How to Treat Chronic Kidney Disease with Food

“In the United States, approximately one in three adults aged 65 years and older has chronic kidney disease (CKD),” as I note in my video Treating Chronic Kidney Disease with Food, but the “majority of patients with CKD do not progress to advanced stages of CKD because death precedes the progression to end-stage renal disease…” Following about a thousand folks 65 years or older with chronic kidney disease for about a decade, only a few had to go on dialysis because most died. The scariest thing for many kidney patients is the fear of dialysis, but they may be 13 times more likely to die than go on dialysis. With heart disease killing more than nearly all other causes combined, decreasing kidney function can set one up for heart attacks, strokes, and death.

That’s why it’s critical that any diet chosen to help the kidneys must also help the heart. A plant-based diet fits the bill, providing protection against kidney stones, kidney inflammation, and acidosis, as well as heart disease. (See below for links to my videos covering these very topics.) That is, “blood pressure control may be favored by the reduction of sodium intake and by the vegetarian nature of the diet, which is very important also for lowering serum cholesterol,” which may not only help the heart but also the kidneys themselves.

In 1858, Rudolf Virchow, the father of modern pathology, was the first to describe the fatty degeneration of the kidney. In 1982, this idea of lipid nephrotoxicity—the possibility that fat and cholesterol in the bloodstream could be toxic to the kidneys directly, based on data showing plugs of fat literally clogging up the works in autopsied kidneys—was formalized.

Since the notion was put forth, it has gained momentum. It appears high cholesterol and fat in the bloodstream may accelerate the progression of chronic kidney disease through direct toxic effects on the kidney cells themselves. Given the connection between cholesterol and kidney decline, the use of cholesterol-lowering statin drugs has been recommended to slow the progression of kidney disease. Of course, “[s]erious adverse effects on muscle and liver must be kept in mind.” This is why plant-based diets could offer the best of both worlds, protecting the heart and the kidneys without drug side effects.

The two potential drawbacks are the amount of phosphorus and potassium in plant foods, which ailing kidneys can sometimes have a problem getting rid of. It turns out, however, that the phosphorus in meat is absorbed at about twice the rate, not to mention the phosphate additives that are injected into meat. So, eating plant-based can significantly lower phosphorus levels in the blood. The concern about potassium is largely theoretical because the alkalinizing effects of plant foods help the body excrete potassium, but it is not theoretical for those on dialysis or with end-stage disease who need to be closely followed by a dietician kidney specialist.

Special protein-restricted vegan diets have been used successfully to slow or stop the progression of kidney failure. One study showed the declining kidney function of eight diabetics for one to two years before switching to the plant-based diet, which appeared to stop the inexorable decline in most of the patients. This led the researchers to proclaim it as the treatment of choice for diabetic kidney failure.

Strictly plant-based diets may also help delay dialysis by one to two years and, after kidney transplant, may improve the survival of the kidney and improve the survival of the patient. Most of the papers, though, are just pilot feasibility studies. It doesn’t matter if it’s effective if we can’t get people to stick to the diet. But while we’re waiting for more definitive studies, existing data support offering these kinds of plant-based diets as an option to all patients with advanced or progressive chronic kidney disease.

“[E]ven if the effects of such diets on the progression of renal failure are still debatable, the unquestionably favorable effects [of plant-based diets] on some of the most deleterious cardiovascular and metabolic disorders usually associated with renal failure,” such as hypertension and diabetes, “provide rationale for recommending a predominance of proteins from a vegetable source” for patients with failing kidneys.

Yet, diet is still underutilized, in part because some people find changing their diet is difficult. Yet, we know foods rich in animal protein lead to metabolic acidosis. Our diets “are largely acid-producing because they are deficient in fruits and vegetables and contain large amounts of animal products.” So, what did doctors do? They gave people baking soda. Instead of treating the cause––the dietary acid load from too many animal products and too few fruits and vegetables––they treated the consequence by saying, “Oh, too much acid? We’ll just give you some base: sodium bicarbonate.” And it works. Neutralization of dietary acid with sodium bicarbonate decreases kidney injury and slows kidney function decline, but sodium bicarbonate (baking soda) has sodium, so doctors may be just adding another problem.

If patients are not going to cut back on animal products, they should at least be eating more fruits and vegetables. They tried that, and it worked, too, and did so without leading to too much potassium in the blood. In fact, it may even work better because fruits and vegetables have the additional advantage of helping to lower blood pressure. The study that examined this is important because it illustrated a simple and safe way to treat metabolic acidosis: with fruits and vegetables. So, the key to halting the progression of chronic kidney disease might be in the produce market or the farmer’s market, not in the pharmacy.

This is the last in an extended six-part series on the latest science on diet and kidney health. Check out the rest of the series:

You may also be interested in my videos How Not to Die from Kidney Disease and How to Prevent Kidney Stones with Diet.

You have to have functioning kidneys to keep you in balance. The problem for most people is not getting enough potassium, which I discuss in my video 98% of American Diets Potassium Deficient, but too much phosphorus in the blood can also be a problem. Thus, phosphate additives are something we should try to avoid. For more on this, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:


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.

107 responses to “How to Treat Chronic Kidney Disease with Food

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  1. I am not sure how the wfpb way of eating plays out with diminished kidney function. Everything I eat is on the high potassium food list! And lentils apparently are higher in phosphorus. If we have a GFR of 60 to 70, will these foods be a problem? (I would encourage folks to know what their GFR test results are rather than be taken by (un)pleasant surprise one day.

  2. My husband has been following a fat-free, plant-based diet for three years due to a stent he had 4 years ago for a 90% blockage in his “widow-maker”. (He had been following the American Heart Association recommendations for 30 years but it didn’t help much, apparently). We watched Forks over Knives and made the switch then 3years ago. He was diagnosed recently with Stage 3 kidney disease which had been coming on for years before his stent. His total Cholesterol ranges about 110 on 10 mg of statin. I make sure to include a plant-based protein source in my recipes, but would it be a good idea to include a plant-based protein powder to boost his dietary protein? He also uses no added salt in his diet.

      1. Thank you for your reply. ;-)

        I was never concerned about getting more protein until dialysis. During the dialysis process a lot of protein is washed out of the body. The note below explains part of this issue:

        “Albumin (type of protein) helps the fluid stay in your blood vessels, something that is especially important when you are on dialysis because you are not going to the bathroom like you used to. Dialysis pulls the extra fluid out of your blood, and albumin helps keep fluid in your blood—instead of pooling around your feet and ankles or around your lungs—so that dialysis can remove it more easily and you will have less stress on the rest of your body.”

      2. Thanks for your reply. We know Americans get too much protein and aren’t worried about getting enough for health, except that folks with impaired kidney function are supposed to get more protein than those without it. I was wondering if a plant-based protein powder might be a good idea. Bonnie

      3. I will not get into the protein requirements or constraints on one with a condition of kidney disease, as they are best served by their specialists recommendations on this.

        However as for protein and athletes, the recognized nutritional bodies all support a increased protein requirement for athletes. There is some body of evidence found in study which supports increased protein for the elderly and also above a low level appears to help in formation of bones and maintance of bones assisting with calcium absorbtion.

        I have versed the study materials and recommendations many times now on this board and can once again if necessary.
        Not all of us are concerned only with living longest. For some strength and ability are important.
        I have no problem with Dr Campbell’s recommendation and Dr Eddlestene as well but consider they are focused on one thing and one thing primarily long healthy life which does not really include any performance aspect.

        So if you feel I am being absurd in this and just following someone who is selling protein powders…respond to my challenge and I will once again provide supportive materials for my postion in study and by recognized authority in nutrition. I have done this many times before.

        So I am ready and challenge your assertation.
        I will start to say….many most possibly all of the negatives associated with protein are derived from study on animal dairy fish or other type animal derivative, not plant. With the possible exception of soy protein, whose amino acid profile represents that found in meat and may at high levels incite the overt production of IGF-1, detrimental effect of normal athletic consumed protein based upon body weight (higher than sedentary individuals) are not generally found.

        So show study which explains or depicts how those plant proteins except as noted at the higher levels recommended for athletes shows detrimental health effects.

            1. NIH study on the necessity for a high quality protein supply at each and every meal for those who are subject to or recovering from long periods of bed rest along with physical activity and exercise.

                    1. From this study we find…–A-Literature-Review.aspx?id=0000440

                    2. This stated on protein and bone health……

                      “Although protein is part of the bony matrix, the type and the amount of dietary protein necessary for bone health are controversial.11 Adequate protein has been shown to be an important component of skeletal robustness.26 Non-collagenous protein makes up 10-15% of the bony matrix.27 Adequate protein provides amino acid precursors necessary for bone structure and anabolic support of bone structure.28 In particular, insulin-like growth factor (IGF-1) may participate in bone growth and maintenance.28 Inadequate protein may contribute to accelerated bone loss through both mechanisms.
                      In addition, protein increases dietary calcium absorption and bioavailability,2”

                      This article is dated but for purpose. It was once assumed due to several population studies animal protein was responsible for acidification and the pulling from the bones calcium to remedy the situation.

                      This was based on some science and some population study which showed those who consumed more milk and then more calcium and protein were found having more osteoperosis.
                      This has been found not true. It is true in population study but that is likely as other agent in milk perhaps saturated fat, has a negative affect on bone formation.
                      The acidification is just not present in enough quantity to necessitate the pulling of calcium from bones as buffer.

                      So this study showed the first cracks in that dam of theory. Those on low protein diets indeed showed lower calcium absorption.

                    4. Does kidney damage result from short term use of excessively above normal amounts of protein in study on competitive athletes….no

                      Again I make no statement in relation to those with present kidney impairment. They should consult with their specialist and follow that advice concurrent with a nutritionists recommended by that specialist.

                    5. From the conclusion of that study..”The present findings support the hypothesis that early intake of protein after resistance exercise enhances total muscle mass as well as hypertrophy of single muscle fibres in elderly humans.”

                      I can literally go on and on and on and on. On occasion I have.
                      So a challenge is presented to the notion stated, no one would desire any necessity in their consumption of protein. I have displayed in study many specifics in which people do, and positive result is present when done.

                      Campbell Eddlestene and others, are concerned with very specific peoples with very specific concerns and that is their focus. And rightly so.
                      However some of us, a large amount of us humans, have other concerns simply beyond living long and healthy. Many of us may indeed live a little shorter, but be perhaps more fully functional than those that live longer.

                      So it is a choice we humans make. Why would anyone be concerned about protein…I have shown many whys.

                      I personally always consume protein in larger amounts at every meal. My personal hobby, me a vegan, well yesterday I lifted with many breaks, 2.5 hours of weights, and various body weight exercise. The day before that I ran for a hour or so up and down hills at 7200 feet in mud and on trail with periodic snowfall as I was running..a quite delightful experience I would not trade for the world.

                      Tomorrow I will punch and kick the heavy bag with drills for about at least a hour of just that.
                      And my profession before all this now, was indeed one of physical necessity that required strength and endurance and some other things.

                      Today I sprint, great fun with three girls who are state level capacity gymnists and soccer players of the best sort, at their respective ages….to and from any place we go.. to and from car to shops, I park away so it is safe. While many other sorts are telling their kids not to run.

                      And I am old and they are quick as any of their age can be. But we four enjoy every minute of it. Kicked a soccer ball as well with one for a bit.
                      So do I need a bit more protein more than most perhaps reading this..I think I may.

                      I suspect I may not die tomorrow. But if I did those sprints today that run in the snow two days ago…..I would not mind, it was so remarkable. Many are like me, I am not alone in this. We are vegan athletes and love every minute of it and all do include more protein in our diets…all of us.

                      So that is the why. If you continue with the demonization I will continue with the rebuttal. I have done this before and really it is not a very hard task to suffer.

                    6. For those that do have questions on accelerating the amount of protein one eats and translates to bodily function…. the current concensus is that small amounts of protein through out the day, are most important for athletes tor rebuild muscle….. “protein intake throughout the day should ideally follow a regimen of frequent, smaller protein dosages to sustain a more positive nitrogen balance (i.e., preserving muscle mass rather than breaking it down). Preferably, this entails a practice of ingesting quality protein every few hours (e.g., 3-4 hours)”

                      20 gms or so appear to be our functional limit as per digestabilty at one intake. AS far as sports nutrition this amount is taken in several meals, however necessary to meat the protein requirements though out the day.

                      Excess at one meal does not seem to fit the bill or serve any purpose for expectant effect.
                      I would run this issue across ones nutritionist for opinion, if they have not specified when and how often protein should be taken daily… instead only giving a gross daily amount.
                      But of course athletes dependent to some extend on endeavor, weight lifting as opposed perhaps to swimming or running… are consuming way more protein than any sedentary individual.

                      And walking around the block with a dog perhaps does not make one a athlete nor does gardening or talking to people while on a treadmill..

                    7. It is usually not necessary for those who are not athletes to supplement protein in any amount on a WFPB diet.
                      Athletes however eat enormous amounts of things at times 12,000 calories per day in certain occupations is not rare. And their protein requirements also increase depending on occupation and necessity to maintain body weight and muscle mass.

                      I supplement some usually soy based as I am not to worried about IGF-1. I think it is Campbell who is very worried about that in soy, but maybe it is another. I did not have a stroke when 18, nor do I have heart disease high blood pressure or anything, no glasses even so their concerns are not mine.

                      But protein powders have often gross contamination problems. Anything sourced from a place with suspect environmental laws one may find pollutants finding their way into protein powders. So I buy organic and try to source especially pea protein not from China.
                      Rice American protein may have arsenic, so I would check on home website to see if it is screened for that. Basically a check to see how and what means for purity they maintain is a necessity. Just going out and buying stuff..I do not recommend that.

                      One brand of soy even had a California necessary known to be cancer causing label, on show how bad it can be. Don’t know what it was but would not buy that stuff.
                      And a recent media event had 800 samples of supplements with large amounts with gross contaminants in them. Steroids being quite conspicuous. UFC fighters test positive for banned substances multiple times every year for legal supplements inadvertently contaminated.

                      One person I know of, reports his facility in China had not been cleaning vats used to compound the supplements correctly and finding untoward amounts of this and that in his.

                      It is a problem. I use generally only one or two known brands I have vetted. Other stuff it is buyer beware this is old school no regulation since Orin Hatch and his deregulations of about 1990’s for the industry.

                      WFPB athletes…. do you need protein supplements..when training in season heavily . You simply will not rebuild and recover without necessary protein amounts. And our authority is not Campbell or Esselstein but sports medicine authority or nutritional sports medicine. There is no reason not to continue as vegan. You can mange it easily.

                      Small and often is the key for protein and probably a bit before and a bit right after workouts but always throughout the day.
                      Beans lentils and such fit the bill though fake meats and all that usually almost pure protein many of them. Not hard at all.

                      What is pea protein really…..pea soup..powdered stuff used to make soup is pea protein. So supplements it may seem but they are not necessarily that.
                      Eat a bowl of a certain type of pea soup..and you have injested a pea protein supplement…the numbers are the same..

                      Or if lazy like me you can buy soy protein or this or that. It is easy to find it and use it regardless as vegan. But you need the additional protein in the field there is no question of that.
                      Those saying you do not..they have not read the studies do not know the science or have agenda. I see obvious leaps made not found in the science some of them make. Reading untoward things into them. Who knows why.

                      Read he science yourself there is boatloads of it.

                    8. This study just out say a thing…

                      In a study of 124 thousand or so the most significant factor affecting long life was exercise.
                      Certainly as a population study there are limitations. This was after all americans with their diet. So we can say ameicans exercise produces this result.

                      But the results themselves cannot be discounted. Dr Greger famously states his grandmom could walk many miles a month after dietary intervention…well how does he know that….she had to be walking miles for him to know that.
                      So she was not so riddled with osteoperosis low muscle mass and all the rest that would make that impossible. There are limits by my read to all
                      effects from things on human to include diet and to the inverse here only helps so much.

          1. I happen to personally favor the consumption of soy protein. IGF-1 in low levels is bone protective and also muscle building and retentive.
            But in the interest of fairness I have included that criticism. INvaribably when one discusses the issue with one who is inclined to demonize protein it comes up.

            1. Ron- it was my understanding that those that need higher levels of protein because of exercise, invariably get all the protein they need because the increased activity levels lead them to eat more. The more calories you eat, the more protein you get because every non-processed food other than fruit is full of protein. Between heavier people eating more calories to maintain their weight (more muscle- more weight) and active people eating more calories in general, like 2800+ calories, I thought that even average athletes got the higher levels of g/kg of protein suggested by sports nutritionists.

              It seems like protein should really be a non-issue on a WFPB diet. Am I missing something?

              1. Yes you are missing something. This notion of widespread overconsumption of protein has challenge in study. One of which I have provided which states this in part…
                “The mean protein intake for adult men and women in the United States and the percentage of individuals consuming each level of protein is summarized in Table 1 (2). For this review, we have identified low-, medium-, high-, and very-high-protein diets in comparison to the recommended dietary allowance (RDA); these are defined in Table 1. Diets with the highest protein levels are observed in men, and protein intake tends to decline with age. Particularly noteworthy is that 15–38% of adult men and 27–41% of adult women have dietary protein intakes below the RDA.”

                The study goes on to state they did not study vegetarian specific, but found that 150% above RDA of protein intake in this population was just not really found.
                The difference between the low end of recommended protein intake and the high end for athletes in some sports specific, is much more than 50% kg body weight increase per recommendation of gm’s of protein. These numbers recognized by many sports nutrition bodies.

                The October 18 12:03 post study.

                Thus it is quite likely a vegetarian vegan athlete is not getting enough protein on a WFPB diet in the actual. More calories does not necessarily equate to adequate protein amounts. Americans are getting fat even at a earlier date when that study was published. yet a significant amount of the population was even than, deficient in protein….well that is not WFPB…certainly…but that is also a meat dairy eating group. Beans do not have the same concentration as meat of protein. They just do not. You may show equality by things like dry weight or perhaps calories but that is not as per normal equilivent servings.

                There is nothing to state vegans cannot meet protein needs of athletes in all sports but we must accept our limitations and prepare and feed ourselves accordingly.

                Those in sport with agenda occasionally take Eddelstein McDougall Campbell and others works and apply them to athletes. Where the notion you describe comes from. It works but only at a certain level. Dr Greger walking and talking on his treadmill 90 minutes a day may consider himself a athlete. And he has no need for any additional protein requirement.

                He is not a athlete in this context. Sports nutrition specifies always a higher proportion of protein intake sports specific per KG of weight. As they require higher amounts per body weight, what would suppose they simply increase a caloric requirement and magically attain the higher numbers. The need in study to have a steady supply of protein at least every 3 hours or so for maximum protein utilization, does not speak to a equal necessity to have equilivent overall caloric consumption in the same proportion. We max out it is thought at around 20 GMs per serving of protein per utilization capacity, it is not simply in out with protein.
                It is just not possible for most to eat the amount of foods in a WFPB only diet at get the 20 GMs every three hours. If you do not overtly supplement with drinking some of it in powders, you must use concentrated forms such as that found in fake meats and such pea soup whatever, which technically are not WFPB, as they are processed and then not whole.

                Those in strength sports most conspicuously are not just eating lots of things when in heavy training, they are consuming, those who are not vegan, concentrated sources of protein, not because they like it, but because it becomes necessary. There are functional limits on our ability to eat foods and at some point choice in intake to obtain calories and protein, type of item becomes a necessity not a choice.

                A vegan is not abstract this reality. They must modify, For one…. obviously on a WFPB diet how can one get to a 12,000 calorie limit…it is impossible unless one is sitting eating all day. So one must concentrate and protein has a necessity for intake and calories also have a necessity, for the athlete, so the two are combined. And it is a volume cannot train when stuffed to the gills.

                Fake meats and such are used to meet the caloric needs and the protein needs. And yes cutting corners, a athlete is likely training 6 or so hours per day…they use powders in drinks.
                Your 2800 number speaks to your bias. You have simply no idea how much in the way of calories a average Olympic level athlete consumes. It is double that always. And yes for normal people that is good and explains why WFPB and vegans are almost all with low BMI’s. But why is that……, we do not intentionally eat less we are not on diets….it is that what we eat has less caloric intensity. More carbs complex less fat and protein overall….that is why we are normal weight and none others are.

                And there are other things in diet which are also sport specific such as includeing necessity for adaptive response to low glycemic conditions of sport such as those found in long duration events which advantage a lower carb diet in training.
                Point being, sports nutrition is not normal human nutrition in many regards and your kind can simply not envision eating say 6000 calories a day for years which is what many athletes do in many sports and try to apply your found proofs on a diet of 2800 to a diet of 6000 and go figure…your numbers and ways of doing things do not apply. It is impossible.

                Which is why back in the day all official stands on the value of steroids for athletes in medical and nutritional literature and study…. was of no result and not improving anything. It was all mind and all placebo effect.

                WE now know steroids of course, obviously enhance muscle recovery and protein utilization…why the difference…..the original studies were of the sort you mention, 2800 calorie athletes not 6000 a day athletes.
                They do not translate.
                Such it is with protein with athletes and how one obtains them on caloric enhanced diets.
                It is not only that we as athletes must consume more calories as our numbers attest, we must eat more actual grams of protein per pound of existant body weight.
                All the WFPB docs are great and greatly reaching their goals, but their goals are not that of the competitive athlete nor functional focus.

                Show me one old age prior competitive body builder with osteoperosis They die early due to things like steroid use, overt meat and dairy consumption, this and that. But certain ailments such as osteoperosis on those living long..never. Protein has other effects beyond that of simple performance which translate to functional ability as one ages. And no it is not all the exercise. I know of many very physically active peoples who develop it late in life. It likely has a to do with…all bodybuilders, every one, consumes much protein. It becomes a habit. Does it stress kidney perhaps, they develop this or that.. if on a meat dairy thing…I say likely yes. But translate that to a vegan…I say that is a stretch, not a proven.

                So do vegans long term show absence of osteoperosis…seems on study not. So is this diverse from protein consumption….likely not. Protein enhances assimiliation of things such as calcium. And if we have one element we are low on as a group, it is likely protein and fat. And fat by my read, sat fat, may have a to do with low calcium absorption in populations with high dairy consumption. Which leaves us with one outlier….protein. Calcium another bugger bo of mine…is also demonized, and likely if performance is our concern, which remains a concern as one ages…both must see a adequate intake above that of sedentary peoples who care not for performance at all.

                The idea we are equal in things despite our physical engagement in things is absurd and preposterous.I have reinforced my position with study results of the finest sort and can continue to do so. Muscle mass in the elderly… certainly protein levels enhanced in diet, as opposed to norms and lower even norms, which may be found in vegans are advantaged.

                The real competitive athletes in the end are those who may do things at the upper ends of our life span. This is advantaged by athletic levels of protein consumption for bone and muscle health. Which fully can be vegan and possibly may be only WFPB as one ages. But is more easily done and with assurance of completeness when one has concentrated source of protein consumed. Not supplement necessarily, they are really not necessary with elderly, but with attention to protein rich foods such as beans.

              2. To remain able to be very active as very elderly by my read one likely suffers the same constraints of that of the very competitive young athlete…one must be doing a thing almost always physically or very often with high intensity.

                Injury predominace and such as one ages, intensity ability declines…. probably it is that our natural state was in earlier times and is now…being active most of the day every day. Which is more that of the competitive athlete dietary needs than a sedentary persons needs. Not necessarily in caloric needs, as there is no intensity, but protein I would not discount the potential advantage to a athletes recommended protein consumption KG per GM level, and not that of a sedentary person which are most of our normal RDA’s or daily values based.

                Much study of elderly and muscle function points to that. Detrimental effect of meat and dairy must be overcome by simply not consuming them. it is not a proven but it is also suggested in study, these detrimental effect predominate not in protein itself, but in choice of protein type. Most of the studies of detriment have meat dairy and occasionally soy as source. It is a bit of a gamble to suggest…. well other protein source will not suffer this same disadvantage under scrutiny and in time with sufficient study…. but it seems study does not support that at present in general.

                1. The problem is on our side…all the nutritionists such as Rhonda Patrick who recognize this as fact, and can support their positions fully as I may do…. all invariably include meat fish or dairy in their scheme of things, to remediate these problems and provide for optimal function.

                  It does not have to be either or, meat dairy fish, as opposed to vegan. We believe in McDougall they believe in Patrick. If so there would be no vegan athletes and there are more each day and each year. And on her side we would not see great in shape elderly but with a tendency for cancer or arterial plaque formation. Perhaps on statins which is not a thing one wants ever.

                  It is that we may recognize the limitations and focus of McDougall and others on our side and incorporate things from their side, which has different focus, ….. to produce a full product. A fully functional elderly person. Who may not live yes absolutely as long. But fully till they die.

                  Not a stooped at the shoulder elderly doc who is living great at a hundred but clearly has osteoperosis by any visual.
                  Yes to have it all. Like a local guy, Clarence Bass, a retired lawyer and bodybuilder, who is fully functional and completely able 1% in his 80 year old age group for function, but without his arterial plaque formed by his notion he must eat dairy and eggs.
                  I am fine if I lived to 90 or so as opposed to 110. If that 90 had me fully functional. Little suggests a WFPB will produce that without the introduction of things such as much exercise. Which necessitates what…a diet of those proportions those who exercise much must have…more protein per KG of weight.

                  I have no problem with those who want to live to 110, or those whose past life choices make a Eddlestein or McDougall’s diet necessary for strict adherence.
                  But that is not a very large proportion of us vegans of present. WE want full function till we die, not a second before that.

                  1. I would not say this, taken from a population based study just released the largest ever of its kind, says diet is not a performer in this, as diet was simply not studied at all. But behavior was studied. What works for typical americans on the standard American diet……this

                    ” The study population included 122 007 patients (mean [SD] age, 53.4 [12.6] years; 72 173 [59.2%] male). Death occurred in 13 637 patients during 1.1 million person-years of observation. Risk-adjusted all-cause mortality was inversely proportional to cardiorespiratory fitness and was lowest in elite performers (elite vs low: adjusted hazard ratio [HR], 0.20; 95% CI, 0.16-0.24; P < .001; elite vs high: adjusted HR, 0.77; 95% CI, 0.63-0.95; P = .02). The increase in all-cause mortality associated with reduced cardiorespiratory fitness (low vs elite: adjusted HR, 5.04; 95% CI, 4.10-6.20; P < .001; below average vs above average: adjusted HR, 1.41; 95% CI, 1.34-1.49; P < .001) was comparable to or greater than traditional clinical risk factors (coronary artery disease: adjusted HR, 1.29; 95% CI, 1.24-1.35; P < .001; smoking: adjusted HR, 1.41; 95% CI, 1.36-1.46; P < .001; diabetes: adjusted HR, 1.40; 95% CI, 1.34-1.46; P < .001). In subgroup analysis, the benefit of elite over high performance was present in patients 70 years or older (adjusted HR, 0.71; 95% CI, 0.52-0.98; P = .04) and patients with hypertension (adjusted HR, 0.70; 95% CI, 0.50-0.99; P = .05). Extreme cardiorespiratory fitness (≥2 SDs above the mean for age and sex) was associated with the lowest risk-adjusted all-cause mortality compared with all other performance groups."

                    To be a elite performer in a athletic regard we have already established protein intake is above that of sedentary individuals. So to provide that we must have this.
                    To be elite you must have optimal muscle recovery and no osteoperosis.
                    So it is not absolute, exercise is but one factor, diet another, but it is certain ability to perform better is connected to ability to iive long.

                    Ronda Patrick and McDougal to not have to be at opposite ends of this thing.

                    1. Ron

                      Tha’s interesting, Ron, but that study was of hospital patients with actual or suspected cardiovascular problems. It is not necessarily generalisable to everybody. However, in line with your thoughts, this 2018 UK review produced under the auspices of four national research councils concluded:

                      “The currently recommended protein intake for ageing adults may not be sufficient for muscle mass and strength maintenance. ”

                      Interestingly, it also suggested that when dietary protein is consumed (morning, evening etc) may be more important that the total amount of dietary protein consumed (above a certain level). Perhaps related to this I don’t know, it’s also interesting to note that the traditional Okinawan Diet – associated with healthy longevity including very high rates of active, functionally independent centenarians – was low in protein by current standards. Something like 9% of total calories came from protein whereas in the US, according to Harvard,something like 16% of total calories come from protein.

                      The Okinawan Diet experience seems to raise questions about current beliefs concerning the need for higher levels of dietary protein to achieve healthy longevity and avoid frailty. It’s difficult to know what the explanation could be for the apparent conflict between the contemporary scientific understanding and the observed real world Okinawan outcomes of lifelong low protein diets.

                    2. Yes Tom this certainly far from conclusive as to longevity.
                      I tried to emphasis that.
                      As to ability to remain functional with muscle mass it appears protein plays a role in retention. Sports medicine study seems to suggest when and how often consumed, is the necessity, as we seems to only be able to metabolize about 20 GMs of this stuff at one time.

                      Was the Okinawan’s protein consumption optimized by a steady influx of protein, as opposed to in the American one fell swoop approach in diet…I plainly do not know. Or was their a genetic variance which assists was it their constant activity load, or does some other factor prove out…really I think it is unknown.

                      Functionally and bone rebuild wise I think it is clear those in study, usually westerners, have those effects with adequate considered protein consumptive levels or a bit above that in athletes and the elderly..
                      Longevity, just living the most years and nothing else considered, perhaps those versing demonization of protein in that specific are correct, McDougall certainly thinks so.

                    3. It occurs to me that most of the plant based docs do great work, but at times seem not ahead of the curve.
                      Before study and actual negative results out of the UK, which destroyed some vegans lives(those vegan in those days were not generally junk food vegans), the docs did not advocate for B12 supplementation. At least one of them is still not committed to it.
                      But thinking about it, conclusions could have been made before the actual studies based on observational evidence….we had not B12 naturally in our environment when once we did.

                      It was widely known in the athletic community B12 enhanced athletic performance and general well being, which is why I stated taking it back then. Wrestlers commonly took B12 shots prior to competition for the edge.

                      So I think athletics has some real carryovers which are applicable to the general public but not found in a traditional sense.

    1. Bonnie,
      Thanks for your question. Its understandable to be concerned because the body needs protein to maintain lean body mass, yet we know that too much protein is hard on the kidneys. Fortunately the plant sources are much easier on the kidneys. The protein recommendation for Chronic Kidney disease is 0.6 to 0.8 grams/kilogram of body weight. (or .27 to .36 gram/pound of body weight). So if your husband weighs 160 pounds, for example, you want to keep his protein level at 44 to 58 grams per day. That is easy to do if he is eating a variety of plant based foods. Here is a link that may be helpful in planning meals for your husband.

    2. Bonnie,

      I’m so sorry to hear of your husband’s problems, and encourage him to keep eating well. However, you should look at how much protein he’s getting. It may be too much. That is damaging, while there’s almost no way NOT to get just the right amount of protein if you eat nothing but whole plant foods. There is protein in all plant foods. Even fruit has a little, though you could possibly get too little if you ate nothing but fruit.

      If you go on Youtube and search for talks by Dr T Colin Campbell on protein he will explain what his 50 or more years of research at Cornell shows about how much protein we need and how you cannot fail to get enough if you eat nothing but low fat whole plant foods. Here is one example of his talks:

      1. Thanks! We’re all on the same page with the plant-based diet since we’ve been following it for 3 years. We have all the books, have watched the movies and have a lineup of recipe books accumulated. His plant based diet has his cholesterol at around 105, give or take a few points, with only 10mg of a statin. He has it checked monthly since we can get it done for only $8. We even attend a monthly local support group put on by Dr Esselsytn’s good friend, a retired Cardiac Surgeon. My husband switched to a different doctor since he wasn’t happy with all the meds he kept suggesting. Most of the meds are gone now but he’s been left with some kidney damage that I feel was caused by his BP meds. I thought a plant-based protein powder might provide him with a boost that would help his kidneys, but I wanted to check first. Bonnie

        1. Bonnie, he should also be monitoring his blood sugar levels, as high glucose results in kidney damage. If he hasn’t already had a Hemoglobin A1c done, he should.
          And don’t let them tell you 6 or even 7 is fine.
          Aim for normal, 4.6 to 5.6 to prevent further kidney damage.
          Keeping blood sugars normal also helps cardiac function.
          So sorry he is going thru this.
          Was he on Atenolol? That is often what causes kidney damage.

          1. ThanksM. He did have an A1C done a couple years ago and it was 5.6. He’s been almost perfect in following the fat-free, salt-free, plant-based diet for the last 3 years, except for an occasional piece of dark chocolate. His doctor is impressed with his health, his weight, his cholesterol of 105, and his stamina, but said he still has the stage 3 kidney disease. He used Valsartan but now takes Losartan since the Valsartan was recalled. I’m wondering if those meds can be causing the kidney damage. He’s cut the dose was down since he’s been following the diet since he doesn’t need much, but he can’t seem to get off it completely. I wonder if the meds designed to treat his BP are the thing that had an impact on his kidneys.

    3. I was looking at research for Kidney transplants and they think the 3D laser printed kidneys might be coming about 5 years from now. I am a little confused by what I was reading about it, because TedTalk showed a Wake Forest Institute kidney passing urine back in 2012 or something like that and the articles I am reading now say that the technology was too slow until recently and the cells died before a full organ could be made, but they were showing a full kidney passing urine so I don’t get it, but the good news is that it used to take hours to print something the size of a tumor and now they can print the same size in 3-1/2 seconds. They also said that Bots have brought the cost of printing organs down considerably. Anyway, I just don’t understand that Wake Forest didn’t succeed back then. It doesn’t make sense to my mind because they had a 3-D laser printed kidney passing urine back then. Oh well, I know my brain struggles when information isn’t straightforward. There might be 12 companies leading the organ 3D printing technology and that is already going to bring the cost down and that means it might be cheap enough that insurance might pay for it by the time it gets here.

      I also went back and looked at the PEMF and Low-Level Laser and Near Infrared LED arrays and came back to what a researcher from Harvard said to Dr. Mercola. It still seems worth looking into.

      Dr. Mercola interviewed Michael Hamblin a researcher and associate professor of dermatology at Harvard Medical School. He’s also a principal investigator at The Wellman Center for Photomedicine at Massachusetts General Hospital, and a member of the Harvard-MIT Division of Health Sciences and Technology.

      He said

      “Near-infrared may also be useful for kidney problems. Anecdotal evidence suggests it could be a powerful therapy for kidney failure.

      “Kidney failure is the third leading cause of death. These are old folks who are dying from kidney failure. You can’t really give them transplants because they’re elderly. You put a near-infrared LED array where their kidneys are and it seems to work like a dream. [But] it’s hardly been studied at all,”

      1. Here is the 3D Kidney printing video

        I watched it right now and I think I get it that they are getting fast enough to produce the capillaries and he talks about that they hadn’t been able to print a liver, but I think they are closer to being able to do a liver now and one company has a video where they are trying to do a heart, so they are advancing with the faster / higher resolution printers.

        1. My numbers are off. The Ted Talk for the kidney was 2011.

          I re-looked up the companies doing the process and there are 11 in one article and 20 in another article.

          Don’t trust my numbers. For some reason, I seem to change 11 to 12 in my remembering process.

  3. I think more education is still needed on exactly what whole food plant base items might be a problem for a person with limited kidney function or just one. I am a 64 year old wfpb vegan who donated his kidney to a friend last week and the transplant center I was at has given me limited and wrong information as to how to stay healthy going forward. Further more, the first thing they tried to feed me was beef broth and then eggs. I will be coming down hard on my surgeon on my follow up visit about this. It would really help me and others as to what foods to focus on. On day 8 of recovery I’m up and about and pretty much normal. Recipient also doing well.

    1. Ed- You’re so right! There is work being done to add nutrition education to medical school curricula, but it is slow going. My heart patients are routinely given processed meat following heart procedures, regardless of what I request as an appropriate diet. It’s a battle we have to fight on every level until health care providers are exposed to the entirety of nutrition literature. Here is one of many published studies (from the large Nurses’ Health Study) that found a strong association between animal fat and protein in the urine (an early marker of kidney disease). -Dr Anderson, Health Support Volunteer

  4. over 40 years of practice as an MD, I learned as much as I could about nutrition and lifestyle. I often found the those with the worst disease had the worst habits. For those with kidney disease, diabetes mellitus, HTN, heart disease, stroke, amputations(often all of the previous), I consulted nutritionists, psychologists, nurse counselors and more as well as reviewing the advice myself. However, I was horrified by hospital food, all the years when inpatients could smoke on campus, and the lack of family support. Walking through the parking lot I had patients ask me why they were not getting better even though I had just witnessed them smoking; there were drawers full of candy, and families bringing in fast foods despite family counseling. i almost never ate hospital food myself as it was overcooked, fatty, and full of sugar and salt. Though I believe the effort is worthwhile, I think the greatest impact would come from childhood education, at home and school, as well as healthful school lunches. Pediatricians need to be educating families as well. We need a much greater focus on lifestyle medicine in all fields of medical education.

    1. Amen! Kids are very receptive to knowledge and carry it home which seems to influence the involvement of parents. I say this as a retired teacher who posted commercial charts from Center for Science in the Public Interest that put broccoli high on the desired list. During parent-teacher conferences I was told by parents, “Now we have to eat [XYZ….]” Kids in my classroom went up to the bulletin board and copied down the things that were listed as extra healthy.

      You are right on target, Robert Haile!

  5. I am 59 and was diagnosed with Polycystic Kidney Disease in 1997 – inherited from my father who passed away at age 46.

    My nephrologist told me to eat very low animal protein and take lots of omega 3 pills daily to reduce inflammation. I did that for 21 years eventually getting to the point where I rarely ate chicken or fish. I felt great, lost weight and had lots of energy. Then my kidney function hit 12% and I had to started dialysis 15 months ago. Since I cannot frequently eat beans, nuts, seeds, green leafy vegetables due to the potassium and phosphorus, I am eating more meat and egg yolks for protein. It’s super depressing.

    Does anyone have ANY idea of what else I can eat to help me with getting protein into my diet without it being animal protein? I never reach my protein goal the dietician at dialysis has set for me.

    1. Have you checked out sprouted plant protein powders? I am not sure how they would fit, but I sometimes take them after a workout, though I’m able to get protein from my plant diet ok.

      1. If you are consuming primarily fresh fruits and fresh vegetables (WFPBD) on a regular basis, there is absolutely no need for any additional ‘processed foods’ (protein powders).

        1. Igking, not necessarily true for those on dialysis, or for those who are very active. They will have to plan their meals more carefully to include enough plant protein sources. Just any mix of fruits or vegetables will not work for them.

          1. That is very true. So many vegetables are loaded with potassium. For example, zucchini and broccoli are two of my favorites but both have too much potassium.

    2. I’d suggest that you need to first check that you aren’t already overdoing the protein intake since
      “Actual dietary protein consumption in CKD patients remains substantially higher than the recommendations”

      The point is that tiigh protein foods aren’t the only source of protein. Even whole wheat bread is about 13% protein (by calories), yet is low in potassium and phosphorous. So many people are likely to underestimate their actual protein consumption.

      Also, you don’t need to completely exclude beans, peas etc from your diet – you just need to ensure that the amounts are low. It is also worth remebering that the bioavailability of phophorous from vegetable sources is only half that from animal sources. Simply measuring the amount of phosphorous in foods can therefore be misleading.

      This might be helpful:

    3. Here is a guideline from DaVita’s dietitians on remaining plant based while on a diet appropriate for dialysis. A couple points are important: 1) the kind of protein carrying phosphorus matters, and meat proteins have phosphorus that may lead to a greater increase in phosphorus rise than plant protein; and 2) the kind of dialysate used can often control for the potassium level in your blood, and you need not avoid potassium containing foods entirely. Red and processed meat are associated with the worst outcomes in kidney patients and others, and are not necessary for protein in your situation. Also, it may very well be that you substantially delayed your time to needing dialysis by eating plant protein! Best to you, Dr Anderson, Health Support Volunteer

      1. Thank you Dr. Anderson for this information.
        I will talk with my Davita dietician about the vegetarian options on the link you gave me.
        I want to protect my heart as much as I can during this time and I know eating meat Is not the way to do it.

    1. Quoting Dr. Greger’s blog post on it.

      The disease reversed in two-thirds of the patients: reversal of heart failure, eye damage, and kidney failure.

  6. I’ve told this story on here before, but I think it bears repeating. My cousin was looking at the feasibility of buying a chain of dialysis centers in a small town in the South. He asked the owners how he could be sure a town was large enough to support a center they told him to take a look at two things.

    1. If the town has a water tower that means it has at least 3,500 people.
    2. If he spots two fried chicken eateries, it will support a dialysis center.

    1. I live in the Philippines and rice and fried chicken is the junk food of choice here. It is everwhere.

      Within the last year, I have noticed two dialysis centres open locally. A few years ago you had to travel to the big city hospitals to get dialysis. Most peope can’t afford dialysis but there are enough wealthier people around to ensure that this is a boom industry. And the wealthier ones are those most likely to be able to afford to eat fried chicken every day.anyway.

  7. Would like someone’s thoughts on the use of Canagliflozin 100mg to improve kidney function. This was the subject of a study by the name of Credence. It recently ended early due to positive outcomes.

    1. Don, Canagliflozin probably did help kidney function, it does it by blocking a glucose transporter. It is usually used in diabetics. But I believe it now has an FDA mandated black box warning. There were more foot and leg amputations in the group using it.

      Since it basically works by lowering blood sugar, you can do that with diet.
      A plant based diet is important, as per this discussion. But it also needs to be low in high carb, high acid foods like most grains.
      Even if you aren’t diabetic, you need to test your blood sugar to see how your body reacts to various foods, or standard meals.
      Not everyone responds the same way to the same foods.

  8. Hi, I’ve been eating a plant based diet for over 5 years because of health issues, (joint inflammation mostly). I also eat a gluten free diet because it causes a terrible autoimmune effect when I eat it. This autoimmune effect I believe is what might be causing my kidneys to decline to a GFR of 44. I am 48 years old and am in very good physical shape because I stay really active all year round. I found out my kidneys were declining about 6 months ago and have since been watching how much potassium and phosphorous I consume also. I feel I’m running out of options as far as food goes. I’ve looked for the How Not To Die Cookbook at local stores and haven’t had any luck yet. I’m assuming the kidney disease section is just a small fraction of the book. My question is, with all my food limitations, will this book benefit me enough to buy it?

    1. There are literally dozens available (How Not to Die Cookbook) at discount and free delivery to your door on Ebay. And I’m sure they are available on Amazon as well.

    2. Kellie, you need a workup to determine what is going on. Yes, I have seen gluten cause enough inflammation to affect the kidneys. But if you are no longer consuming it, your numbers should improve.
      I am assuming that you are on no drugs that may be damaging your kidneys?

      1. No I am not on any medications. I just had a kidney biopsy and we are going from there to figure out what’s causing the decline. I just love to cook and love to eat good food and am very frustrated at this point on my options. Looking for new ideas.

    3. Have you tried to heal your leaky gut?

      Cabbage juice and Broccoli Sprouts, I think were what I found to help with that.

      It helped my smoker cousin. Though he has to do the process often.

      It also helped my friend who was on FODMAP and couldn’t do any grains. She makes cabbage soup, instead of juice, but it does seem to cause it to improve for a while before she causes it to come back again. She got all the way back to being able to eat gluten again, but it only lasted a few months, before she was back to not being able to eat it and she needed to do the cabbage soup process again.
      Neither of them is WFPB.

  9. Dear Kellie, I have been watching videos on Nutrition Facts for 8 years, ans I have the book. I am also the same person that asked the first question (comment ) of the day today. So….what I CAN recommend is that you thoroughly explore these links. The first is a collection of all the kidney vids Dr Greger has compiled, and the second tells us what will preserve function best. The last is his Daily Dozen diet recommendations in case you need a refresher. I dont believe the book will add anything more on this topic imo though you could check for it at the library. My frustration is that dietitions and nephrologists are often not up to speed on plants. Best of luck to you !

    1. What is also helpful, is to look at an acid-alkaline balance food chart.
      Many people aren’t aware that that even plant foods vary quite a bit.
      Try to balance your meals by including a number of more alkaline foods with those, such as beans or grains, that are higher acid.

  10. This rat study from China suggests that high (animal) fat diets may be a factor in CKD since they damage kidney function (it also suggests that green tea may be a protective factor).

    How relevant this is to humans is unknown but, that it is, is at least plausible given that CKD rates appear to have increased worldwide with the spread of high fat Western diets.

  11. Tom, interesting study, albeit on rats. Have to take time to get into all the details of it. But did note that calorie restriction helped thru autophagy. So, presumably, limiting meals to fewer hours a day, more time in the fasting state, should be beneficial.
    And, of course, weight loss, especially abdominal fat, where appropriate.

    Also interesting is the link with AMPK. Metformin, particularly Glucophage type, raises AMPK. Seems a better choice than Canagliflozin. Berberine also raises AMPK. There are a number of things which tie to diabetes and metabolic syndrome.
    So dietary strategies to lower glucose and insulin levels seem valid.
    Thanks for posting.

  12. Just my personal experience with this. I had a friend, actually a work out friend, we both participated at the same gym. Heavy lifting all those years he began to take pain relievers, think it was Tylenol, pretty often. I also received recommendation from others to take these before the work outs so I could do more. But never did.

    He last I heard had need for dialysis and was close to terminal. Attributed to this use. This was to my guess also compounded by a earlier steroid use.

    Looking through it seems this is not uncommon and is actually a real risk with prolonged use of these things. And few comparatively I think are aware of it.

    Just read through a thing today, that American are expected to fall much further in life expectancy by 20 years time. And we are seemingly now beginning a decline…. a thing virtually unheard of without specific cause such as epidemic or war.

    What hazards we are putting ourselves at not just diet but things like this little bothered with or known of but with real risk.

    1. Yes, Ron.

      The NIDDK is pretty clear that NSAIDs for example increase risk for kidney problems but some people seem to throw them down like sweets (candy). Tylenol isn’t an NSAID

      “NSAIDs include popular pain relievers and cold medicines that can damage your kidneys if you take them for a long time, or lead to acute kidney injury if you take them when you are dehydrated or your blood pressure is low.”

      However,Tylenol isn’t an NSAID and I understand that most US doctors consider it relatively safe for kidney patients (although it has well-known liver toxicity effect)s. Nevertheless, this Swedish study suggests that regular use of acetaminophen (Tylenol) may be ven more strongly associated with kidney disease than regular use of NSAIDs like aspirin.

      1. Sure Tom thanks for that. I actually got the information on Tylenol second hand from a professional associated more recently with him, so assume it is correct but do not know personally.

        I just checked now and find there is some suggestion for kidney damage in relation as I found this..
        “Kidney damage — Acetaminophen: Introduction
        Kidney damage — Acetaminophen: Damage or injury to kidneys caused by a type of analgesic called acetaminophen (Tylenol). Mild kidney damage may cause few if any symptoms whereas severe damage can ultimately result in kidney failure. Symptoms may be acute, subacute or chronic depending on the severity of the toxicity. Kidney problems usually only occur with chronic use of the drug. Factors such as age, dehydration and underlying kidney problems may also influence a person’s risk of developing kidney problems and the severity of the symptoms.”

        And like I mention steroids. I don’t know his personal steroid use but do know he had use and it seems it was pretty common. So it may be a question of steroids with Tylenol use..little studied perhaps. The person I had this mentioned to me, was also a overt steroid user and her mouth seemed to drop a bit when I firstly mentioned….well I know he used steroids so maybe it was that as well in combination. If peoples take a thing they express ownership and are always less inclined to admit any faults to it.

        Statins, when people discuss them it seems they are always saying they are great, we should all take them as a matter of course, say fifty or so, many docs….those not taking them not so much. Pain stuff same thing it seems to me.

        1. But yes you are absolutely right. I forget the name of the non profit responsible for kidney health but there is one and they recommend Tylenol for patients with occasional pain. I personally stay away from all the stuff even aspirin. My dad was a strong advocate for the aspirin a day thing for years and years. But with no family history of macular degeneration suddenly developed it. Stopped then but I see personally possibly a result he was not a smoker.

          So why chance stuff?

          1. Thanks for the green tea information on this post as well. I have started a week or two ago, to add green tea to my coffee in the morning as the base instead of water and/or hibiscus I used earlier. Lowering a bit the amount of coffee grounds, so I will not overdose on caffeine.
            They have me now worried about kidneys…so no thank you I may have protection ;)

            Still use hibiscus when just drinking though..stuff tastes great to me. Always read your comments closely there are nuggets of important things found within often.

            1. Thanks Ron. I prefer black tea to green/white tea tastewise but there s certainly a lot going for green tea.

              For example, a few days ago, I saw this Chinese study of functional dependency and vitamin D status in centenarians. While it did find a link between higher serum vitamin D status and reduced risk of dependency, it also found an even stronger association between ‘lack of green tea drinking’ and functional dependency. Outdoor activities and visual impairement in turn were even more strongly associated but there is an obvious chicken and egg type question with those two factors…

              1. Green tea and vitamin D….seems odd. But I guess FD is not a worry for me!
                China seems to come up with some odd points in research at times.
                Reminds me of the old soviet union in that back in the day.

  13. It is 5 in the morning and I still haven’t had a wink of sleep.

    My dog has eaten about 40 Wag More Bark Less Pumpkin and Peanut Butter dog biscuits and 10 teeth cleaning vegan bones and some hemp calming chews and some digestive enzyme chews and some baked goods. He only seems to want baked goods right now. Hard to make decisions when he is still eating about 2000 calories per day. Just none of it dog food or human food. All dog treats and baked products. My coworker said that he will stop eating someday and stop going outside and you don’t have to worry about it, he will let you know. I know that he will, because he is communicating and get that dog food away from me is what is being communicated.

    1. Well, I just bought every vegan organic dog biscuit possible. Greens, berries, veggies, sweet potatoes, pumpkin,

      The last hurrah. He is showing hunger and I felt bad the past few days because he isn’t getting a wide enough range of nutrition, but they have every kind of fruit and veggies and quinoa and rice and other things in vegan dog biscuits. It looks like that will be what he eats until the end. If I had known how many different kinds they have, I would have already been using them.

  14. Dr. Greger
    This is a very important topic considering the number of people who a succumb to CKD. But you neglected to mention Dr. Walser from Johns Hopkins who wrote “Coping with Kidney Disease”. He claims to have kept CKD patients from dialysis for up to 9 years or more. He did this by reducing their diets to 21 grams of protein per day plus an essential amino acid mixture. He used Dr. Rose’s formula for essential amino acids, but this was corrected in the 1980s by Dr. Furst in Germany. For those who claim this is excessively low, we should remember that there are other sources of protein going to the stomach such as the phlegm in your throat and esophagus. Some doctors claim this to be as much as 20 grams per day. Healthy people need at least 40 gm of protein per day, minimum. Walser found this amount to be too much for CKD patients.
    Nutritionists who advise CKD patients to get 0.6 – 0.8 grams per Kg of protein per day are dangerous and are sending their patients into dialysis sooner. They are biased by the high protein levels (~100 gm per day) consumed by the American public and hesitant to advise any “drastic” changes. But dialysis is much more drastic than a new diet. We can confirm that the diet really works and it isn’t that hard to stay on. Thanks for your informative blogs and videos.

    1. Great stuff I am not qualified but certainly it seems well founded.

      This comment however since I have versed extensively on protein levels on this blog must add comment..
      “They are biased by the high protein levels (~100 gm per day) consumed by the American public and hesitant to advise any “drastic” changes”

      .8 per KG of weight is the norm accepted for consumption by sedentary peoples by dietary study of protein utilization in humans, not on American norms.. AS americans weight goes up seemingly does also that of recommended dietary intake of protein in actual grams. It is not so much one should in any event when fat, eat more protein, but that to be healthy a certain percentage of protein is conducive of best health for muscle repair and functional necessity.

      Should that number go down and down as most of the population becomes really nonambulatory in actual daily function..probably.

      I am not intending to challenge the other content you present. Docs are not generally ordering nutritional suggestion on the norms but probably in relation to RDA or considered required for function estimations based on study.
      Do americans eat to much protein…well certainly they eat to much meat dairy eggs and such. To many beans if vegan, then producing to much protein and then disease…my guess is not. Study does not find that but it is to a extend not well studied.

    2. I think the key point here is the ‘plus an essential amino acid mixture’ statement.

      My uderstanding is that very low protein diets are deficient in essential amino acids and can cause serious complications if not managed effectively.

      When these low protein diets are used, essential amino acid and ketoacid supplements need to be used,

      A Cochrare Review, leaning heavily on Italian research, found that a very low protein diet may be superior to the moderate protein diet, and delay progression to dilysis and end stage kidney disease (in certain circumstances).

      Italian consensus guidelines on dietary treatment of CKD were published a couple of months ago.

      As always, discuss the issues with your licensed medical and nutritional specialists before making dietary changes.

  15. I think I posted this at Dr. G’s site sometime before — maybe not: Several years ago one of my neighbors…a guy by the name of Frank….had to travel from his cozy warm apartment to a dialysis place for his weekly treatments. Can’t remember how many days a week he took this annoying trip.

    After a while he got so tired of the whole thing, he decided “no more.” He said he’d rather die than endure any more of that misery. So he quit cold.

    And — as per his wishes — soon after that, die he DID. I’m sure ol’ Frank is resting in peace.

  16. A recent lawsuit received publicity on the young turks and some other media outlets, just two days ago . This one is from RT I think, and mentions it, by one of the attornies concerned. Apparently big pharma this suit claims, is not vetting some of their things correctly, leading to no warning or little warning of hazard for kidney damage…

  17. I liked what you said about how a plant-based diet may help delay dialysis by one to two years and may improve the survival of the kidney if you get a transplant. My mom has been developing kidney issues and might be experiencing kidney failure of some sort, so I’m hoping I can help her change a few things to improve her chances. Thank you for the information about how changing your diet can really help you even if you have advanced or progressive chronic kidney disease.

  18. Is there really any case study available where someone wit CKD and high creatinine (>5), low albumin, high urea has been able to reverse this condition on WFPB diet?
    In my mom’s case all her symptoms of diabetes, acidity, etc went away but her creatinine shot up on a WFPB diet because of which she stopped doing the green smoothies.
    Is there a place to take specific case consultation for such a person ?

  19. Hi I’m a RN health support volunteer.I’m so sorry to hear what your mother is going through. I think the best case studies on reversing chronic kidney disease, heart failure, and hypertension were done by Walter Kempner, a controversial figure, but considered the most effect dietary treatment for disease ever.

    Dr. McDougall, mentor of Dr. Greger’s, has written more on this:

    At a certain point, the kidney tissue may not be able to be repaired. But as Dr. Greger put so well, a healthy diet can prevent heart disease and other issues that renal patients are at high risk for and prevent worsening kidney disease.

    Please wish your mom all the best from all of us here at

  20. My mother has Stage 3 Kidney Failure from taking Lithium for mental health issues. She took it for over 20 years! She has been vegetarian most of her life, eating meat on occasion. She has been on a WFPB lifestyle with our family for 5 months now. What can we expect to see in her kidney functions as she continues to eat a WFPB diet? Her numbers normally stay around 4 and sometimes creep up to 6. Thank you!

    1. Hello Krista,
      I’m sorry to hear about your mother’s health issues, but will do my best to offer some guidance. As discussed in the above article, plant based diets have been shown to improve kidney function and delay dialysis or kidney failure in those who are severely effected. Based on this information, at the very least a WFPB diet should improve her quality of life and delay worsening of her condition, and at best she can expect significant improvements in her condition. If at some point she does unfortunately approach kidney failure, there is also a protein-restricted vegan diet that has slowed or even stopped the progression of kidney failure.
      Ultimately, just remember that the side effects of a WFPB diet are good side effects, and will very likely improve kidney function.

      I hope this helps and never hesitate to post further questions down the line if anything changes.


      Protein-restricted vegan diet for kidney failure:

  21. I’m a 37-year-old wfpb (vegan since my late 20’s, vegetarian from the age of 6) mom of a vegan toddler, and I’ve been dealing with kidney disease since being diagnosed around the age of 20.

    My diet is extremely low in sodium, but after the pregnancy (which was shortened to only 32 weeks due to complications with the chord secondary to my renal insufficiency) my GFR has dropped off to about 20.

    The white coats are impossibly keen to start talking to me about transplant options, but as soon as I raised my concerns about not wanting to spend the rest of my life in a nightmare cocktail of immunosuppressors which are known carcinogens, they suggested an appointment with a specialist from their pharmacy team.
    At no point has anyone suggested a nutrition consult, though I have now requested one.

    My genuine hope is that I’ll be able to hold out long enough to see a wearable, if not a transplantable artificial kidney become a viable option so I can go back to life as I’ve not known it for some time.

    1. I guess you’ve read all the previous replies starting last year. Being a living kidney donor and knowing people with CKD I don’t think the medical community is to interested in getting people off dialysis. There are a few nephrologist who are vegans themselves and could guide you for nutrition. If you are in the New York area there is a doctor who works at Bellvue and over at Mt.Sinai who could be of help for your specific needs.

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