FOOD AS MEDICINE FOR CHRONIC KIDNEY DISEASE AND HIGH CHOLESTEROL, A PATIENT STORY
Health column by Dr. Greg Feinsinger. Champion of Whole Food Plant Based Living and righteous person.
The two kidneys are the shape of beans but much larger. Around a million microscopic filters in each kidney get rid of waste products in the blood, via urine. In addition to glomeruli, kidneys are made up primarily of blood vessels.
Over half of American adults currently age 30-64 are expected to develop chronic kidney disease (CKD), most of which is caused by atherosclerosis (hardening of the arteries). Because kidneys are so vascular, they are particularly sensitive to atherosclerosis. Causative risk factors include hypertension, smoking, sedentary lifestyle, obesity, diabetes, high cholesterol, inflammation, and a diet rich in animal products.
According to Dr. Michael Greger in his book “How Not to Die” and his website nutritionfacts.org, researchers have found three specific dietary components associated with a decline in kidney function: animal protein, found in meat, poultry, seafood, eggs, and dairy; animal fat; and cholesterol (all animal products including seafood contain cholesterol). Animal protein harms kidneys primarily because it causes acidity and inflammation. A fourth substance that harms kidneys is phosphate additives in cola drinks and meat, used for color enhancement.
Kidney function is determined by the following: serum (blood) creatinine, with normal 1.22 or less; GFR (glomerular filtration rate), with normal being greater than 60. Results of these 2 kidney function tests are part of chemistry panels done in doctors’ offices, hospitals, and health fairs.
Another important test for kidney health is a urinalysis, which is not done at health fairs due to collection and storage issues. Any protein in the urine is abnormal. The most sensitive test for urine protein is the microalbumin/creatinine ratio, with normal being 7.5 or less in a female and 4.0 or less in a male.
If you have protein in your urine; an elevated microalbumin/creatinine ratio; a blood creatinine of > 1.22, or a GFR of < 60, you have chronic kidney disease, which needs to be evaluated and treated (treatment involves treating the risk factors for atherosclerosis in the second paragraph). There are various degrees of CKD. For example, a GFR between 15 and 29 is classified as severe, meaning heading in the direction of dialysis or kidney transplant.
Now, an illustrative patient story: A.S. is a man in his seventies who was referred to the Center For Prevention and Treatment of Disease Through Nutrition/The People’s Clinic by a friend of his. He presented on July 12th, 2021, accompanied by his wife. For years he had been on a high sodium diet recommended by physicians for low blood pressure (note that sodium not only raises blood pressure but also directly damages the endothelium organ system that lines our arteries). He has also been on the Paleo diet for over 3 years, which is high in kidney-damaging animal protein. He was diagnosed with CKD a year before last month’s visit, at which time a kidney ultrasound was normal (usually the pathology causing CKD does not show up on an ultrasould). He was not given any advice about diet, but made the decision on his own to increase his daily intake of animal protein even more.
A.S.’s lab results on 6/23/21 showed a serum creatinine of 2.63 and a GFR of 25, putting him in the severe class of CKD, heading in the direction of dialysis or kidney transplant. His total cholesterol was 232 (“normal” being < 200 but ideal < 150); LDL or bad cholesterol 173 (“normal” < 100 but ideal < 50).
The patient was encouraged to go on a total plant-based, whole food diet, with no sugar, salt, or added oil. With the support of his wife, he did so. Repeat lab on 7/31/21 after 2 weeks on the diet showed a creatinine of 1.55; GFR of 46; total cholesterol 181; and LDL 132. So just with these dietary changes for 2 weeks—although his kidney function isn’t normal and his cholesterol isn’t ideal—he’s out of the woods regarding both issues. Hopefully with time, both problems will improve further, and possibly resolve.
Unfortunately, the medical system in the U.S. isn’t geared towards prevention, or treatment of disease through simple measures such as lifestyle changes. Medical schools fail to teach students about the power of unhealthy food to cause disease; or of healthy food to prevent, treat, and often reverse disease. And most practicing physicians aren’t aware of the extensive medical literature out there that supports food as medicine.