"Plant-Based Diet for Minimal Change Disease of the Kidney"
Chronic kidney disease is one of the top ten leading causes
of premature death in the United States,
and its incidence is increasing.
Chronic kidney disease affects more than 10 percent
of the adult population, and each year,
more than 100,000 Americans develop end-stage kidney disease
and have to go on dialysis.
What’s crazy is that a staggering 96 percent of individuals
with mild to moderate decreases in kidney function
and about half of individuals with severely
decreased kidney function go undiagnosed.
Meaning the vast majority,
like 24 out of 25 people with chronic kidney disease,
don’t even know they have it.
What can we do to maintain our kidney function?
Well, in a study that followed more than a thousand older women
for a decade, those consuming a diet that is richer
in plant-based protein had a slower decline in kidney function,
extending support for the health benefits of plant-rich diets
in the general population to maintain kidney health.
Compared with protein from plant sources,
animal protein has been associated with an increased risk
of end-stage kidney disease in several such studies.
We’re not exactly sure why.
Kidney damage from animal protein could result
from the dietary acid load, excess phosphorus,
or gut microbiome bad bacteria and the resultant inflammation.
The dietary acid load in a Standard American Diet is derived
mostly from animal sources such as meats, eggs, and cheeses.
In contrast, by including a higher proportion of foods
with natural alkali, such as fruits and vegetables,
a strictly plant-based diet is nearly acid neutral.
Even just eating plant-based 2 or 3 days a week
can significantly bring down the acid load
delivered to the kidneys, and eat plant-based full time,
and you can actually flip over into alkaline territory.
Even just cutting out meat can yield an alkaline load
compared to the acid load in the nonvegetarians.
All this is important, since dietary acid may promote
kidney injury and a progressive decline in kidney function.
The intake of animal protein can also cause an imbalance
in the composition of the gut microbiome by producing
more ammonia and the rotten egg gas hydrogen sulfide,
and have a proinflammatory effect that may result
in reduced kidney function,
but it also may be the animal fat.
In the Harvard Nurses Study,
higher intake of animal fat was directly associated
with the loss of protein in the urine,
which is a sign of kidney damage,
and to protect against that, they suggest diets lower
in animal protein, animal fat, and cholesterol.
That may help explain why vegetarians
have better kidney function than nonvegetarians
matched for sex, age, size,
physical activity, alcohol, smoking, etc.
So effectively, even a meat eater who is just as slim as a vegetarian,
just as healthy cholesterol, blood pressure,
and blood sugar control-wise still had inferior kidney function.
They think it might be the higher dietary fiber intake
on more plant-based diets contributing
to the protective effect on kidney function,
again through a microbiome mechanism.
Whereas the consumption of animal protein may lead
to a proliferation of meat-eating bugs,
which can result in a leaky gut, uremic toxins,
and resulting inflammation, oxidative stress,
and chronic kidney disease progression.
That can be blocked, with the decreased inflammation
and acid load thanks to the eating of more fiber rich foods.
No wonder an egg-free vegetarian dietary pattern
was associated with a 37 percent decreased odds
of developing chronic kidney disease.
But, what about plant-based diets for not just the prevention
but the management of chronic kidney disease?
Can comprehensive lifestyle change alter
the course of chronic kidney disease?
This was the case report of someone diagnosed
with minimal changes disease.
That’s when someone’s kidneys start leaking protein,
even though there are minimal changes seen
in biopsies under the microscope.
You give people steroids, and in a few months,
you can knock it down, but a significant fraction
may fail to respond to the steroid therapy.
He was diagnosed 18 years prior,
but only by replacing animal protein with plant-based protein
was he able to put his chronic
kidney disease into remission.
At age 44, he suddenly developed swelling that crept up
throughout his body since he was losing so much protein.
He was weak, unable to concentrate, and lethargic.
Diagnosed with minimal change disease
and treated with a water pill
and four different blood pressure lowering agents.
Because of unresponsiveness to high-dose steroids,
a powerful immunosuppressant was added;
yet, severe protein loss continued
and his hypertension and kidney function worsened
until...he started eating plant-based,
started exercising, lost 60 pounds,
and his kidney disease went away and stayed away.
Let’s hear it in his own words.
“I appreciate the recommendations my doctor gave me
about making dietary modifications:
‘replace your protein intake with plant-based protein.’
This one change has had a monumental impact on my life.
I have gained back a quality of life that I thought was gone forever.
My benchmark for normal has been my ability to keep up
with my professional work demands and still be able to exercise.
For the last 7 months, I now swim over three miles every other day:
a distance that surpasses my pre–kidney disease life.
I perceived I lived a healthy lifestyle before kidney disease;
today, I live a healthier, happier lifestyle,
and I have my kidneys to thank for it.