Image Credit: Dr Michel Royon / Wikimedia Commons. This image has been modified.

Preventing and Treating Kidney Failure With Diet

Our kidneys are highly vascular organs. That’s why when you see kidneys in the meat case they look so red. After all, our two little kidneys have to filter through our entire blood supply and as such receive about 20% of our cardiac output every time our heart beats. So if the standard American diet can be so toxic to the blood vessels in our heart, back, abdomen, and pelvis, contributing to heart attacks (Heart Attacks and Cholesterol: Purely a Question of Diet), spinal disc degeneration (Cholesterol and Lower Back Pain), aneurisms (Abdominal Aortic Aneurysms: Ticking Time Balloons), and sexual dysfunction (Cholesterol and Female Sexual Dysfunction), what might it be doing to our kidneys?

In my 2-min. video, Preventing Kidney Failure Through Diet, I profile a recent Harvard study putting that question to the test. Thousands of women, their diets, and their kidney function were followed for a decade. The researchers found 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: animal protein, animal fat, and cholesterol. All three of these risk factors are only found in animal-based foods. No such association was found for plant protein or plant fat.

Failing kidneys can be a canary in a coal mine, informing us about the health of our blood vessels. Quoting from the Harvard study, “modest decrements in kidney function are powerfully associated with subsequent overt kidney disease, cardiovascular risk, and all-cause mortality,” meaning a shortened lifespan. “In summary, diets lower in animal protein, animal fat, and cholesterol may be protective” against this kind of kidney damage.

What if the damage has already been done, and you’re already suffering from chronic renal failure? That’s the subject of my video Treating Kidney Failure Through Diet.

One of the important functions of our kidneys is to filter out excess phosphorus from our bloodstream, and so when our kidney function declines, phosphorus can build up in our bodies and cause something called metastatic calcification, where your heart valves and muscles and other parts of your body can buildup calcium deposits and eventually result in skin necrosis, gangrene, and amputations.

So, if a person has diminished kidney function their doctor will likely put them on a low phosphate diet, which is tough, because basically everything with protein has phosphorus. So both plant foods and animal foods have phosphorus. But vegans have been shown to have significantly better kidney function, on average, compared to omnivores. So while researchers concluded that “These results can confirm the usefulness of vegetarianism here and support the use of a vegan diet for the patients with kidney failure,” maybe it was just because the omnivores were getting a higher protein load. We know that lower protein diets appear to delay the progression of kidney failure, so did the plant based diet help because they were eating less protein or because the body somehow is able to handle plant protein better than animal protein?

To do that you’d have to split people into two groups, half on a vegetarian diet, half not, with the critical caveat to make sure both groups eat the exact same amount of protein and the exact same amount of phosphorus. And that’s exactly what researchers did. Published recently in the journal of the American Society of Nephrology, they took vegetarians and put them on a meat diet, and then took meat-eaters and put them on a vegetarian diet. Even though  phosphorus and protein intake were kept the same in both diet groups, in the video you can see an illustration of the level of phosphorus stuck in the bloodstream of those on the meat diet, compared to those on the veg diet. Something about plant foods appears to enable our bodies to better handle their phosphorus content. Plant phosphorus appears easier to cleanse away.

Positive results have been seen with even semi-vegetarian diets, but the reason the new study  “observed more dramatic differences after only 1 week, was perhaps because of the pure vegetarian diets used in our study. Taken together, vegetarian-based diets may be beneficial for the control of phosphorus balance in patients with chronic kidney disease.”

This is another reason why Plant Protein is Preferable. Food is, after all, a package deal. In addition to kidney failure, plant based diets can help prevent and treat diabetes, prevent and treat COPD, prevent and treat arthritis, prevent and treat cancer, prevent and treat heart disease, and prevent and treat obesity. Why, then, don’t more providers in the medical community embrace plant-based diets? Part of the reason may be The Tomato Effect.

-Michael Greger, M.D.

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


18 responses to “Preventing and Treating Kidney Failure With Diet

Commenting Etiquette

The intention of the comment section under each video and blog post is to allow all members to share their stories, questions, and feedback with others in a welcoming, engaging, and respectful environment. Off-topic comments are permitted, in hopes more experienced users may be able to point them to more relevant videos that may answer their questions. Vigorous debate of science is welcome so long as participants can disagree respectfully. Advertising products or services is not permitted.

To make NutritionFacts.org a place where people feel comfortable posting without feeling attacked, we have no tolerance for ad hominem attacks or comments that are racist, misogynist, homophobic, vulgar, or otherwise inappropriate. Please help us to foster a community of mutual respect. Enforcement of these rules is done to the best of our ability on a case-by-case basis.

  1. If we need another reason to eat a plant-based diet this would be a good one to add to the exhaustive list.

    Thank you for great information presented in in easily digestible fashion. Love the videos too!




    1
  2. A good video, but my compputer had you speaking over yourself about a different topic.  I’m not sure if everyone has this problem, but I did, and it’s under no other e-mail I have ever read.




    0
  3. Hi Michael, I am a great fan of the extraordinary work you do.  I have 4 questions for you: 1- in the Spanish study, Crossover study of diets enriched with virgin olive oil, walnuts or almonds. Effects on lipids and other cardiovascular risk markers, how significant are the results of this study considering the fact that the groups went from a baseline intake of cholesterol of 231 mg/d to about 130 mg/d when they change from their regular diet to the experimental diet with olive oil or nuts?2- When you attended McDougall Adavance Weekend last February you were going to ask a question following Fuhrman’s and McDougall’s debate. I am curious to know what you were going to ask? I am assuming that you are not a great supporter of McDougall’s high CHO diet. 3- Contrary to McDougall Dr. Willett from Harvard substantiates well the need for PUFA and MUFA in the diet. What is your take on Willett position? 4- What is the risk for vegans who eat the way you suggest to become deficinet in DHA, as reported by Fuhrman? Thank you for taking the time to answer these questions, André Saine




    0
  4. Dr. Greger, thank you for all that you do.

    Is there any risk in worsening chronic kidney disease with a vegan diet, due to the increased potassium in plant foods? If someone has diminished GFR, would the extra potassium from plants overwhelm there glomeruli or would it bring their kidney function back?

    Thank you.




    0
  5. I still don’t understand if a diabetic with kidney problems can still eat plant-based protein or should plant-based proteins be eliminated as well? When one reads about a renal diet, which is low protein, are nutritional guidelines including plant-based proteins or not? Can’t figure this out! I




    0
    1. Carole: I can’t comment on your specific condition of diabetes *and* kidney problems. (what a bummer). But I did want to respond to this part of your comment: “can still eat plant-based protein or should plant-based proteins be eliminated as well?”

      I don’t think the question fully makes sense since all plant foods have protein. You might be surprised at how much protein even veggies have. So, unless you were planning on never eating plants, you can’t eliminate plant based proteins. You could try to eat plants that only have less proteins, but then you would be missing out on some super-healthy foods – foods that in general are less in protein than animal foods I believe. So, I don’t see how you could go wrong eating them??? (I’m not a doctor and don’t know about advising you for your specific condition.)

      For a really great tutorial in understanding proteins and our need for it and how much plants of all types have, check out this awesome page:
      http://michaelbluejay.com/veg/protein.html

      I hope this helped at least a little. Good luck.




      0
  6. I am a registered dietitian in Long Beach, California. I was
    vegetarian for over 40 years, and about 4 years ago, when realizing the cruelty
    of the dairy and egg industry, became vegan.
    The patient population I work with have end stage renal
    disease and are on dialysis, either hemodialysis or peritoneal dialysis.
    One of our biggest problems, besides high phosphorus levels, are low albumin
    levels (goal being 4.0 or higher). For thirty years I have been
    encouraging my patients to eat more animal protein in effort to raise albumin
    levels, as this has always been the recommended practice.
    As I am sure you are well aware, albumin is not a great
    indicator of nutritional status, but for renal failure patients it seems to be
    the best, if not least expensive, parameter we have. One of the markers of
    inflammation is a low albumin, and our patients have plenty of co morbid
    conditions which contribute to inflammation. My new hesitancy in recommending
    increased intake, especially of red meat, is that consumption of animal protein
    itself is a contributor to inflammation. I therefore, have begun
    encouraging more nut butters and limited amounts of beans and nuts to my
    patients. Because of the higher phosphorus it has long been recommended that
    dialysis patients avoid these foods. (we now know that the
    bioavailability of plant foods is lower than that of animal foods)
    However, I can no longer, in good faith, continue to advise my patients
    to increase animal products when the number one cause of death in dialysis
    patients is cardiovascular disease. But is this possible???

    My question to you is the following: Are you aware of any
    literature or studies regarding a vegan diet for dialysis patients which
    I could share with my doctors? There is much research about the benefits of a
    vegan diet in preventing renal disease, but I am now referring only to
    those patients with renal failure, CKD stage 5. I do have meal plans for
    vegan diets for renal failure, but I am specifically looking for something to
    present to my doctors which would help them come on board with more of a
    plant based diet (while still maintaining potassium and phosphorus levels
    within goal ranges) for their patients? Or is the current state of the
    art diet for dialysis patients, a diet lacking in fiber and phytonutrients and
    high in fat, still what the doctor ordered?




    0
    1. Hello compassionate RD,

      Thank you for asking this question. I also work in a dialysis center and I am in the same situation as you are. I recently switched to a whole food plant based diet (vegan) and I am struggling to find sources and literature on what to recommend my patients.

      You’re right, we’re always taught to recommend animal protein for albumin levels and I don’t want to do this anymore. I really need help with resources on finding non-animal sources of protein, also low in phosphorus (which is hard to find). My doctors at this clinic never recommend this, they don’t even put them on low protein diets prior to dialysis.

      If you have anything that you’re willing to share please let me know. I would love to reach out and find out what you recommend to dialysis patients. I am struggling, because none of the RDs I work with are vegans.




      0
  7. I am a registered dietitian in Long Beach, California. I was
    vegetarian for over 40 years, and about 4 years ago, when realizing the cruelty
    of the dairy and egg industry, became vegan.
    The patient population I work with have end stage renal
    disease and are on dialysis, either hemodialysis or peritoneal dialysis.
    One of our biggest problems, besides high phosphorus levels, are low albumin
    levels (goal being 4.0 or higher). For thirty years I have been
    encouraging my patients to eat more animal protein in effort to raise albumin
    levels, as this has always been the recommended practice.
    As I am sure you are well aware, albumin is not a great
    indicator of nutritional status, but for renal failure patients it seems to be
    the best, if not least expensive, parameter we have. One of the markers of
    inflammation is a low albumin, and our patients have plenty of co morbid
    conditions which contribute to inflammation. My new hesitancy in recommending
    increased intake, especially of red meat, is that consumption of animal protein
    itself is a contributor to inflammation. I therefore, have begun
    encouraging more nut butters and limited amounts of beans and nuts to my
    patients. Because of the higher phosphorus it has long been recommended that
    dialysis patients avoid these foods. (we now know that the
    bioavailability of phosphorus in plant foods is lower than that of animal foods)
    However, I can no longer, in good faith, continue to advise my patients
    to increase animal products when the number one cause of death in dialysis
    patients is cardiovascular disease. But is this possible???
    My question to you is the following: Are you aware of any
    literature or studies regarding a vegan diet for dialysis patients which
    I could share with my doctors? There is much research about the benefits of a
    vegan diet in preventing renal disease, but I am now referring only to
    those patients with renal failure, CKD stage 5. I do have meal plans for
    vegan diets for renal failure, but I am specifically looking for something to
    present to my doctors which would help them come on board with more of a
    plant based diet (while still maintaining potassium and phosphorus levels
    within goal ranges) for their patients? Or is the current state of the
    art diet for dialysis patients, a diet lacking in fiber and phytonutrients and
    high in fat, still what the doctor ordered?




    0
    1. Compassionate RD,

      Did you ever receive a response or find what you are looking for? I am also a renal RD and would love to learn more about this area. The renal diet has never sat well with me. I feel that years from now it will be abolished and we’ll look back and say ‘what were we thinking.’ Would lvoe to hear from you!

      AW




      0
      1. Hello Dialysis RD,

        I also work in a dialysis center and I am in the same situation as you are. I recently switched to a whole food plant based diet (vegan) and I am struggling to find sources and literature on what to recommend my patients. We’re always taught to recommend animal protein for albumin levels and I don’t want to do this anymore. I really need help with resources on finding non-animal sources of protein, also low in phosphorus (which is hard to find). My doctors at this clinic never recommend this, they don’t even put them on low protein diets prior to dialysis.

        If you have anything that you’re willing to share please let me know. I would love to reach out and find out what you recommend to dialysis patients. I am struggling, because none of the RDs I work with are vegans. Any help/advice you have would be great!

        Thanks!




        0
  8. Thank you for your question. I totally understand your issue. I work in a hospital and despite the evidence renal patients are still recommended an animal-based diet.
    This video may help you
    https://nutritionfacts.org/video/treating-chronic-kidney-disease-with-food/

    It is clearly possible to get enough protein from plant sources and phosphorus may not be such as issue according to the data presented in this video. The issue with potassium may be more of a problem but close monitoring in the initial stages of a transition to a plant based diet for your patients should help establish if potassium levels are negatively affected. Sadly the renal community does not promote a plant based diet and therefore resources are difficult to come by.




    0
  9. Joan Brookhyser, a renal, plant-based dietitian has written a book about this topic and many articles which I found on Davita.com. Hope this is helpful.
    NatB




    0
  10. Hi I have recently been diagnosed stage 3 ckd and have been watching videos such as these to see a way forward and to prevent further detonation. I have completely bought into the idea of going vegan to either stall or turn my condition around but I have a problem! The disease requires that you must keep consumption of High potassium, phosphorus and salt down, how can this be done on a plant based diet if most of its staple food items legumes and vegetables are high in potassium and phosphorus? It leaves you with virtually no food options and struggling for calorie and protein sources. I saw a dietician who said it’s incredibly difficult to do on a vegan diet and that I should give up the idea. Any advice on a way forward would be very much appreciated, any retreats or programs that are available that could help someone like me? I’m in total dispare at the moment as I felt going vegan might give me some hope.




    0
    1. The dietitian should not have advised you the way she did. You can absolutely eat a vegan diet with chronic kidney disease, and if planned correctly it will be of great benefit to you! Yes it’s true that many plant foods have high potassium and phosphorus.. but so do all animal foods. Therefore, when you cut out the animal foods from your diet, you have a lot of room left over for potassium and phosphorus from plant foods. There are many other factors that make plant based eating desirable for kidney disease. I’m a renal dietitian and would be happy to work with you virtually, let me know :)




      0
      1. Thank you for your swift response dialysis rd I would definately be interested in working with you on my issues virtually I have been struggling to get to grips with this and nobody seems to appreciate anything about how going vegan could help. Let me know how we could make contact and go forward with this.

        Kind regards Maurice




        0
    2. Hi there. I’m so sorry to hear about your diagnosis. But I’m happy to have found Dr. Greger made a video specifically addressing the question you asked:
      https://nutritionfacts.org/video/treating-chronic-kidney-disease-with-food/

      Here are a few other videos of Dr. Greger’s you might find helpful:
      https://nutritionfacts.org/video/how-to-treat-heart-failure-and-kidney-failure-with-diet/
      https://nutritionfacts.org/video/which-type-of-protein-is-better-for-our-kidneys/

      You might also like this video about the famous Kempner Rice Diet that he used for renal failure patients:
      https://nutritionfacts.org/video/kempner-rice-diet-whipping-us-into-shape/

      I really hope that helps. Best of luck to you!
      Kelly
      Moderator.




      0
      1. Thank you for the video suggestions, I have already watched these and they dont address the issue with a vegan diet and kidney disease which is having to keep potassium and phoshorus levels down is complicated with a vegan diet because the staples of nuts and legumes are naturally high in these two elements. It feels incredibly difficult to.manage this balancing act, would be grate if future videos addressed this problem.




        0

Leave a Reply

Your email address will not be published. Required fields are marked *

Pin It on Pinterest

Share This