An interesting video suggesting a plant-based diet may be beneficial in the treatment of kidney disease:

http://nutritionfacts.org/video/treating-chronic-kidney-disease-with-food/?utm_content=bufferc8bce&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer

I have had a basically vegetarian diet since childhood and unfortunately it didn't stop me developing kidney disease but it may well be a factor in maintaining a steady level of kidney function loss since diagnosis 7 years ago.

Acid load damages kidneys?

The following video explains how animal proteins increase acid load compared to plant proteins and this seems to be damaging to kidneys. Interesting. The message, as always, is "eat more fruit and vegetables"!

http://nutritionfacts.org/video/protein-source-an-acid-test-for-kidney-function/

Test results 2016

About 15 months have zoomed by since my last lab tests and so I was delighted to find no significant change in today's test results. My blood creatinine level remains at 2.0mg/dl, which is right where it was when I was first diagnosed with chronic kidney disease almost seven years ago. Kidney disease tends to progress so I consider avoiding progression an achievement!

You can view 7 years of my test results, from initial diagnosis to present, here.

I can't say if my attempt to live a healthy lifestyle has been a factor in avoiding progression of the disease but it probably doesn't hurt (and has other benefits), so here's what I do:

Diet

• Relatively low protein (protein is believed to damage kidney nephrons). In my particular case this means no meat; fish about once or twice a months; eggs once or twice a week; dairy a few times a week; tofu a couple of times a month; rice and beans quite often, etc.
• Very little sugar or salt (my theory is that these encourage unhealthy eating by making undesirable foods seem tempting).
• Very little wheat. Around the time of my diagnosis with kidney disease I would often have large, hard, balls of gas in my intestines (these were visible on an ultrasound but the doctor I saw at the time couldn't think of any reason for them so just told me to chill out more). Avoiding wheat and/or too many simple carbohydrates seems to keep the problem at bay.
• Light breakfast: Bananas and almonds usually.
• Snacks of fruit and nuts (especially pure cacao).
• Filling lunch (dinner): Usually a small amount of protein, some carbs, vegetables and salad. Avocado and beetroot feature quite often.
• Light supper: Sometimes amaranth and yogurt, sometimes humus and carrots, sometimes an apple.

Exercise

I still don't do as much exercise as I think I should but probably more than most people as I cycle about 40 minutes a day and generally try to go out of my way to be active (despite having a desk job). I manage to maintain a reasonably slim physique but could probably lose a couple of pounds around the waist...

Sleep

I don't sleep as well or as much as I would like to but do get close to at least 7 hours of sleep a night.

Meditation

Have tried and failed several times to incorporate some form of meditation into my day as many people seem to enjoy great benefits from this. New habits are hard to form!

Blood test results 2014

After over a year with no tests, I decided to subject myself to the needle again and have my blood analyzed.

The good news: no change

The tests show no signs of kidney function degradation. Serum creatinine is 2.0mg/dL, exactly what it was when I was diagnosed with Chronic Kidney Disease over five years ago. All other parameters are pretty consistent with the results obtained over the last five years and are within, or close to, the normal healthy range.

This either means that:
a) My hard work watching my diet and trying to live a healthy life is paying off and protecting my kidneys from further damage, or,
b) None of my lifestyle changes have made any difference whatsoever!

Truthfully I don't know which statement is correct but there are other benefits to being healthy and I'm convinced that in the long run it will help me extend my life. In any case my dietary choices are more about moderation and avoidance rather than total exclusion... though I haven't had any pizza in a really, really, really long time...

View lab results (5 year history)

GFR: Glomerular Filtration Rate

Kidney function is measured by their GFR, basically how much filtering power they have. Normal is over 90mls/min/1.73m2 and "failure" (inability to filter sufficient toxins from the blood) is 15mls/min/1.73m2.

Previously I've a few creatinine clearance tests to estimate my GFR. These tests require collecting ones urine over a 24 hour period so the lab can measure how much creatinine has been filtered from the blood, compared to the level remaining in the blood, and use this to estimate the GFR. Unfortunately it's apparently not all that accurate and my own lab tests have shown a lot of variance: as high as 52.5 and as low as 30.0, which frankly is a bit an emotional roller coaster ride. Given the questionable utility of the results and the inconvenience and cost of the process, I decided to give it a miss.

This interesting article suggests that estimates based on serum creatinine levels adjusted for body weight, etc. have proved to be more accurate than creatinine clearance tests and I believe it given the that my serum creatinine level has been fairly constant: 1.8mg/dL to 2.4mg/dL. Variations in the serum creatinine level are probably due to variations in protein intake. Unfortunately they say the estimation formulas may not work well in cases where the subject differs significantly from the population used to develop them, giving the example of a vegetarian diet. I don't eat any meat or chicken but I do it fish and eggs, so hopefully the formulas will be somewhat accurate.

In my case the MDRD calculator gives a worst case estimate of GFR of 30mls/min/1.73m2, which is consistent with the creatinine clearance tests.

Apparently GFR tends to decrease by around 1mls/min/1.73m2 every year. If this happened to me it would imply that I have around 15 years of  healthy life left before reaching kidney failure (15mls/min/1.73m2). Hopefully I can beat the "average" and extend my mileage by looking after my body.

Lifestyle

As a reference, my current lifestyle, which may or may not be optimal, is as follows:

Exercise:

• Sedentary office job 8 to 10 hours a day. I try to get up and move around during the day however to avoid sitting for long periods.
• Cycle everywhere. About 40 minutes a day.
• Occasional moderate exercise (body weight exercises, swimming, etc.). I should probably do more of this.

Diet:
No meat or chicken. Occasional fish and eggs. No gluten (I feel I may have sensitivity to gluten, though I'm not 100% sure). Very limited consumption of products with added sugar and salt. Limited starch, mostly rice and potatoes. Lots of nuts (almonds, pecans, cacao), fruits and vegetables.

Sleep: Try to get enough sleep so I wake naturally shortly after dawn. For me this is around 8 hours.

Medications

I've been taking 50mg/dL of Losartan (Cozaar), an ARB, fairly steadly since diagnosis of CKD. This was initially prescribed to reduce my blood pressure. A month ago I fasted for a day as a kind of  "body reset" and found that my blood pressure dropped to around 100/60 so I stopped taking the medication. Since then I have been checking every day and my blood pressure has remained below 120/70 even without medication (or further fasting). I will probably start taking the medicine again at some point, as the experts seem to think that it is beneficial to conserving kidney function for reasons other than blood pressure reduction.

Living with Reduced Kidney Function

Just wanted to share this "Living with Reduced Kidney Function" guide I came across from Australia as I think it has very useful information for anyone dealing with chronic kidney disease. The focus of the guide is the practical steps patients can take to conserve their kidney function and slow down or halt degradation.

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.

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!