Tuesday, July 23, 2013

NutritionFacts.org - the health benefits of a plant based diet

Dr McGregor is a very amusing doctor who recommends a plant based diet based on the health benefits discovered by mainstream medical research. He has a little bit to say about kidneys here but I recommend you view his general presentations like this one as they're pretty amusing and informative.

Personally his presentations have inspired me to limit my animal protein intake. Let's see how it goes.

Tuesday, April 30, 2013

A whole year had passed since my last lab tests so I've subjected myself to another round of needles and blood and urine collection.

The good news is that nothing much has changed. My current blood creatinine level, the most common marker of kidney function, is 2.1mg/dL. The lowest reading I've had was 1.8mg/dL while the highest reading was 2.4mg/dL. The doctors say that a significant change is 1mg/dL, so probably my kidney function is about the same as when I was first diagnosed four years ago. This is pretty good because I've seen some progression graphs that show people going from my level to failure in around seven years!

Creatinine clearance is a supposedly more accurate measure of kidney function, as it directly measures how much creatinine gets filtered out of your blood and into your urine, but my results have been quite variable. My best result as been 52ml/min (which corresponds to around 50% of normal kidney function) and my worst has been 33ml/min (about 30% of normal). My current result was 37ml/min.

The amount of protein in the urine is also around the same as previous readings: 815mg in 24 hours. 300mg is the upper "normal" limit. The lowest I've had is around 335mg and the highest 1485mg.

One interesting change was an increase hemoglobin to 14g/dL, which takes me out of the anaemic range (less than 13g) for pretty much the first time. Not sure what caused that. Possibly increased cacao, bean and cabbage consumption (I've been experimenting with homemade fermented cabbage) which contain iron.

My current thinking on surviving chronic kidney disease
Current medical opinion is that damaged kidneys can't be repaired and their function worsens over time. I haven't, unfortunately, found any evidence to contradict the essence of this opinion but there does seem to be evidence that the decline in kidney function can be slowed (or even stopped) by adopting healthy lifestyle habits, which to me mean:
  • Avoid all refined sugar and salt. Apart from being bad in themselves, I believe these ingredients trick your body into thinking what you're eating is more nutricious than it really is.
  • Limit the amount of starchy foods you eat. Supposedly these turn into sugar pretty quickly in your body which may be a problem if you have excess body fat or at risk of diabetes.
  • Eat mostly plants. Here is a very entertaining and informative presentation about the reduction in health risks that vegans apparently enjoy.
  • Experiment with your diet to find out if any foods seem to have negative effects on your well-being, e.g. milk, wheat, coffee, etc.
  • Do enough exercise to keep yourself in shape. High intensity training is in fashion right now and has the advantage that it doesn't take much time out of your day.
  • Learn to be happy. Figure out what makes you happy and do more of that. If you really think about it, you'll probably find that nothing else matters too much. On the subject of happiness, I found The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom to be a very interesting analysis of ancient wisdom from the viewpoint of current psychology research.
I'm going to try and take even better care of myself for the next year and see what happens!

Tuesday, June 26, 2012

Progress report

It's now been three and a half years since I was diagnosed with Chronic Kidney Disease (CKD) and began my quest to cure myself. Although I have not achieved the dramatic recovery I was hoping for my condition appears to be generally stable and this can be considered an acheivement given that the tendency for CKD patients is to gradually lose kidney function until replacement or death becomes necessary. Here are my findings and tips to date so that others may benefit from them (none of which should be construed as medical advice!):

Comments on this blog
Thanks to all the people who've taken the time to comment on this blog. I have just noticed I had almost 2 years of comments pending my approval. These have now been posted and I will try to answer them.

Background information and lab test results
For anyone interested in the technical details, I have a 40 year old male of British/Dutch/Austrian ancestry living in on the caribbean coast of Mexico. Height 1.82m, current weight ~76kg (previously 85kg). You can review my complete lab test result history here:
https://docs.google.com/spreadsheet/pub?key=0AhX6YZKS2qpCdFpObVlQQXNmMjBfT19kUUdxUHAxaEE&output=html

UK consultation
In April I consulted with a nephrologist in England, Dr. Rowe, and also took blood tests. The UK test results were consistent with all my previous test results done in Mexico. The nephrolgoist provided the following information:
  • Natural decline: The natural tendency of a healthy kidney is for a reduction in function with age of around 5 to 10mL/min per decade, so based on my current estimated GFR (glomular filtration rate) of 30 to 40mL/min, he would expect "renal replacement therapy" (kidney transplant) to be necessary in 10 to 20 years, as a GFR of 15mL/min is the level at which toxins are no longer adecuately removed from the body.
  • Ultrasounds: Ultrasounds don't provide good diagnostic information for kidney disease and the measurements are highly variable, depending on the operator, etc. I have had three ultrasounds (one a year) but in his opiniĆ³n they can't be used to observe any changes, just to confirm the presence of damage (scar tissue). He also doubted that the number of kidney stones had changed as no stones have been passed (the first ultrasound showed 4 stones, the most recent only 2).
  • Diet: In his opinion diet options should be based on reducing the kidneys workload and for this reason salt should be avoided as much as possible as well as excessive protein. He noted that protein reduction may reduce the measured serum creatinine levels but this doesn't necessarily indicated improveed kidney function, it may just indicate less creatinine in the blood due to less protein consumed.
  • Blood pressure: He believes strict blood pressure control to be very important and recommends continuing to take 50mg/day of losartan.
No miracle cure
My research and experiences to date have reduced my expectations of finding a "miracle cure". Even though kidney tissue does not normally regenerate I had originally hoped to somehow (through some "alternative" therapy) find a way to turn on the gene responsible for kidney growth and achieve miraculous regeneration of the damaged tissue. However, I have found little evidence of this type of miracle, even among people involved in advanced spirtual/meditive practices. My focus, therefore, has shifted away from looking for a cure and more on accepting the cards I have been dealt and playing them the best I can. This means striving to be as healthy as possible and trying to enjoy as much as possible whatever time I have left. More on this below.

Patient involvementI think it's very important for anyone with any kind of disease to get involved and learn about the disease and your body, and not just blindly follow your doctor's orders. I have consulted with three Nephrologists, as well as reading a wide range of materiales, and there have been significant differences in their treatment recomendations. This doesn't mean any of them are "wrong" but the reality is that a doctor is just a human being and the state of medical science is advancing all the time. However well trained your doctor is, and however much experience he has, he has never experienced what it's like to be you and live inside your body. He also doesn't have as much time or interest to think about your case as much as you can.

Staying healthy
Probably the best defence against any disease is maintaining your body in as healthy condition as possible. I always considered myself healthy before but now I am much more so. After much research and reading of conflicting opinions and experimentation, I believe the pillars of health are:
  • Sleep. Make sure you get enough of it and wake naturally every day.
  • Happiness.  Make sure you enjoy what you do every day.
  • Diet. There are so many conflicting messages regarding diet that the area has become a veritable minefield. After looking at the evidence of healthy people living on an extremely wide variety of diets, my personal philosophy is to eat whatever you feel like provided it contains no added sweeteners or salt, as I believe these substances trick your body into believing a particular food is nutritious regardless of its real benefits or otherwise to the body. I also think there is a lot to be said for eating foods as close to their natural form as possible. My personal diet contains nuts, fruits, vegetables, yoghurt, some rice, some corn, some low-salt cheese, some fish/shrimps, no wheat, no meat.
  • Excercise. There is also lots of conflicting advice about types of excersise but I think everybody agrees that at least 30 minutes a day of some sort of excercise is important for your health. In my case excercise is limited to walking at least 30 minutes a day and maybe once a week doing something more streneous but I feel like I would benefit from doing more! Yoga is probably an excelent option for people suffering from chronic disease as it may help your whole body (and mind) to work better.
  • Immune system. I've read that a large part of your immune system resides in your gut (intestines) and therefore to have a healthy immune system you need to have a healthy intestinal tract. If you are intolerance to a certain food (e.g. gluten or wheat) its consumption may cause damage or inflammation of your intestines and weaken your immune system. It could be coincidence but since avoiding wheat, and being careful about my diet in general, I have not missed a single day of work due to illness. I have certainly been 'sick' and been aware of having a virus but have only experienced mild symptoms. Previously I would usually miss one or two days a year due to colds or flu (at least that's my perception).
Blood pressure
Most experts believe that avoiding high blood pressure is a very important for conserving kidney function.
At the time of my diagnosis my blood pressure was in the 140/90 range (and often higher). For the last few months it has been in the 120/70 range. I was prescribed losartan (cozaar) but didn't notice any effect from this until I made changes in my diet. Without medication my blood pressure would be in the 130/80 range and taking 50mg of losartan a day keeps it in the 120/70 range (often less). It's hard to be very specific as exactly what foods increase or decrease blood pressure but I would recommend trying the following to see what works for you:
  • Avoid/reduce foods with added sugar 
  • Avoid/reduce foods with added salt (cheese, for example)
  • Avoid/reduce starchy grains.
  • Avoid excess fruit consumption (after eating 4 bananas one morning I noticed a spike in my blood pressure. Since then I have cut back on bananas and enjoyed low blood pressure).
  • Unsalted peanuts with the skin (I eat a fair amount of these and some sources say the skin contains something which reduces blood pressure).
Sodium Bicarbonate
There a few e-mails going around touting sodium bicarbonate (baking soda) as a 'cure-all' for all sorts of things. They say that the one of the signs of a 'quack' treatment is if it claims to work for lots of different ailments and this has certainly been my experience in general. I have experimented with taking half a spoon of sodium bicarbonate daily (mixed with water and a little grape juice) for extended periods with no obvious impact (positive or negative). Lately I have stopped taking it regularly but I do still take it now and again if I feel like it. It could be my imagination but I feel it like it helps ward off common colds.

Diuretics
There are any number of natural cures for kidney problems, e.g. dandelion tea, or things that are "good for kidneys" that are really just diuretics that excercise your kidneys by making them generate more urine than normal. Some of these cures talk about cleaning your kidneys and removing the 'sludge' but I have never read anything about kidney sludge in any serious medical literature. It is possible that some diuretics may be good for some kidney conditions, or for healthy kidneys, or for passing kidney stones, but I am unaware of any benefit for chronically damaged kidneys.

That's all folks
That's everything I have for you now. The bad news is that if you have damaged kidneys there is no known way of repairing them. The good news is that it may be possible to prevent further damange if you make an effort to live a healthy life. This blog has been written to share my experiences with other people with kidney problems in case it helps them in anyway. If you want to ask me a question please leave a comment and I will respond (eventually!)

Thursday, February 24, 2011

Monday, October 25, 2010

Test results - the complete history

I finally had the brainwave of putting all my test results into a spreadsheet to make it easier to view changes over time.

You can view them here if you so desire:

https://docs.google.com/spreadsheet/pub?hl=en_US&hl=en_US&key=0AhX6YZKS2qpCdFpObVlQQXNmMjBfT19kUUdxUHAxaEE&output=html

The progress points are:
  • Serum Creatinine back to same level of 18 months ago.
  • Proteinuria (protein in urine) way down.
  • Increased Serum Hemoglobin (reduction of anemia)
  • Blood pressure reduced.
The "lack of progress" points are:
  • Serum Creatinine and Creatinine Clearance unchanged (i.e. no improvement in kidney function)
  • Uric Acid high (being controlled by Alopurinol)

After experimenting with many different things, I believe the main factors responsible for the progress are:

Healthy, balanced diet
I ate pretty healthily before but I've improved some areas and feel like I could improve some more. After researching and experimenting, my personal advice is to eat whatever foods you feel like in their natural form. This means avoiding anything with added sugar or salt (which I believe trick you into thinking the food is better for you than it really is). I recommend experimenting with removing wheat from your diet for a month to see if you notice any improvements.

Sleep
I try to make sure I get just enough of it.

Happiness
Possibly your mental state is the most important factor in your wellness, so I recommend trying to only do things that make you feel good and avoid things that make you feel bad. Again, I recommend experimenting to see what really makes you feel good and what doesn't. It may not be what you expect. Sleep is probably very important for feeling happy as any parent of small children will tell you...

Monday, October 4, 2010

Test results

Just did another 'full-blown' set of lab tests.

The results are basically the same as those of 7 months ago, which can be considered good news as they show no decline in kidney function.

The general prognosis for Chronic Kidney Disease is a gradual worsening of the condition until dialysis, so avoiding disimprovement can be considered progress.

Here is a summary of the results:
* Serum Creatinine 2.0mg/dL (same as it was when my condition was discovered 18 months ago, and lower than the high of 2.5mg/dL of about a year ago)

* Creatine Clearance is calculated at 41mL/min. This can roughly be interpreted as meaning my kidneys are functioning at 35% of normal, which is asymptomatic. Below ~15%, however, and death (or Dialysis/Transplant) is not far away... (and frankly, provided my children are grown, I think death may be preferable to dialysis or a transplant)

* Protein in 24-hour urine 375mg, about the same as the last test and way down from 1,800mg when my condition was discovered. I understand that this is important as because proteins leaking through the kidneys may damage them further. Normal is less than 225mg.

* Uric Acid 7.6 mg/dL. This should be kept below 7 according to my first nephrologist. Taking Alopurinol controls it pretty easily but I'd prefer to be controling it naturally through diet. Will have to research this a bit.

Next Steps:
* I've been taking Co-enzyme Q10 for 3 months and this doesn't seem to have had any effect so I'll stop that.

* I'll probably continue taking a half a teaspoon of bicarbonate of soda every day. I'm not sure if it's helping but it doesn't seem to be doing any harm and it's cheap and easy to take.

* I think I need to work harder with my diet. I have a little more body fat than I'd like yet I'm often hungry, which suggests I'm not eating the nutrients my body requires, however I'm not sure what I should be eating (and it's frustrating not being able to eat many of the things I crave because of protein/salt/gluten restrictions).

* I'm tempted to dedicate 15-30 minutes every day to "mental programming" activities for a month to see if it helps.

Friday, September 17, 2010

Sonic Healing

Apparently listening to this "harmonic overtone" style of singing can help your kidneys regenerate and generally help you to be healthy:

http://www.sonic-healing.com/store/index.php?act=viewProd&productId=61

The program can be downloaded but costs $99 USD. If they offered a money back guarantee I might try it!