge them to come up with a single study that ___”  I don’t remember the exact challenge, but the answer was, “They can’t because there isn’t a single study out there.”

            I’m sure there are studies that show that eggs can have some benefits.  The point, though, is to look at the “body of evidence”.  Given politics and people’s desires not to change, I think we get a better overview of the body of evidence from this site than the Academy provides when it comes to animal products.

            I didn’t explain myself very concisely.  My appologies.  And I want to say that I’m not trying to be argumentative.  It’s just that your comments challenged me.  I felt your comments were particularly good and it was my responsibility to be able to answer such thoughts for myself.  Then I decided to write them out.  Thanks for your comments.

          • BPCveg

            Thanks, Thea, for your excellent response to my question. Your perspective does seem very reasonable to me and, of course, I agree with you that the general message of Dr.Greger’s website is on the right track.

            Despite my strong support for a whole foods plant based diet, I have had conflicted feelings about rejecting the opinion of the Academy (who recommend eggs, fish and dairy) mainly because of my respect, in general, for scientific concensus. I think the critical scientific community is very good at weeding out extreme and bizarre viewpoints and that this process is very valuable and should be respected by the public. That was my reason for lending some support to the claims of the Academy.

            However, subsequent research has supported Toxins suggestion that the Academy has been bought out by corporations. For more, see:
            http://en.wikipedia.org/wiki/Academy_of_Nutrition_and_Dietetics#Controversy

            I am now feeling more skeptical as to whether this Academy represents the scientific concensus at all. It is extremely sad that laypeople can not even trust a major nutrition body!

            I will also keep in mind your point about the tomato effect. Thanks again.

          • Thea

             BPCveg:  Thanks for reading my post and giving such a nice reply.  Your link is quite interesting.

            I came up with another idea over the weekend.  I was feeling that my post had a hint of anti-science in it, and I am not like that at all.  Like you, I think the process of scientific consensus building is extremely valuable.

            Then I remembered a young friend from a couple years ago who was studying to be a registered dietician.  We had several conversations about her education.  While she talked about learning the results of a fair amount of science, her education was all about taking in information – not about how to do experiments, understand them, and participate in the scientific community.  Contrast that experience with my roommate in college who was getting a BS in biology.  She was running scientific experiments and learning about the process from day one.

            My point is: Based on my very limited understanding of what a registered dietician is, they are professionals, but not necessarily scientists.  There is a difference between a professional and a scientist.  I have no reason to believe that non-scientists would have processes that are similar to something that you would recognize as building “scientific consensus”.

            That’s it.  It just made me feel better to think that the Academy may not be up on the science since they are not (at least to my knowledge) actually scientists.  Which is not to say that they don’t try to keep up.  I just think that their assimilation of the latest experiments would be different compared to someone who is in fact a scientist. 

            I don’t know how legit this idea is.  I just thought I would throw it out there. 

            If any dieticians are reading this, please don’t take this the wrong way.  I’m a professional too.  I just recognize a difference between my profession and being a scientist.

          • Thea

             BPCveg:  I forgot to add:  I really do appreciate your comments. 

            Your conflicted feelings make perfect sense to me.  The conflicting information pushed by “expert” organizations and the media is something that the general public is dealing with every day.  The available information is both conflicting and confusing.  People are often left feeling that the science does not actually point anywhere since it seems like anyone can make the science appear to say whatever they want.  I come across (and work to fight) this belief constantly. 

            I’m not saying you have this belief.  I’m just saying, if you, as an educated person and a plant-advocate, are struggling with trying to find out what the science tells us about nutrition, it is perfectly understandable and no wonder that other people are thoroughly lost.  It is important that we, (plant advocates/professionals/vegans?), be able to answer these types of questions.  And thus, we owe thanks to those people who keep us on our toes by doing the asking.

          • BPCveg

            Hi Thea,

            I think you made a really interesting argument about how people in the medical professions may interpret new scientific data differently from those who are actually conducting scientific experiments. Of course, I am sure you would also agree that both of these groups can bring something valuable to the table. Like you, I try to be as open to as many points of view as possible.

            Although I agree with the general message of nutritionfacts.org and think that this website makes a valuable contribution to educating the public, I have some doubts as to whether this site offers a completely balanced perspective. It seems to me that Dr. Greger does look at things through a vegan lense.

            I would like to be able to compare Dr. Greger’s views with those of other experts in nutrition. That way I can learn Dr. Greger’s views in comparison with the mainstream scientific view.

    • M.Harris RD, LD

      Anytime you are evaluating nutrition information, it is important to keep in mind the source of that information.  What are the credentials of the author or speaker?  Do they have a hidden agenda for promoting a certain food?  For example, the egg board would like the American public to believe that eggs are a healthy part of anyone’s diet.  I disagree.  When I am looking for the consistency of scrambled eggs, I use extra firm tofu with a pinch of turmeric, onion powder and salt.  Saute in a little olive oil and add onions, peppers and mushrooms if you desire.  Throw in some veggie sausage and you have a very satisfying, high protein and cholesterol free breakfast!  Thanks for your question!

      • Thea

        I also find that tofu, ***when cooked just right***, has the consistency of scrambled eggs.  

        That’s consistency, but what about taste?  As you describe your recipe, the taste can be very good.  But here is a tip making tofu taste a little more like eggs: black salt.

        I read this idea recently in a vegan cookbook.  The author said that the black salt does something to really help the tofu have an eggy taste. I had to order the black salf off the internet recently, so I can’t yet attest to this assertion myself.  After reading your nice post, though, I wanted to share the tip before I forgot.

  • Groovy Vegan

    My father had a kidney transplant last year, and it’s high time people put thought and effort into preventing kidney disease, rather than waiting until their doctor tells them their kidneys are failing.  I sent a link to this video to some doctors I know to share with their patients.

    • LynnCS

      I have a friend who’s father had sudden onset of kidney failure with no obvious symptoms leading up to it. Went on dialysis and died withing a few months. Another silent killer. For me, better to be safe than sorry.

  • Mary

    I would have liked the data to be longer.  I was diagnosed with end stage renal failure in October 2011. I was asked to sign a consent form for immediate dialysis. That evening I spoke to a Nephrologist who asked if I would like to try reversing it by diet before undergoing dialysis.  I agreed.  Problem: Neither Nutritionist nor M.D. has been able to furnish me with a diet I can easily follow at home. 

  • Randy

    Regarding eggs – are the comments about the toxicity of eggs applicable to organic / free range eggs?

    • Toxins

       The issue with eggs have to do with cholesterol and arachadonic acid which are inherent components of eggs whether they be conventional or not.
      http://nutritionfacts.org/?s=eggs

  • Kydkop

    SO will eliminating all animal protein from diet reverse such MA?

  • jeffj

    I’ve been diagnosed as follows:

    Papilary renal cell carcinoma.

    The carcinoma is metastatic (Stage IV).

    Wondering if you have any subscribers know of anyone who have beaten this type / stage of metastatic cancer using diet?

    Any advice you have would be greatly appreciated. I need to make a decision very soon regarding traditional (western) treatment or a better way.

    Thank you very much,

    Jeff J.

    • http://nutritionfacts.org/ Michael Greger M.D.

      The nice thing about dietary interventions is that they can be undertaken in addition to whatever you and your physician agree upon is the right course of action in your case.

      Unfortunately I’m not aware of any studies on the role of diet in surviving renal cell carcinoma. I do have videos on diet for bladder cancer survival, early stage prostate cancer (in relation to flax seeds, saturated fat, plant-based diets), breast cancer survival (in relation to soy, flax seeds here, here and here, saturated fat, trans fat) and reversing the progression to esophageal and oral cancer, but none that cover dealing with kidney cancer because it just hasn’t been looked at.

      However, because Cancer Prevention and Treatment May Be the Same Thing in many cases, I would recommend you consider eating the kind of diet that has been associated with kidney cancer prevention. For example, in the current issue of one of my favorite journals, the American Journal of Clinical Nutrition, this question was put to the test in what may be the largest prospective study ever, the NIH-AARP Diet and Health Study, which followed nearly half a million people for about a decade. Noting that “Plant-based and fiber-rich diets high in vegetables, fruit, and whole grains are recommended to prevent cancer and chronic conditions associated with renal cell carcinoma, the study found fiber intake was associated with a significant 15-20% lower risk of renal cell carcinoma and that the most powerfully protective foods included legumes (beans, chickpeas and lentils), whole grains, and cruciferous vegetables. Refined grain intake, however, was associated with increased risk. Last year the same group of researchers found that cooked meat carcinogens may double the risk of papillary renal cell carcinoma. The only other new study I know of found that nitrite from processed meats and other animal sources (but not plant sources) was associated with an increased risk as well.

      Finally, given that most of the new treatments developed for renal cell carcinoma (Axitiniband, Bevacizumab, Everolimus, Pazopanib, Sorafenib, Sunitinib, Temsirolimus) attempt to block the formation of new blood vessels to the tumor, that would be all the more reason to pack your diet with foods containing anti-angiogenic phytonutrients such as

      apigen, luteolin, and fisitin such as strawberries, citrus, celery, peppers, and other fruits and vegetables. I have a video coming out soon on this whole concept called Cutting Off Tumor Supply Lines. Stay tuned!

  • Jeff

    Hello Dr. Greger. What can you tell me about treating Nephrotic Syndrome? My son is 4 and was diagnosed with this a few months before his 3rd birthday. He’s had two relapses since, and has taken prednisone for it each time. Any information you have on it would be greatly appreciated! Thanks!

  • me8932

    I went on a plant based diet 8 months ago and guess what… ? I’m currently in hospital with worryingly impaired kidney function! I’m 34. The moral to the story is to not precede 8 months of plant based eating with chronic over indulgence in animal protein and a propensity to consume protein and creatine supplements! I’m going to do my best to heal myself with diet because I was feeling great before this latest episode.

  • rome

    My wife has just lost a kidney to cancer and has been a long time on prevacid now going to take tagamet and eliminate prevacid for indigestion will the tagamet have adverse effects on her kidney?