Dr. Fung is dedicated to diabetes cure..you can see many great long very technical videos on youtube too, and this is where i was hoping "if it's good for them, why not us?"

I'm glad he is working on prevention of diabetic complications...but what about those of us who didn't make that cut? And what about high protein causing a more rapid kidney decline? I am surprised he isn't advocating for EVERYONE knowing their GFR et al.

He has a profile on his blog of someone with kidney disease. Doesn't go into a ton of detail though.

I thought you had said that in another thread, but my memory is not what it used to be either. But yes, malnourishment or even starvation is exactly what I had in mind for a negative consequence of too little protein. What good is a diet that spares the kidneys at the expense of the life of the patient?



Here's a site (which I found by googling HCLF + kidney failure) recommending closer to normal protein intake, .8 to 1.0 gram. Notice on this link they recommend more like .75 grams protein per kg of normal body weight:

http://www.edren.org/pages/edreninf...nal-disease.php

But on that page is a link that leads to:

http://www.edren.org/pages/edreninf...ney-and-ckd.php

And from that page:



Also from a link (Energy, at the bottom of the first page I cited, tips on how to increase calories if you are losing too much weight on the standard kidney diet:

http://www.edren.org/media/handbook...eets/Energy.pdf

While I see that they are adding fats (butter, cream, margarine, oils) to carb-ish foods, they advise no cautions about fat. I can't know for sure, but I suspect the general cautions about fat you see on most kidney organizations' websites are carryovers from the Fat is Deadly era. Since they have so much money coming in from pharmaceutical companies, why would they want to change the status quo?

Oh, and I also noticed under the phosphorus link that when you come to the point where you really have to reduce phosphorus, you should eliminate cereals (perhaps that is due to a preservative/additive? idk). While this diet does not overtly recommend LCHF, it certainly doesn't disrecommend it (though it does dis-recommend their interpretation of Atkins as a high protein diet).

I see from the Dr Fung thread that you've contacted him - that's great! Between him and Franziska you should get some good information. While I've never heard him address kidney disease + his diet directly, he did state very clearly in the Diabetes Summit that he came to his interest in diabetes because of his kidney patients. I can't imagine he would use a diet that cures the diabetes and kills the patient. He can be very vocal as well about the influence of Big Pharma on the accepted practices in medicine.

Also, Gary Taubes in Good Calories Bad Calories mentions the connection between insulin levels and kidney function. He lumps kidney disease in with other manifestations of metabolic syndrome. On page 149 he says:

Chapter 10 of GCBC is devoted to the Role of Insulin, and chapter 11 The Significance of Diabetes, where he explains how high blood sugar and insulin damage the kidneys.

Oh and as far as reversing kidney disease with HFLC, I'm only repeating the verbiage of the authors of the study. Check out the headlines that announce the study:

http://www.aarp.org/health/conditio...ey-failure.html

http://phys.org/news/2011-04-high-f...rse-kidney.html

http://www.sciencedaily.com/release...10420184429.htm

Certainly conventional wisdom is that you can only arrest progress of kidney failure, but the authors of the study seem to think they've done better than that. Maybe they're right and maybe not. I'm simply using their verbiage.

Liz, thanks for dredging up all this!!! as a kidney patient with serious drop in function over 60 days of LCHF, all other factors being good…the assumption is too much fat may do harm in some way. I already see on my test I dodnt manage protein well..and I was eating 45-60..mostly eggs, dairy, chicken, Ppowder.

The the Dr. Mobbs mouse reversal study is 4 years old NO new info… so it doesnt even matter yet. ( I've searched all over..nothing on him orLC)

Dr. Fung MAY study his patients with diabetic issues, but we dont know if the ones with CKD 3-5 are responding as well as those with healthy kidneys. h made a blanket statement to Gonwtwindo, and said he does not follow CKD!

Next LOW protein MUST be supplemented with amino acids..this is Dr. Walsers book, Coping with Kidney Disease, the UK site make mention of low protein with NO amines info, and scare people off….( muscle wasting under 30g pro a day) the whole point of the J Hopkins /Dr Walser push to study low protein and amino acids was to SLOW serious CKD for YEARS…avoiding dialysis as long a s possible or needing a kidney..

People have the general idea you just hook up and can live forever as normal..what happens is NO life to go and do anything, no energy, juts recovery between 3x weekly long 4-5 hour visits, getting yourself there and back, and NO fluids, rationing water intake, forever? no travel, AND after a few years you fail anyway, the people who go off dialysis just want to die, and do, gentle death tho it is said to be. many of CHD which gets them faster. Like cancer who patients who dont DIE of the actual cancer, they die of Cahexia..lack of nutrition and ability to function.

HOME dialysis is new ( and a BIG money sucking business, as the US Gov pays for ALL of it, no matter who you are, it is the ONLY disease that is fully covered for homeless to billionaires) is complicated and people who live alone like me CAN;T do it, you must have a daily caregiver ( spouse/family/or hire help DAILY) to help and monitor the machine..AND in power outages? I just read the backup plans.but if the machine isn't working you die in a week… or how do you get to a treatment at your dialysis center in a major emergency, like a quake, blizzard, etc. it happens..we are tied to electricity, or generators..everyone..who will do that at 79, living in an apt. with a niece to come help? 60K new people a year need dialysis, or a transplant 300k are on it in US.

I have contacted younger 40s guy who is on dialysis after his egfr went to 9…he is happy now, but what about 5-10 years?

GETTING a kidney live or cadaver is not easy, AND who gets one? AN old person in line gets the next match..BUT a young person in line may get an old kidney, and need 2-3 more transplants, costing 3x as much as if he got the younger one, and the older guy dies in 3-4 years anyway, wasting that young kidney…so the ethics people are TRYING to figure if they can give a child a younger kidney, and let the older person wait for an older one…to me that seems fair. Rating people is an ongoing hot debate. I've read questions asking: who gets a kidney- brilliant doctor with a lif of contribution, mom of 4, a child who will die soon, person who can pay millions to the hospital funding it..who matters?

News yesterday showed a younger man who after 6 years is failing, and looking for a cadaver kidney. His son is famous on social media-so you've heard of him.
http://www.inquisitr.com/2012423/su...-needs-a-donor/

As a medical trained person I've read the reports where clinicians admit older kidney failure patients don't want to accept death, and fight to stay on their dialysis long after it is viable. we all want to live.
We spend $170 Billion on ESRC and related costs, and MUCH of this might be avoided if a patient were aware, and followed a diet of NON meat that stress filtering.

I called the company making the special amino acids Dr. Walser advocated with <30g protein, all vegetarian diet..and the scientist there told me only 2 nephs in the US will even use this approach.

So we are SHUT OFF of getting aid for the experts, and if you choose to follow a VLPro plan, with amino acids, and the diet….there has been much success….for me it is a real consideration.

Because we are losing kidney function with age, 1 pt a year after 40, and it is not reversible..then why spend money on research or education? it goes elsewhere more urgent. AND NKH has the KEEP program, but did you know March is Kidney month? did you get a KEEP test, free? so how can 26million unaware, untested do anything with the SAD foods they eat to help themselves??? Tell someone no FF or cheeseburgers forever….only veggies? yeah that will go over, so people will just fail one at a time. If Johns Hopkins and all the effort they made with $100M study to promote this didn't fly…..we're on our own.

Muddy Gurl, I'm not sure I am following you. Are you saying that you think fat is harmful to the kidneys? By what mechanism? By extension, are you saying you think carbs and/or protein are less harmful than fat?

Liz, this is not ME saying it, this is a MASS assumption that HF is good for everyone. The excitement over LCHF is going to extremes….as much as I want butter daily…what if?….

Since we know CICO is not 'the answer' for all, how can we say this LCHF is too? without further stats?

My renal test showing severe drop(3-4 years worth!!) in 60 days under a LCHF diet, with all other factors GOOD: BP, ldl. trig/BP/sleep, etc.

this alarmed me and the urologist. So I am reducing fats greatly, stopping coffee, reducing dairy fats and adding more veggies.

Basically..Can I improve renal function with diet?..and see if there is a change. It COULD be something unknown…but starting with food is prudent.

so LITTLE is known about FATS consumption since we've had 40 years of LOW FAT sold to us..( Yes, all the books Taubes, etc all say High fat is GOOD..FOR HEALTHY overweight people and some diabetics..but it is less than 10 solid years, and few actual studies..you'd think the Beef & Dairy lobbies would want lots of studies t support LCHF.

BUT over in the "Low Carber & Keto" groups in MFP people are going to ALL FATTY MEAT 24/7, NO nuthing else..yikes.. eat ad libitum..no calorie counting. I believe they are getting nutrition BUT are they already harming their kidneys??? since MOST have no clue, and MDS never say, is weight loss more important than long term health?

I LOVE the LCHF food style, i WANT to continue, but what if I, and OTHER CKD patients are being harmed by it?

One sentence by Dr. Fung isn't trustful enough to give my life to..is it for you? if you had some health issues?

this is why I am anxious to see what the 'experts' like Fung and others say.

I am JUST NOW finding articles..all in clinical journals, so I will keep posting as I learn more. This one says MOST older CKD patients dont get to ESRD..BUT younger ones DO… if those 30-50 started adding damage by diet….not smart. I COULD be an HF outlier..but am worried about more than myself.

Managing advanced chronic kidney disease: A primary care guide
id=105745&tx_ttnews[tt_news]=369697&cHash=3afd81fe9305c77be0eaaf7642f7ec1c
"Hyperlipidemia is a common risk factor for cardiovascular morbidity and mortality in CKD. However, until recently, all studies of outcomes of patients treated for hyperlipidemia excluded patients with CKD."
As CKD progresses, especially as the patient reaches an estimated GFR of 30 mL/min/1.73 m2, the nephrologist will take a more active role in the patient’s care and medical decision-making..

(I am now at GFR 26..and real worried!)

OK, I understand better now what you are saying. I have found that for myself high fat/low carb has only improved my health.

If you feel it is undermining your health, then I can see why you would not want to eat this way. It is certainly a personal decision. All the best to you.

Haven't caught up on the posts here yet, but here's what I posted in my journal re: my LC Dietician appointment today:

ok!!

I spent an hour on the phone with the Low Carb Dietician. And almost immediately thereafter, my son called in a chatty mood and we talked for and hour and 20 minutes.

First of all: Her name is Franziska. She's in Huntington Beach. She is a bright, lively, kind, *normal* person who I am so happy to have spoken with. She is a wealth of information and has a super informative blog: http://www.lowcarbdietitian.com

I think I found her by googling "low carb dietician". I read a brief amount of her website, then clicked on "working with me". Didn't really delve into her blog at that time, but I looked it over today while chatting with my son. Like I said, a wealth of information...and insight.

So:

Dietician says my kidneys are stable. She says for someone my age with undiagnosed diabetes for 6 years, (plus the 6 days on a Cipro IV, NSAID use and pre-eclampsia) I'm doing amazing. She says she sees other patients without those confounding factors whose kidneys are worse. And I'm not not likely to decline much more...I think because my BG is so well controlled, and I don't have high BP. Those are the top 2 causes of progressively declining kidneys. And my poor kidneys have had a lot of 'insults' in the past, that they hopefully won't suffer again.

The LC WOE I was following before this diagnosis is exactly how she advises me to eat (!!), with the exception of slightly less protein. She says 60-80g daily, with a lower or higher day here and there, is what I should shoot for. In looking further back at my sparkpeople tracker, I had a lot of days over 100. She says even 100 is ok, just not every day.

She is not a fan of fats over 70%. She says beyond that point, fats are too much taking the place of foods that provide nutrients and fiber.

Advises repeat labs annually, submitting them to her for possible dietary tweaking. But if I remember correctly, she thinks I won't need it, or at least not much.

Her opinion of my kidney disease diagnosis is, while I meet the current diagnostic criteria, it's probably a little premature. I don't have protein in my urine, which is notable.

We discussed a paper I found last night calling for CKD to be staged like other diseases: there should be 4 stages, with no diagnosis without a identifying a specific pathology. Kidneys do become less efficient as we age, pathology or not. So do brains, hearts, etc. So to to diagnose someone with Kidney Disease due to a lower glomerular filtration rate, but without a specific pathology, is possibly stretching it a wee bit. An analogy would be: for most people, brain function declines as we age, but we don't say someone forgetting appointments has Stage 1 Chronic Brain Disease. They're just aging.

I'm a little fuzzy on this but I think she said no one my age has a gfr of over 90 (which is current criteria for no CKD). Or was it my mother's age? (84). grr. There goes my Stage 1 Brain Disease!!

I just realized I forgot to ask her about different sources of protein. D'oh. Email time. Before she saw my labs, she did say we would probably have to work in more vegetable protein, but didn't say so today, after seeing them. (remember, they improved when I went off my prescriptions, and drank more water.) And - we didn't discuss weight loss. It wasn't on my radar...but funny, it's back now

We spent time discussing many additional aspects of my health including cholesterol, diverticulosis, and supplemental vitamins and minerals. No supplement I am taking is harmful to kidneys, but my B12 is high, so that one is now once a week, and retest.

Also - my Vitamin D is 76. She said new research is indicating that is too high and I should shoot for 40-60. So, I'm going to be reducing to 5,000 iu once a week in summer, and every other day in winter.

She has heard of Dr. Fung. I think she said they have both been presenters at the same conferences, but she has never met him. She says he gets a bad rap - people think by emphasizing the problem is insulin, he is ignoring the fact that BG does the damage. I would have to say that is only because they don't fully understand his premise. I think I will email her links to his lectures.

Liz, thanks for doing some research and sharing it on this thread. I just read about the 8 week study of mice on LCHF on Franziska's blog today. I think she posted a link to the original study publication. But you're right, the headlines about it are awesome - encouraging!!

Great news! I've been reading Franziska's and Fung's blogs regularly for some time. I think you've gotten great advice. Will look forward to hearing how you do - really glad to hear further decline is not likely.

I see you posted again after I did. You know i think the whole Atkins is high protein is an interpretation from his detractors. It's what the media say, not what Atkins (nor his successors Phinney, Westman and Volek) said. Even Dr Fung refers to Atkins as high protein, but that is Urban Legend Atkins. Anyone who actually reads an Atkins book sees you replace carbs with FAT, not protein.

Have fun reading Fung's blog and watching his video. I hope you will join us over at the Fung thread. We're all learning alot from each other. Again, so happy for you.

All he said was "LCHF is safe for CKD; it is high fat, not high protein."

This was gone over quite a bit in the Kidney Education class. Dialysis is exhausting; 3 or 4 times a week, it forces the blood through your body at a much faster rate (I think that's it) and the RN said you feel weak, like you have run a race. It's less exhausting overnight (slower: 6 hours instead of 4), but you get out at 4 am (begin at 10). The at-home one has to be run 4 times a day for 30 minutes, and someone must be present with you during those times. Apparently you can have a low blood pressure episode and would be unable to help yourself off the machine to get help.

Agree. Instead of getting no commentary on declining gfr on our annual exams (extremely common), why not bring it up? It is widely accepted that the only way an individual can slow the progression is by incrementally reducing protein as the creatinine in the blood increases. So they don't mention that...why?

I agree it is at an extreme in some circles, not unlike the raw foodists of the vegan world.

I hadn't read of the 1 point per year after age 40 decline. Then it makes sense that Franziska would have commented that no one my age (62) has a gfr of over 90 (the line in the sand that says "kidney disease", by current criteria.) So...everyone my age has some stage of CKD? I'm 22 years over 40...so around 22 points down would be normal aging, but also Stage 2 CKD? Ridiculous!

I do think this whole staging thing with kidney disease needs to be re-invented...big DUH right about now.

Admittedly I have not reread Atkins yet - my bad - but I seem to recall him saying to eat until you were satisfied...followed by a list of foods, most of which were high-protein foods. Something like meat, fish, poultry, eggs, cheese, small amount of cream, and salad. The only thing high fat, and not high protein, was cream...right? Oh, maybe there were oils in there, too. Then you go up the ladder by adding more cheese, and beyond that I'm not clear. Maybe more vegetables, and nuts, which are high fat. Anyway my interpretation of it was Scrambled eggs! Tuna salad! Ribeye! Cheese! lol High fat, yes, but also high protein.

Thank you Liz. I will join in over there. I have so much to attend to...videos galore; websites and blogs to comb through. Interesting you already knew about Franziska!

That's one of the things i like about New Atkins for a New You. It's essentially the same program as DANDR (it counts net carbs, encorages you to eat vegetables), but is much more explicit about what to eat. There is a chapter called Fat is Your Friend. It has a chart that gives a range of how much protein to eat in grams and the equivalent in ounces of meat according to your gender and height. It has bullet points and certain passages emphasized in bold type. I love the Chatty Dr Atkins to feel good, but really find NANY easier when seeking out clear information.

In defense of Dr Atkins, meat is quite a different story now than it was in 1972. In 1972, meat was well marbled and there was a thick rim of fat all around. As a teenager already indoctrinated about fat, i avoided the fat, but my grandparents, parents and aunts and uncles sought it out. So when Dr A says eat a steak, he knows it will contain a substantial amount of fat. Since then beef and other meats have been bred for leanness, so a steak of the same weight will contain proportionately more protein and less fat.

Just the same if it's been a while since you've read Atkins, it's a treat. He got so much of it right re: insulin and how it affects hunger and weight.