Kidney News website allkidney.com

Dr. Roger Smith MBBS, DM., the Webmaster of All kidney News, says:

"We provide new on topics such as chronic kidney disease, kidney stones and dialysis. All articles are evidence based and written for patients."

New Nephrologist

I went to see a new nephrologist (kidney expert). Although I didn't get any big insights from the visit, his advice seemed more in line with my own research than the previous nephrologist so it was good to confirm this.

A quick summary of what the nephrologist said:

• At my stage of kidney disease (aproximately 30% kidney function), maintaining function is considered an advance as the tendency is for function to reduce.

• Kidney function is maintained through three main levers:

1. Diet: low salt and protein, to avoid stressing the kidneys.
2. Blood pressure.
3. Can't remember the third thing... (pathetic, I know!)
   

• That in the majority of cases it was possible to maintain, or even improve kidney function of people at my stage.

• That Cozaar (losartan) is considered a kidney protector drug, so even if it doesn't lower blood pressure it is worth taking.

• That my blood test results indicate that I should be eating more protein.

• That the main thing to avoid is salt. Protein-rich foods like milk, eggs, meat, seafood, nuts, beans, and anything else can (and should) be eaten in moderation provided they contain no salt. The previous nephrologist had banned these items.

• That ketosteril (the amino acid supplement I'm taking) is very beneficial to the kidneys but is very expensive (tell me about it!).

• That it was very difficult to tell what caused the kidney problem.
  

The doctor ordered another 24 urine test (fun, fun, fun...) and prescribed a special vitamin supplement: Autrin

Reversal of Proteinuric Renal Disease

I have come across a few articles which claim that proteinuric renal disease (which is what I have) can be halted, and the effects reversed, by taking certain ACE inhibitors or ARBs. These medicines are usually taken to control high blood pressure but are apparently independently beneficial to the kidneys:
http://cme.medscape.com/viewarticle/577765%3Bmeddomainjsession=K8ttKyDhrwqY34pBFmp75zL6x32cy0K682fSZnnh23NZqTTpZQyw!224157304

I was taking Cozaar (losartan), an ARB for around 3 months and saw no improvement in kidney function, at least not in my creatinine levels. Maybe one of the other drugs would be beneficial? Time to try and see a nephrologist again (there are only two in my area. The one I've seen didn't inspire confidence, and the other is always out of town).

Test results

Did another creatinine test today. Result about the same as always: 2.3 mg/dL (this should be about 1.5 mg/dL with perfectly functioning kidneys).

The fact that my creatinine levels have effectively remained unchanged despite all my "healthy" lifestyle changes, tells me either one of two things:

1. The healthy lifestyle, although undoubtedly improving my general health and lowering my blood pressure, has done nothing (so far) for my kidneys.
-or-
2. My kidneys are permanently damaged but thanks to my healthy lifestyle they are not worsening.

I'm planning to do another ultrasound in about a month which may shed some light on what's going on. I'm hoping it will show that the kidneys are no longer inflammed, just scarred, and this is the reason for their sub-optimal (though perfectly adequate) performance.

If the ultrasound shows no change I guess I'll get a biopsy to see if they can give me any more useful information... hopefully something like "don't worry we don't expect any progression, feel free to eat pizza again..."!

Juice recipes

This is just to quickly share what has worked for me in the juicing department:

Watermelon Juice
Lots of sources talk about watermelon to solve kidney problems. I think this is because they have a diuretic effect and therefore clense the kidneys. I've been consuming about a watermelon a week for about 5 months now and can't say I've seen any particular benefit but you never know...

The fastest way I've discovered to consume watermelon is:

• Fill a blender with slices of watermelon (seeds and all)
• Blend
• Strain and serve

Carrot Juice Combinations
The best tasting carrot juice combinations I've discovered are:

• Carrot Juice and Lime (about 1 lime per big glass)
• 70% Carrot, 30% Beetroot, Lime
• 50% Carrot, 50% Pineapple

Gluten

For some reason I discovered that some people recommend gluten-free diets for autistic people. This sparked my interest both because of my apparent sensitivity to wheat and its possible relation to my kidney problems, and the fact that (coincidentally or not) my personality has autistic tendencies.

http://www.autismweb.com/diet.htm

What I found extremely interesting is that they claim that gluten, a protein, can have an opiate effect on the brain, giving rise to the desire to eat more gluten. Ever since first trying to stop eating wheat a few months ago I have consistently lapsed as the desire to eat wheat was so strong. Currently I have been basically wheat-free for around two months, with the great result that my intestinal gas problem has disappeard, yet I still find myself attracted to odd bites of wheat products (even though I think it's bad for me and may even raise my blood pressure).

Searching, I discovered a lot of cases where gluten-free diet has apparently solved kidney problems (including those with proteinuria). I can't believe I didn't specifically look for this before, or that I didn't read anything about it in my regular kidney research:

http://books.google.com.mx/books?id=w9rGR_rZ__AC&lpg=PA76&ots=uJi7jbE3WR&hl=en&pg=PA76

http://www.ncbi.nlm.nih.gov/pubmed/428155
http://cat.inist.fr/?aModele=afficheN&cpsidt=3046136
http://ndtplus.oxfordjournals.org/cgi/content/extract/2/2/161

So it's settled, I'm going to have to overcome my addiction and try a strict wheat-free diet for six months and see if it has any impact.

Test results

Did another mini-blood test to see how things are going. I was especially curious as my blood pressure has been fairly low lately (without medication) and so I thought (hoped) that might things were improving in the kidney department.

Unfortunately it was not the case and curiously the results came back with EXACTLY the same numbers as 6 weeks ago:

Serum Creatinine 2.4 mg/dL > (normal: 0.8 - 1.5 mg/dL)

Blood Urea Nitrogen 11 mg/dL (normal: 9 -20 mg/dL)

Although it's disappointing not to see ANY improvement after so many lifestyle changes (diet and less work hours), I have to admit that I do feel much healthier for them and so should feel grateful rather than cheated... on other hand, maybe it means that indulging in some of the pizza I crave from time to time isn't going to make anything worse!