Calling all Vegans on Dialysis!
From time to time, I get messages from people on dialysis who want to know more about how to eat vegan while on dialysis. I send them to this short page of resources (link). But, I have never had any sort of ongoing communication with a vegan on dialysis.
I thought it could be helpful to start a page on this blog where vegans on dialysis can post about their experience and any hints they have. So if you are out there, please let us know how you’re doing and what you have learned.
Thank you!
August 24th, 2011 at 11:00 am
Thanks for starting this page. Any dialysis patients out there? Those who do not need to lose weight.
1. How do you get enough protein? As you know protein is VERY important because you lose protein during dialysis treatments. Cutting out your meats wipes out the good protein intake.
2. Soy is high in phosphorus and potassium. Your binders may help control some of the phosphorus but all the beans and nuts are suppose to be avoided in the diet. You cannot have too much potassium. That could bring on sudden death of stopping your heart. A lot of the fruits and vegetables are very high in potassium.
Very hard to be a dialysis vegan:
Need Protein
Limit Whole Grains
Limit Phosphorus
Limit Potassium
Avoid Salt
Limit Fluids
August 24th, 2011 at 9:01 pm
I had been happily learning and eating a vegan diet for just under a year when my kidneys completely failed (not due to the diet but to long-term chronic health issues), and I was catapulted into the dialysis world a year ago this month.
Out of many culture shocks one of the biggest was the diet. I’d already been on a “renal diet” which is quite different from a dialysis diet. In fact it’s one of my pet peeves on this year long journey that so often I’m referred to a renal diet, or as when I spent some time in a hospital and was put on a “renal diet.” Many of the foods were not good for me, and they wouldn’t allow me to have others that would have been fine. A dialysis diet is NOT the same as a renal diet.
Once on dialysis, I was amazed that dieticians had become a big part of my healthcare team when they never had been in my 63 years for any other health problem. The diet was strongly emphasized, with dire predictions if not followed. At the same time it was very confusing. I was given different handouts by various dietician which often contradicted one another. At first it seemed they wanted to make me anorexic: “eat nothing!”
Since I’d already been eating vegan, certain parts of the diet were not difficult, such as avoiding dairy (because of the phosphorous). But other parts were shocking, such as avoiding dark green leafy vegies (my favorite!) and quinoa which I’d just learned to love and use in many ways… very high in protein, but also alas! in potassium.
No (or little) whole grains, no (or very little) pulses, no potatoes, no avocados… the verboten seemed endless.
I found a vegan protein powder made by WF. It’s soy-based which some say is problematic, but I can’t otherwise see how to get the amount of protein that’s recommended. I eat it every day, but I have also started adding back some animal proteins.
Another problem I have (which I’ve heard is common in dialysis patients) is a weak appetite. For me I think it’s partly due to having such a limited diet. So that makes it even more difficult to get enough protein. So now I eat eggs and chicken and a little fish. Always organic and free-range and wild but still….
I call the dialysis diet the Perverse Diet. Everything you learned and struggled to change about diet for forty years is now reversed. No whole grains, no leafy greens, not too much fluid, no pulses for vegetable protein, no or low salt.
That’s where I am today. In the city where I live there are some fantastic vegan chefs. Lately I’ve been thinking about challenging them to come up with some dialysis menus.
August 25th, 2011 at 8:44 am
Riding in the same boat as you.
They do seem to have eased up on the potatoe issue. If you cut them up in little cubes and soak them in water overnight (changing the water a few times) they say that takes a lot of the potasium out.
Did you find your protein levels were low because of the vegan diet and therfore had to put the chicken, fish and eggs back in the diet?
Did you ever eat the veggie dogs and burgers? Most you buy at the store do not list potassium content and they say the soy based products do have a lot of potassium so it is scary eating these products with soy not knowing if you are overloading on potassium.
This is new to me. Been a vegan for a week. Always have good labs so very nervous about the next round of bloodwork due to yanking out all the meats and dairy. I can say it was a very nice surprise to find the rice milk taste good.
August 26th, 2011 at 6:47 am
Nice to meet you, Beverly. Glad there’s plenty of room in this boat!
I heard about the “dialyzing high-potassium vegies” early on. Since it’s a bit of trouble, for a long time I simply avoided them. But I often had a craving for potatoes. A couple weeks ago I finally followed the “soak, rinse, soak, rinse, cook in lots of water” method and cooked enough potatoes to make some mashed and a small potato salad. It was disappointing to me because I found they lost a lot of flavor. So I’m over potatoes, though once in a while the whiff of a nice baked potato comes out of nowhere, lol.
My protein levels were not low, and I’ve managed to keep them within good range. Before dialysis, I made sure to get adequate protein on my vegan diet with pulses and quinoa, foods I can’t eat as much now because of the potassium levels. That’s why I felt the need to add back some animal protein… where else can I get enough protein.. the amazing quantities we need to get?
Like I said before I feel the need for vegan chefs/dieticians to help us figure this out. I haven’t been able to find the protein in the amounts needed so that’s what I did. Don’t worry if your levels go down at first, you can always bring them back up.
Thanks for communicating. I hope there’s more of us out here.
August 26th, 2011 at 6:51 am
P.S.
Forgot to say that I’ve never much eaten the veggie fake-meats. You have to be careful as a vegan…. many of them have cheese in them. And they’re often very high in sodium too. I ate a lot of tofu and tempeh as ‘meat substitutes’ as well as beans and quinoa. But now have to watch out for the potassium and phosphorous in those, so don’t eat as much.
August 26th, 2011 at 8:41 am
> many of them have cheese in them.
Gardenburgers that are served in restaurants often (or usually?) have cheese in them, but most fake meats do not contain cheese. Quite a few contain eggs, but avoiding them is as easy as reading the labels. Unfortunately, they are normally quite high in sodium. I would think that you could dailyze some of the sodium out of them, though. But there would still be phosphorus and possibly potassium.
What about phosphorus binders? It might be that vegans on dialysis need to rely more on phosphorus binders, though you should have a doctor’s supervision. Here is some info on phosphate binders: http://bit.ly/qlveaU
August 26th, 2011 at 9:00 am
Hi, I hope, I can give some answers. First of all – sorry about my silly English 😉
I’m 39 Year old, male, and make dialysis since January 2006. I make Peritonealdialyses (PD), witch is basically different from the conventional Haemodialysis (HD). I use a cycler (CCPD) at night at home. My therapy volume are 21l per night. My last Kt/V = 2.3!
I’m vegan since end of 2009, before that – with a smooth transition – I eat mostly vegetarian.
I have a short time job and I make lot of sport (~1x per week aerobic, ~1x per week running (up to half marathon), stair climbing (next competition next week 😉 and ~1x per week pilates).
So, what’s about protein? The target value is in border range (last serum values: urea=130 mg/dl, crea=16 mg/dl, albumin=3,5 g/dl)
I eat plenty of soy product like tofu, soy drink, dimpling etc. but also pasta and wholemeal products (blood glucose = 72 mg/dk)
Phosphorus is a great problem. I avoid nuts, chocolate, cakes, sweet or salty pastries, soda pop and alcohol. I have 3 different phosphorus binder. My laboratory values: 1.8-2.0 mmol/l
My potassium is OK (5,9 mmol/l), but on PD hyperpotassemia is not relevant.
Salt is also on PD not very relevant (139 mmol/l)
The great vantage of the PD is to preserve diuresis, so I have not have to limit fluids.
These values are very individual! This is definitely not representative, but I hope, I can motivate some concerned people.
In conclusion: I think it is not difficult for dialysis patients (esp. PD) to life vegan. My personal most problems I have with drugs, because lots of them contains gelatin.
Please ask, if you have more questions.
August 26th, 2011 at 11:38 am
Guido said – In conclusion: I think it is not difficult for dialysis patients (esp. PD) to life vegan.
It is for a hemodialysis patient. The sodium build up will cause high blood pressure, water retention which in turn makes leg swelling, shortness of breath. Many dialysis patients no longer urinate so all what goes in does not come out. It stores up and if for some reason you miss your next dialysis appointment you can be in serious trouble. The potassium build up could cause problems with the way your heart beats.
Jack Norris said – What about phosphorus binders? Yes, those do help. To me, the phosphorus is the least to worry about. You can control the phos. with knowing what foods to not eat and taking binders with your meals. The good thing about the binders is it will as they are called bind the phosphorus and you will be able to get rid of some of the phos. when you go to the bathroom (#2) Unlike, the buildup of sodium and potassium which is rid by urinating and if you no longer go #1 then there is no way to rid your body of it other than dialysis. A lot of the fruits and vegetables are high in potassium so taking a lot of things out of the diet really does make it hard. Sometimes, it seems there is nothing to eat.
As mentioned in my earlier post, I am a brand new vegan so throwing out the meat and treats is a hard transition. I am still finding all the vegan products but the high potassium content in soy based products concerns me very much. It is a guessing game because most nutrician facts listed on the products do not show the potassium content. Does anyone know which brands/products of soy based products are not so high in potassium?
I have not tried tofu or tempeh. What does it taste like? How much do you eat?
What the heck do you do with it? I see it at the store and looks like a slab of glue. I saw some that said firm.???
August 26th, 2011 at 11:49 am
Beverly,
Have you check out this link yet? http://www.jrnjournal.org/article/S1051-2276%2808%2900050-2/fulltext
It was listed on this page: http://veganhealth.org/articles/kidney
In my experience, some of the companies keep this info on hand and will share it with you if you write them.
> I have not tried tofu or tempeh.
You can Google it and find a plethora of info.
August 26th, 2011 at 12:08 pm
Hi Jack,
Thank you very much for the link showing the nutrition facts. That is exactly what I was looking for. I did find the second link a few days ago. I have been googling like crazy. That’s how I found you 🙂
August 26th, 2011 at 2:08 pm
@Beverly,
sodium and phosphate are too much in vegan patties and some dimplings. If you eat self cooked tofu or soy based products you do not eat to much phosphorus.
I looked into my nutrition index: 100g tofu contains 110 mg phosphate, 100g hard cheese have 600 mg phosphate and a steak (100g) contains 180 mg phosphate.
So I do not belief, that “pure” soy products are more bad than milk products or meat. But stay away from convenience foot, junk foot, foot with food additive or any kind of powder stuff – so it is also very easy to reduce sodium.
There are tons of very delicious recipes in the web for cooking tofu. 🙂
Your can considerably reduce high blood pressure and water retention with doing sport! Particularly running, aerobic, pilates, yoga … (also with HD)
It is not difficult to reduce sodium (also with HD), if you only eat so much salt, how the body really need. Typically we use to much salt in our food.
Only the potassium is a real problem for HD. But watering fresh vegetables and fruits reduce the potassium. You have to deal with potassium in every case, also if you feed vegetarian or omnivore. So it make no difference, if you are vegan. My nutrition index say about potassium: 100g tufo = 42 mg potassium, 100 fresh apple = 144 mg and 100g fresh boiled peeled potatoes = 341 mg potassium! So I think there is nothing to concern about soy based products.
It is important to discuss the vegan diet with the doctor! It is possible, that he is disapprove the diet. Say it with blood test results or chance the doc!
August 27th, 2011 at 5:53 pm
Hi Guido,
Is the nutrituion index you are looking at available on the internet?
August 28th, 2011 at 3:53 am
Yes, but it is in German: http://trainingstagebuch.org/nutrients/show/1073
August 28th, 2011 at 11:06 pm
Thank you. I used this page to translate it to english
http://babelfish.yahoo.com/
August 30th, 2011 at 7:49 am
Can someone give a list of snacks you eat that isn’t a piece of fruit?
August 30th, 2011 at 5:05 pm
Take a look in a health food store/wholefood shop. They have much kind of vegan cakes and cookies made of oat, spelt or quinoa. There you can find soy based yogurt or candy bars too.
Sometimes i like to eat this things, but I don’t have to forget the phosphorus binder.
August 30th, 2011 at 6:06 pm
Beverly, DaVita is the website on which I’ve found the most helpful information, although sometimes we still have to sort out what is “renal diet” from “pd diet’ from “dialysis diet.” This page has been particularly helpful to me:
http://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/potassium,-phosphorus-and-the-dialysis-diet/e/5309
And though of course we have to spend time learning the basics of the chemistry of it all, the truth is I eat food not its parts…. I mean, I eat certain vegies and fruits, snacks and protein foods, not potassium and phosphorous!
So I tend to do as it shows here and simply avoid the really high (in phos & potass), & especially the “double jeopardy” foods.
I don’t know how it is where you live… in our town there are many choices in the health food stores and even the “health food sections” of regular grocery stores. For snacks that are not fruit (which I do eat– berries and cherries and apples), I get chips made from veggies (a brand called Terra makes really good beet and sweet potato ones that I like a lot– with no salt). No-salt blue corn chips, rice cakes, other crackers or chips (just checking the sodium mainly). There’s a brand- not sure how far it’s sold– called Tofutti which offers outstanding cream cheese (called “Better than Cream Cheese) and sour cream (called Supreme Cream) alternatives. So I use those for spreads or dips for chips, crackers or vegies.
I have posted on my fridge a list of the best veggies and fruits we *can* eat fairyl freely.
Oh, if you want sweet, I find soy ice cream really good. Especially vanilla with berries on top. ;-D
Protein is still the problem. Getting enough, that is, on a vegan diet. I’m told I need 80g per day. That is a huge amount, and I don’t even have that kind of appetite! Does anyone have any suggestions about that?
Hi Guido, thanks for sharing so much information. From what I understand it’s not PD per se that protects from having to worry about phosphorous, it’s the longer time dialyzing. For instance, those who hemodialyze for 8 hours nocturnally also have more leeway with diet. I tried nocturnal for a month but could never adjust to sleeping in the center so I became sleep-deprived and a little crazy 🙂 Now I’m back to days but I run for 5 hours instead of 4 which also helps. I have excellent clearance and labs, but I do work at it. I prefer to run in center because I like to keep dialysis apart from my regular life. It feels more freeing to me. Personal choice.
August 31st, 2011 at 11:37 pm
Hi Peggie,
Thanks for all the brand names and ideas. That will help in my search. You mentioned the soy ice cream. What brand is it? I would like to try some.
I think I saw the brand Tofutti at the grocery store today but I don’t remember what the item was. I will check it out the next time I go. I got some cheese slices called Rice Vegan made by Galaxy Foods. I also got some Smart Bacon by Lightlife. They are described as bacon style strips (veggie protein strips). I am anxious to know what it taste like.
Guido said: They have much kind of vegan cakes and cookies made of oat, spelt or quinoa. There you can find soy based yogurt or candy bars too.
Do you know of any soy based yogurt or candy bars that we could eat.? What they are called and the brand name? I always want something sweet after I eat. Candy sure does sound good. I am trying to cut out all my sugars too.
By the way, I live in Texas
September 2nd, 2011 at 9:38 am
I just found the tofutti website http://www.tofutti.com/
I thought I hit the jackpot but was disappointed to see a lot of the products are made with hydrogenated oils and sugar. I am trying to cut both of these out of my diet. The hydrogenated oils are what sticks to the arteries. 🙁
September 19th, 2011 at 5:04 am
I am so glad to have found this blog & I will refer to it often. Reading what many of you had to say really answered a lot of my questions about being a vegan & on dialysis. Two years ago, my oldest son tried to get me to become a vegan. I told him about the restrictions of the minerals but he didn’t want to hear it. At the same time, he contracted cancer & thought that being a “vegan” would cure him. I knew that being a vegan would be a contradiction to a dialysis diet. However, he lost his battle to cancer. I wish that he was alive to read the messages that I read today. I also wish that he was alive so I could physically love him. I shall return to read what people have to say. Thanks for being here.
September 19th, 2011 at 11:18 am
Hi Brenda,
So sorry to hear about your son. May good memories keep you strong.
Being doing the vegan/dialysis thing for a month now. First blood work comes back at the end of the week so I will know if I should continue or not. I’m sure I will but may have to tweak a few things.
I’m not doing 100% vegan due to the worry of not getting enough protein so I do sneak in some chicken breast. I don’t think I can go back to eating hamburgers and all the bad stuff after doing this for a month. Animal proteins and trans fats scare me now.
Feeling good 🙂
Beverly
October 5th, 2011 at 1:45 pm
New article:
Plant-based diets in kidney disease management
by Joan B. Hogan, RD, CSR, CD, CLT
Dialysis & Transplantation
Volume 40, Issue 9, pages 407–409, September 2011
http://onlinelibrary.wiley.com/doi/10.1002/dat.20594/abstract
Full article available by clicking “Get PDF” in the right sidebar under Article Tools.
I didn’t think it it provided anything new, but if you read it and find it worthwhile, let me know and I can add it to the links on this page:
http://veganhealth.org/articles/kidney
March 30th, 2012 at 10:24 am
I just found this blog and find it very interesting. As a renal dietitian and one that promotes plant based eating in my patients I am always interested in the experience vegetarian patients are having on dialysis. One suggestion I would have for those of you struggling with potassium control. If your potassium is climbing try backing off a little on some of your high potassium foods and then try gradually reintroducing them,
slowingslowly of course, maybe around the time of the month labs are drawn. As one’s kidneys fail the digestive track can get more efficient at taking over in removing K+ however the adaptation may happen slowly. I am not saying this will always be a fix, but might be worth trying. Also once you achieve good potassium levels and good intake try to avoid big variations in your potassium intake. Keep consistent. If you need more protein from lower P0 and K+ sources try seitan. For a protein powder try rice powder. I recommend not taking in too much soy protein powders (over 20 g per day). Thank you Jack for starting this blog. I am also taking an informal survey on potassium and P04 intake of vegans and vegetarians. If anyone is interested in keeping a weeks worth of food records for me and what their labs are running please feel free to email me at vegitrd@gmail.com. Joan Hogan, author: The Vegetarian Diet for Kidney Disease.March 30th, 2012 at 4:12 pm
Joan,
As possibly the world’s expert on vegetarian diets and dialysis, thanks a lot for piping in!
March 31st, 2012 at 12:04 am
Joan said “If your potassium is climbing try backing off a little on some of your high potassium foods and then try gradually reintroducing them, slowing of course, maybe around the time of the month labs are drawn. As one’s kidneys fail the digestive track can get more efficient at taking over in removing K+ however the adaptation may happen slowly.”
I don’t think this is good advice for dialysis patients. Many no longer pee therefore the potassium can build up fast. You don’t play around with potassium and it is best to play it safe and go by the rules of avoiding high potassium foods. To suggest making adjustments around monthly labs is just playing a trick. The other 3 weeks of the month can get you in serious trouble if your potassium gets high.
Just my 2 cents…..
March 31st, 2012 at 8:33 am
Beverly,
The potential typo that I pointed out in Joan’s post changes the meaning of her sentence quite a bit. I think she meant to say to slowly add potassium foods close to the time of your labs so that you will be able to immediately see if adding the foods is a problem. Her typo made it seem like she was saying the opposite.
April 3rd, 2012 at 3:22 pm
Jack yes my I meant “slowly.” Sorry about that. With regard to Beverly’s comments, having worked with dialysis patients for 30 years, each situation needs to be looked at individually. I really try to work work with my patients and find what we can safely add. I do not like to generalize “no beans” “no nuts”. Just like a dialysis treatment varies for each person in how much dialysis they need, pump speed, dialyzer to remove urea, length of dialsyis, so too needs and tolerances for K+ can vary as well. So if you are vegetarian and your potassium is dangerously high your dietitian should review your diet in detail with you, what you are eating and what you need to back off on. I will make suggestions on what I think is the cause and recommend avoiding certain foods and then wait and see a repeat K+ to make sure the K+ is coming back down(sometimes K+ can be up for non diet reasons) once we remove what we think is the problem. If after the K+ is normalized the patient is desiring some plant based options that were omitted I would add some again in smaller amounts, usually close to lab time so I get an immediate result. I never find this to be a problem. Then my patient knows what they can eat safely. I just feel a lot of healthy plant based foods are often totally eliminated unnecessarily and could often have been added back in in moderation. The key ideally is to work with your physician and dietitian. But I know most of my independent dialysis patient do their own thing. And so I like to make the above suggestions to those that do. I will also add, that very seldom do I see beans or nuts the cause of dangerously high potassium. In my 30 years of working with dialysis patient most almost all of my dangerously high K+ are due to watermelon, taro root or excess juice. Occasionally I have had dangerously high levels due to an unusual herb. Sometimes patients that eat a lot of meat and in addition eat beans will have higher levels. That is not to say I do not see high K+ due to beans and nuts, but not dangerously high and with some education from a well informed dietitian they can be educated accordingly in portion sizes, types of beans, etc. and re-introduce. I really support patients who are trying to eat healthy on dialysis. A lot of information for dialysis patients is promoting unhealthy food – meat, white rice, white bread, sweets, refined cereals etc. I like to help my patients eat as healthy as possible and include plant based proteins where ever possible. Hope this helps.
April 3rd, 2012 at 8:26 pm
i just proof read sorry for my typos. I am “writing on the fly”
March 26th, 2014 at 7:00 am
Hi
Thank you everyone for your input it really is a great
support
I’ve been doing dialysis for 10 years now. And I have been a vegan for the whole time. At first I had issues with potassium and phosphate but now there are certain foods I don’t eat banana’s and other foods like mango avocado etc I only eat a small piece. I’m off my binders as the doctor said I didn’t need it. I believe the vegan diet allows you to be more Health and energetic than going back to meat. Especially as kidneys are impaired the less stress by having too much protein is better for them. Dark leafy greens quinoa is great and you don’t have to have a huge amount. On dialysis days I take with me a juice made from 300g Kale (your top veg for protein) 3 apples ginger and lime. This has improved my blood work tremendously. I drink about 330ml only on those days. By juicing my body is getting the nutrients to my bloodstream quickly.
I hope this is helpful
April 20th, 2014 at 5:28 pm
Hi, I am in stage 3 CKD and am vegan. I am having trouble figuring out what are the best foods to eat for protein and meals in general trying to follow the renal diet. As of now I do eat beans and nuts mainly for protein which are high in potassium and phosphate. If anyone can give some advice about what you might have eaten prior to dialysis I would really appreciate it!
May 20th, 2014 at 11:27 am
Beans and nuts may be a good source of protein for those on dialysis if their potassium isn’t high. Athough these foods are typically high in phosphate, the organic form of phosphate from plants may be less absorbed int he GI (30%-50%) compared to animal sources of organic phosphate (40-60%) or inorganic phosphates found in prepared foods or colas (100% absorption).
http://www.ncbi.nlm.nih.gov/pubmed/20404416
September 3rd, 2014 at 3:31 pm
Laura: If your potassium is running in the normal range, I would not worry about restricting your potassium. Potassium only needs restricting in later Stage 4 and Stage 5 for most people. Dried cooked beans and organic soy products, non processed soy products are best. Using whole grains like quinoa and amaranth can also be a moderately good source of protein. Usually stage 3 we recommend .8 g/kg body weight. Of course plant protein is not as hard on the kidneys as animal protein so if your intake is slightly higher than that with plant sources you should be fine. Continue to keep a variety of vegetables in your diet. Joan Hogan, RD, CSR, CD
October 21st, 2014 at 7:01 pm
I was diagnosed stage 3 kidney disease in 2013. I am struggling with my diet. I think chicken taste like what a wet cat or a smelly wet dog smells like. beef tastes like liver. so I’m going to become a veg. I only get 1/2 cup of beans per week. I love beans. I get only 1 egg a day. I get 1 Table spoon of salt free nut butter a day. I started making my own bread with only 1/16 teaspoon of salt. I can only have 800 mg of sodium a day. I don”t like rice. So I’ve been eating all the wrong foods. I’m rebelling. So then I take water pills, which I’m not suppose to take. I don’t like the feeling of puffiness all over my body. Im 67 yrs old. I will see my dietician in November. I know I will change my attitude one day. if you have any suggestions, please help me. ty very much.
October 22nd, 2014 at 9:30 am
Hi Carol: There is no reason why you cannot follow a vegan diet. Especially because you are Stage 3, potassium usualy does not need to be restricted, Phosphorus will need to be restricted but only from dairy and processed foods such as dark colas and other foods and beverages that have phosphate additives. Whole grains, dried cooked beans and nuts do not need to be restricted much at all. Hopefully your dietitian is knowledgable on plant based diet and kidney disease and can help you plan a protein level with these foods. If you see a deititian that tells you you can only have white bread and white rice and no whole grains or dried cooked beans, find a new dietitian, for they are not up to date on renal nutrition and plant based eating. A vegan diet can help delay kidney function decline. I encourage my patient with your level of kidney function to swap out their meats and other animal proteins for more whole grains, dried cooked beans and unprocessed, organic soy products. Sodium will also need to be modified but 800 mg is a little low, we usually say 1500-2000 mg, and the biggest source of sodium comes from processed foods, dressings, canned soups and sauces. Again your dietitian should be able to help give you ideas in this area. You may find my book helpful as well. The Vegetarian Diet for Kidney Disease Treatment. The American Academy of Nutrition and Dietetics also has some information as well. You will have to do a search on their website. Do not refer to the NKF website it is very outdated on it’s diet section related to vegetarians and kidney disease. Keep us posted. Joan Hogan, RD – renal dietitian
October 22nd, 2014 at 10:10 am
Joan,
Thank you so much for taking the time to help out on this page. I really appreciate it!
December 8th, 2014 at 5:22 pm
I have been on home hemodialysis for 32 years. I watched a few too many documentaries and cannot bear the thought of eating meat. It’s been a year and a half. My lab are good but I feel like I’m loosing muscle mass. Looking for a protein supplement low in K and phosphorus.
December 8th, 2014 at 5:46 pm
Hi Barb: There are a number of great vegetarian protein powders. If you are vegetarian you can go with Whey protein powder. If you prefer to go vegan try Rice Protein powder or Pea Protein Powder. I do not recommend Hemp because it is pretty high in potassium. You could use some soy protein powder but I do not recommend more than about 10 g per day. Also if protein is a concern have you tried seitan? It is made from wheat gluten. As long as you do not have an intolerance to gluten it is a great low potassium low Phos way to get in protein. Also make sure you are getting enough calories(energy) Sometime the reason you are losing muscle mass is not the protein but that you are not getting enough calories overall. Your body starts breaking down protein for energy. Good high calorie sources of grains, brown rice, quinoa, barley. In addition healthy oils olive oil, sesame, avocado, coconut oil (not coconut thought high potassium). Hope this helps.
August 26th, 2015 at 12:19 pm
I have been a vegetarian for almost 50 years, a mostly-vegan for more than 30 years (with veganism as my ideal diet, which is much easier to follow when I eat at home all the time), and on peritoneal dialysis (CAPD) for nearly 20 years.
High potassium or high phosphorus levels have never been a problem for me, although I’ve fairly often had low potassium and rarely low phosphorus during the past few years. My diet included tofu until I developed an intolerance to it. Now it includes nut butters (mostly peanut butter), nuts and seeds, soy milk, whole grains, occasionally beans or other legumes, a variety of fruits and vegetables (mostly vegetables) including a moderate amount that are high in potassium, and rarely vegan commercial cheese substitutes and meat substitutes. I have no urine output but have never cared for salty food, so too much fluid is not normally a problem at all. Eating something high in sodium only occasionally doesn’t cause problems. Herbs are a good seasoning to use.
My daily breakfast is a whole grain (whole wheat toast, cashew French toast, banana-nut waffle, etc.) with peanut butter and banana slices, and a cup or more of soy milk. Sometimes I also have oatmeal or leftover brown rice with raisins and/or dates, chopped walnuts, wheat germ, coconut, banana slices, occasionally a little flax meal and/or kelp powder, and a little honey and soy milk. When I don’t have any ripe bananas, I drink orange juice. Keeping chunks of peeled banana in the freezer also works well for having bananas on hand for making the banana-nut waffles.
My albumin levels are 4.0 or more most months, which has been the case most months now that I eat one Brazil nut daily. It took six months to make a difference, but now it seems to keep the level up there nearly every month. I usually met the acceptable range in the past, but now the ideal level is considered to be 4.0.
When I still had urine output, my lab values were never out-of-range, so my nephrologist laughingly said that I was “boring”! It would be nice to be “boring” again. I’m working on it! 🙂
October 15th, 2015 at 11:47 am
I am new at this. The Davita calculator says I am stage 2 CKD. SO far I have learned that I can eat nothing healthy!! I am perplexed I have not been back to the Doc yet bc I know he will say I am fine, my numbers look good. except for this little thing called the GFR and then my potassiim is high within the normal range. The blood test was fasting and after I have lowered my pot, phos and sodium for about 2 weeks. So my test would be worse had I not jumped right on it. THe signs were kidney pain and spasms blood in urine and severe fatigue for a long time but worse that week. I am at a loss. I need a renal dietitian to help me, and a huge miracle.
October 15th, 2015 at 11:16 pm
Hi Glinda,
I think you will get more questions answered if you go to the Davita.com site and look at the forum. You might get a dietitian to answer some of your specific questions.
I wish you the best!
October 18th, 2015 at 7:07 am
I first want to thank Pam for contributing to this blog. As a renal dietitian I can talk, write, speak until I am blue in the face encouraging plant based/vegan diets, but there is nothing better than a patient themself sharing their success with a vegan diet. Pam I am not sure if you can tolerate seitan but that is also an easy way to obtain low phosphorus, low potassium protein. High gluten flours can also be mixed in with garbonzo beans for some fun veggies patties as well. I am also thinking you are an example of how the digestive track takes overs for excreting potassium in kidney disease. Normally 90% of our potassium is excreted through the urine, but with kidney disease we find the gut slowly takes over that role, increasing potassium excretion, especially when there is a consistent level of potassium in the diet.
Glinda, you are not alone in assuming you can only eat animal protein, white, refined grains and minimal fruits and vegetables when you have kidney disease. Unfortunately this misinformation fills the internet and is far from fact. Not only can you eat a high plant based diet or vegan diet but it can and will delay the progression of your kidney disease, and possibly reverse it. For years we thought that whole grains and plant proteins were a danger to anyone with kidney disease and now we know that not to be true. Plant based diets, especially vegan diets decrease acidosis which can progress kidney disease, decrease proteinuria which is common in kidney disease and decrease other hormones responsible for impacting kidney disease progression. Continuing a vegan/vegetarian diet without dairy now will do nothing but help you. Some of the information on the internet is related to Stage IV or greater in which potassium is sometimes a concern but even then you can work in a very nice vegan diet as noted with Pam. More renal dietitians are feeling comfortable with planning these diets and so I do recommend you work with a renal dietitian who knows how to help you. Some still do not feel comfortable working with plant based diets and plant based protein, so if they start telling you cannot eat whole grains, beans, soy, nuts, move on until you find someone who will work with you. I also do phone consultations and face time consultations if you choose. My book the Vegetarian Diet for Kidney Disease may also help you.
Joan Hogan, RD
April 11th, 2016 at 9:46 pm
Glinda,
There is a lot to the dialysis thing. Be very careful what you eat. Watch out for things with a lot of preservatives in them. If for example it has hexaphosphate as a preservative, steer clear of it. It is loaded with phosphorus. If you like to drink iced tea, there are certain brands to avoid, like most Lipton brands for example have phosphorus in them. This is especially true for your powdered teas. With the whole kidney failure thing, you have to be your own advocate.
Learn the procedures for how to connect and disconnect yourself. Learn what is supposed to be done. Learn what your dosages are and watch what they inject in your blood while on the machine (hemo dialysis). You are your own best advocate. The temptation when you go into clinic is to allow the tech to do their job. Some of them don’t have a clue as to what they are doing…..at all! I have had to correct my fair share of techs and even had to tell them what to do to get it right. Pay attention to everything. As for eating healthy, I have found doing so in moderation is best. It is hard to eat the diet as they tell me. Mainly because there seems to be confusion on what you can eat and what you can’t. They do discourage the use of salt. Some are in there for high blood pressure and some are on dialysis because of diabetes.
There is not much stuff they don’t want you to eat. Wheat bread, lunch meats, cheese and peanut butter to name a few. There are some things you can trade off though. Moderation is the key with that. So they will say eat a half of a cup of rice because rice counts as a fluid. Anything that absorbs water counts as fluid. In general the daily allowance is 32 ounces, which is half of the 64 ounces everyone else takes in. If you drink plenty of water, it will help your body out tremendously. The Davita website is ok but I think of them as a racket based on how my clinic is run. If you want to eat healthy while on dialysis, you will have to be creative. For example, if you like to eat a large bowl of greens or a large salad, you will have to take into account which veggies absorb the most water. For example, lettuce absorbs a considerable amount of water. Having been with them 11 years next month, the challenges of dialysis revolve primarily around fluid overload and the crippling depression that can come with dialysis. Stay active or stay as active as you are able to. It is hard to be active sometimes but be careful to take care of yourself. If you choose to eat vegan, do so with caution. They are quick to write prescriptions because that is their thing to do.
There are a lot of proteins out there. You can get them in protein bars, protein mixes etc. Stay on top of your labs. It will be a bit tricky for a while. Try not to eat all the white bread they tell you to eat. The healthier you eat, the easier it will be to stay out of the hospital. Keep an eye on your potassium. Watch out for tomatoes, oranges, orange juice, watermelon and so on. Apples are lower in potassium, so are grapes. Again, be careful and calculate your fluid intake. Fluid overages can result in cramping and is quite painful. It can also result in blood pressure spikes and so on. The appetite comes and goes. They don’t always tell you that. If you don’t eat pork or keep kosher, then you may hear about your protein dropping or being below what they suggest. The suggestion is 4.0 and often if it is below that it is considered low. Take your time and you may need to visit your primary care doctor to find out what lab values are. My clinic likes to give me information two weeks later than I need it. Watch out for your PTH (parathyroid hormone) because secondary Hyperparathyroidism can result from kidney failure. I hope I have not scared you. Best wishes. I hope this helps.
July 20th, 2016 at 7:47 am
Thank you for having this feed available. I am not a medical professional but a plant-based lifestyle coach and cooking instructor who works with a nephrology clinic. Our doctor recommends a plant-based dietary pattern to all his CKD patients so I’m here to support their transition. He is also wanting to include plant-based guidelines for our dialysis patients (which we have onsite) since this would help support other chronic conditions like diabetes, hypertension and cardiovascular disease which these patients also suffer from. I am currently digging into the research available (sleeping, eating and dreaming about potassium and phosphorous) It’s heartening to see so many positive outcomes here from folks following a vegan diet. I do have Joan’s book and welcome any additional resources you all know of. I look forward to following these posts. Thank you so much for sharing your experiences in an effort to help others.
October 26th, 2016 at 2:47 pm
@clairebrown, where is your practice located?
March 21st, 2017 at 2:21 am
Hey my name is Ray and.. I’m a dialysis patient , im from newzealand Hamilton waikato..I’ve been on dialysis for nearly 7yrs.. I’m also start up to be Vegan. . Was bought up as a Meat eater all my life.. I am now trying to go Vegan for Animal’s because of the Animal Cruelty Around the world..
April 3rd, 2017 at 12:15 pm
Hello Ray: Congratulations on your change to a vegan diet. You can review my previous posts on this subject or my book, The Vegetarian Diet for Kidney Disease. But a just a few words of caution. Vegan foods may add an increase load of potassium to your diet and in your transition to a vegan diet you may find your potassium running a little higher if you do not keep a few things in mind. Gradually increase your plant based proteins that are higher in potassium such as dried cooked beans or nuts. In th beginning choose more tofu, tempeh or seitan as your plant protein because these choices are lower in potassium. If you are having trouble keeping your protein intake high enough, you can use a protein powder such as pea protein or rice protein powder (if you are vegetarian you can use egg white protein powder or whey protein powder) and add it to hot cereal, applesauce or a low potassium beverage such as almond milk or rice milk. As your digestive tract adjusts to the higher potassium load you will begin to excrete more potassium through you digestive tract and you should not see spikes in your potassium. However if they are still a problem, make sure your doctor has you on a K1 concentrate. I have seen some people switch to a K-0 but some doctors are hesitant to do this due to a few health concerns in recent years. I hope this helps. Joan
June 21st, 2017 at 8:50 am
Hi – on P.D. 3 yrs., stable doing well! 68 yrs. old , male.
Vegan 30 yrs. now eat a little air/cooled chicken.
Labs are good, intentionally lost close to 50 lbs, B.P. Good.
I am looking for ideas to naturally build the red blood cell’s.
Am now seeing a tendency towards anemia (Hemoglobin 9.5).
Any help greatly appreciated.
Thanks!
June 27th, 2017 at 11:30 am
Hi Tom: One of the complications of kidney disease is that you lose your ability to make the hormone EPO (errythropoietin) which is manufactured in the kidneys. EPO is needed for the production of red blood cells. I remember when I first started in dialysis over 35 years ago this hormone was not available. People on dialysis were constantly tired and anemic. It did not matter how much iron or other nutrients they took, if the hormone EPO was not there for the final steps in making these cells it would not happen. I can appreciate you not wanting to add another substance to your body but sometimes you have to weigh out when a medication is going to improve your quality of life. Now that being said there are certain things you can do to help your EPO work more effectively or another words require less EPO. This includes keeping your phosphorus in a good range. Hyperphosphatemia can impact red blood formation in the bone. Also exercise can be of benefit in boosting your own ability to make Red Blood Cells. Congratulations on staying vegan on dialysis. I hope this helps, Joan Hogan, RD
July 9th, 2017 at 8:02 am
Hi, I have recently switched to a vegan diet and I am on dialysis.
In order to supply protein I use a plant based protein called Humapro, made by ALRI. I have gone to the extreme of using only these tablets for protein w success. My albumin is 4.3 and is consistent.
July 9th, 2017 at 8:11 am
Whey protein was being advised by my nutritionists. Whey powder is the least efficient protein source out there, as far as Net Nitrogen Utilization. Whey produces 80+% waste in the blood. Animal protein is roughly 40+% efficient, producing 60% waste
Humapro, being plant based is 99% efficient, w 1% waste created. The company can be contacted to discuss studies and effectiveness in renal patients.
July 22nd, 2017 at 6:42 am
Joe:
You bring up an interesting area of protein needs in kidney disease. Studies have documented that in kidney disease abnormalities in Branched Chain Amino Acids (BCAA) exist. This is thought to occur due to a lack of the kidney contributing to amino acid metabolism. Supplementation with BCAAs have been found to increase appetite, improve brain function, improve muscle mass, possibly help improve hyperparathryoidism and insulin sensitivity. However there are also concerns about supplementing with too much BCAA. High intake of BCAA can cause excess cell hyperexitability potentially causing cell and neuron death.
The studies that I have reviewed have ranged in supplementation of BCAA from 4 to no more than 12 g of BCAA per day. If one decides to try supplementing with BCAA I would not exceed this amount. I would still encourage obtaining the bulk of your protein from plant-based protein foods. By providing protein this way you provide the body with whole protein and a variety of amino acids not just contributing to BCAA but to all of the other non essential amino acids the human body requires (our body requires 20 different amino acids for adequate function). In addition, plant based proteins provide phytonutrients, vitamins, minerals and fiber that isolated amino acids do not provide.
Joe, I commend you on your high albumin but keep in mind a high albumin is not just about protein intake. I think it may have just as much to do with the fact that you are eating a plant-based diet. Albumin is one of many hetapic (liver) biomarkers and actually is a better measure of inflammation. It is why I think a vegan diet is excellent in kidney disease because if you are eating a pro-inflammatory diet, high in animal proteins and processed foods this will add to more inflammation. It is why I suspect I would see so many dialysis patients eating high meat diets full of processed foods, still running low albumins. When I would look at NPR (nitrogen protein ratio) in our dialysis patients, I would often see based on this measurement greater than 1 (or in other words they were meeting their protein needs) but their albumin levels would still be low. Then you look at India, where most dialysis patients follow a vegan diet, albumins are frequently running in the 4’s. These people do not have access to BCAA supplements, limited resources for a high protein diets, but do eat a high plant based diet, limited processed foods.
So I am thinking rather than the Humanpro being the total cause for your high albumin, your anti-inflammatory, high plant based diet might be providing more of the benefit you are seeing in your numbers.
Now that is not to say albumin does not measure protein adequacy. Early studies did find people starving in the hospital and that the albumin indeed was a measure of lower protein synthesis in the liver due to a lack of protein in the diet and thus indicated by a low serum level. But this role will only account for a .2 g/ml drop in albumin max.
It is unfortunate that this focus on albumin has gained so much attention in kidney disease. It has pushed way to much animal protein on patients which I do not think is healthy and does not necessarily resolve a low albumin. I know in small circles this has been discussed (getting rid of albumin as a measurement in dialysis patients). But for now it stays.
I strongly believe a plant based diet, vegan diet, provides not only a benefit of overall health, but when carefully planned can provide adequate protein from plant based protein sources. For larger individuals a protein supplement, such as pea protein powder, or if a vegetarian (not vegan) whey or egg protein powder can be of benefit. And lastly if one wants to try a BCAA limit this to no more than 5 g per day.
http://www.kidney-international.theisn.org/article/S0085-2538(15)51962-5/fulltext#s0070
https://www.ncbi.nlm.nih.gov/pubmed/15660573
https://examine.com/supplements/branched-chain-amino-acids/
September 14th, 2017 at 8:23 am
My son has kidney disease. I hope to educate myself on foods and recipes for vegans with kidney disease since I plan on making him frozen and dried meals. He is limited to 775mg sodium and potassium in a target range of 1500-2500 mg and low in fat. I use Self Nutrition date web site to read complete nutrition data on most foods and on DeVita for kidney information. My second son is a type 1 diabetic and I have lost and maintained a 200 pound weight loss for 15 years. So I am knowledgeable on nutritional needs, but not as familiar with vegan diets. I am specifically looking for vegan recipes that can be added as part of his diet. I hope to stay and learn from the people with the most knowledge, vegans with kidney disease.
September 29th, 2017 at 10:22 am
Hi Teri: First of all I want to commend you on your ability to not only improve your own health through nutrition but your son as well. With regard your son with Type I Diabetes I think it is very important to start diet control not only for management of blood sugar but prevention of the complications of Type I Diabetes. A vegan diet especially can be of benefit in preventing the complication of Type I Diabetes but also in slowing down the progression of kidney disease. There are a number of places to obtain vegan recipes and ideas. My website has some of these. http://www.food4lifecounseling.com. Pinterest is also great. I think Brenda Davis has wonderful books on vegan diets and vegan diets for diabetes. I have written the the book The Vegetarian Diet for Kidney Disease in which I touch on diabetes and kidney disease.These are aww to start with, I hope these helps. Let me know if I can answer any of your other questions.
October 4th, 2017 at 11:01 am
I have a daughter with alport syndrome, she is 7 years old now. We have been seeing several specialists regarding her kidney health which is slowly Will deteriorate. I am looking for a solution to extend her kidney life for as long as possible. We eat a pretty clean mostly organic diet with only once a week meat. I am confused how much protein she needs as she is still growing. If necessary I will cook vegan but is this wise for a child. Doctors here don’t really believe in diet as a solution. Hope to find some advice from you all. Kind regards.
October 4th, 2017 at 12:20 pm
I hate when doctors don’t believe in diet solutions. You know the saying – You are what you eat!.
Hopefully a dietician can come along for better advice but my understanding is when your kidneys are failing you lay off protein and once on dialysis it is the opposite you need protein. Hard decision for a growing child. I wish you all the best.
October 15th, 2017 at 6:58 pm
You are right Beverly that is what they say. But it is so much more than that. The type of protein you eat regardless of being a pre-dialysis (CKD) or on dialysis, is what is important. It i hard to write in one paragraph these concepts. It is why i wrote my book The Vegetarian Diet for Kidney Disease. But honestly you do not need to be a total vegetarian to obtain benefit from plant-based eating with CKD or a diet for being on dialysis. You may want to check this out. Plant-based proteins are the key, not animal proteins. If you are seeking a renal dietitian to help you, ask them before you schedule an appointment if you can have help with planning a plant-based diet for your kidney disease. If they seem focused on animal protein, move on to another dietitian.
December 6th, 2017 at 7:55 pm
i am really glad I found this web page. I am 37 and have been on dialysis for 7 years and on the waiting list. I have just become a vegan and trying to learn the ins and outs so reading everyones suggestions will help me.
September 11th, 2018 at 7:37 am
Labs showed stage 4, put myself on kidney diet and labs improved then went to vegetarian diet and labs now show stage 3. Am experimenting with various ingredients with an eye to K, P & Na content. Would like to write a kidney-friendly vegetarian cookbook someday as I love to cook and would like to share some of my discoveries. Any help from anybody would be most appreciated!
September 14th, 2018 at 3:11 am
In order to find out potassium, phosphorus content if these aren’t listed on a product I email the manufacturer and usually they reply with the information very soon. Fortunately the local Hy-Vee grocery store I use where they shop for me and deliver has store brands which are just as good as name brands and they will immediately answer my email questions about nutritional content. Sometimes the Hy-Vee brand is lower in potassium and phosphorus – and sodium! – than the name brands.
September 17th, 2018 at 2:29 pm
vegitrd@gmail.com.
That is great Kamama. We need more vegan cookbooks for those with kidney disease. Sometimes it is hard to find the phosphorus and potassium on labels. For one reason they are not required by law to be on the label and second, at least for phosphorus, it apparently is a more expensive nutrient to analyze . At least that is what I am told. The biggest thing with phosphorus is looking at the ingredients. You want to avoid foods (it’s usually processed foods) that contain phosphoric acid or phosphate. These are inorganic forms of phosphorus that are least healthy with kidney disease. Most whole, intact vegan food is made from organic sources or phosphorus. The difference is inorganic is highly absorbed (as much as 90% like in dark colas and many other soft drinks and processed foods). Organic is only about 30-50% absorbed and is found more in intact grains, dried cooks beans and nuts. Joan Hogan, RD
December 18th, 2018 at 7:06 am
My husband and I have been on a WFPB diet for years.
His kidney function went down to 8GFR in May 2018.
He was on hemo dialysis for 4 months which drained him plus
The hassle of the clinic wanting him to eat animal products
All day long.
He now does PD which is so much better but we’ve been
Alone in figuring out his diet.
What’s worked that we’ve finally figured out is he eats
According to his labs.
We never pay attention to protein because it’s always in
Normal rang. Plus his labs have been very good.
Phos coming down. Potassium very good.
However it’s been difficult keeping his hemoglobin up.
It was at 10. Now it’s 8.
Anyone have any experience in this?
We’ve included a diet high in iron plus supplement.
If this is a group on dialysis and are vegans I’m going to
Be very happy because we’ve been alone in this world
Of kidney failure.
Colleen
December 28th, 2018 at 7:40 am
I cannot contribute any info from personal experience, but I have just come across this brand new article from the Clinical Journal of the American Society of Nephrology: https://cjasn.asnjournals.org/content/early/2018/12/24/CJN.08960718 It’s open access (available free of charge). From the article:
“Conclusions
There is growing evidence, mostly observational, that
plant-based/DASH diets in individuals with eGFR [estimated glomerular filtration rate] of 30–59 ml/min per 1.73 m2 may delay progression to ESKD [end-stage kidney disease] and dialysis and may potentially improve survival. Larger prospective studies are needed to confirm these findings as well as to determine whether the benefits of plant-based diets in CKD extend to patients with
diabetes. […]
Some individuals whose remaining kidney function
is not adequate to avoid elevations or wide
variations in serum potassium associated with high potassium
dietary intake may be precluded from consuming diets that are plant based due to the potential adverse event of hyperkalemia. For this subset of individuals, the availability of newer once daily potassium binders may facilitate achievement of potassium
homeostasis while maximizing the benefits of diets enriched in potassium. Prospective data are needed to confirm this hypothesis.”
February 21st, 2019 at 12:19 pm
I highly recommend seeing a renal specific dietician (get a referral from your nephrologist) at different stages: 1st during stages 1-3, again at stage 4 (or just before getting to stage 4), at stage 5 (on dialysis), and then again after transplant. If you’re on Medicare or Medicaid, it’s covered. Diets at these stages vary quite a bit and is very dependent on your specific lab numbers. Portions play a big role too. At stage 4, I was vegetarian by default due to any kind of protein (even the smell of it) gave me horrible nausea. As long as I was reasonable with my portions, I was fine with higher potassium foods but phosphorous was still high. Phosphorous binders only did so much before the dosage was high enough to cause other problems. I was told by my dietician being vegan was impossible on a dialysis diet. This can vary depending on how much function you have left in addition to how much filtration you’re getting from the dialysis. I started on dialysis earlier than some people due to the toxin build up causing horrible nausea. I followed a pre-dialysis diet for several years and knew it was coming from a mile away. I never lost my ability to urinate while on dialysis (for 4.5 years). A lot of patients’ kidneys fail very fast and hard before knowing what’s happened and have other restrictions (fluid, etc) It’s really a case by case basis and getting info from your nephrologist and renal dietician are far better sources of information than some stranger on the internet that have different lab numbers and needs than you. Just because a food is healthy, doesn’t mean it’s what you need. Renal patients at all stages have different dietary needs and “healthy” isn’t necessarily good for you specifically. Educate yourself from reliable sources like Davita, American Kidney Fund, National Kidney Foundation, etc and then talk to your dr before doing anything different. Having an open ongoing dialogue with your dr office via online messaging, text, etc is very helpful so there isn’t any wait on talking between appointments.
December 26th, 2019 at 1:24 pm
Hi, my name is Andy from Germany, I am 36 and suffer from IgA since early childhood, now almost 2 years on HD. Currently I do 2 times 8 hours HD over night and I work full time. I am vegan since more than 7 years and live oil free and (almost) sugar and salt free since more than 3 years. I believe that prescribed renal diet makes people more sick, so I try on my own way.
Up to now I am very happy with the results of my experiment: My blood pressure is normal without medicals, phosphorus in normal range without binders, albumin in upper normal range, …
To control potassium I select only low potassium fruits and veggies (in fact many fruits and vegetables have lower potassium than average meat). Most of the time I eat rice or pasta with veggies. I eat most time white rice (due to high phosphorus content in brown rice), but eat pasta and bread mixed (around 50% whole grain). For protein I add a little bit tofu and soy yogurt, but in moderation. To “refill” amino acids lost in HD I take around 5g of essential amino acids per day (pure amino acids, no protein powder!). I try to minimize salt, which first took some time to get the taste adjusted, but it has the great benefit that I have no thirst and have low weight gain (despite no more urine output).
No one dies from CKD but from its complications. Number 1 complication is disease of heart and blood vessels. So i think a good diet is one that is cardio-protective (no oil, low salt, no animal protein). Check out the work of Esselstyn, Campbell, Ornish and others…
January 3rd, 2020 at 3:25 pm
vegitrd@gmail.com
Andy: I could not agree more. Congratulations on your success with vegan eating on dialysis. In the 32 years I worked with dialysis patients I strongly felt people could feel so much better if they were were more plant based. Joan Hogan, RD
November 8th, 2020 at 7:34 pm
Hi, I’m trying to find a way to be a vegan on dialysis I have a great protein source by naked nutrition its pea protein with nothing else in it. My dietitian tried to get me to take nepro and something with collagen and red 40. However the pea protein has better nutritional value than either or. I just lost my 3rd transplant in April I received it in December of last year. This has lead me to stomach issues and everything in between. Are there any websites besides nkf and davita. Are there any dietitians who are available and actually want to see us live?
November 10th, 2020 at 11:06 am
vegitrd@gmail.com
I am sorry for all of your difficulty with following a vegan diet. Its should not be that difficult but as a renal dietitian and a speaker on this topic for decades I know a lot of renal dieticians are very uncomfortable with this eating preference. Of course that is no excuse you are seeking help. I have a book called the Vegetarian Diet for Kidney Disease that I wrote about 8 years ago that might give you some direction. I also counsel people by telemedicine if you think you need a more personal approach. I agree the products like nepro are disgusting and yes red dye #40 not to mention a number of other additives can be a problem and can even impact your stomach problems. You could take the pea protein and make some nice smoothies of your own with berries, soy milk or almond or rice milk. Seitan is always a nice protein, although lacking more amino acid completion, its still is good(unless you are gluten intolerant). You can obtain other nice nutrients with some greens, again it’s moderation. A lot of renal dietitiansare not comfortable with vegans and with freak out over anything green but honestly I never saw this a problem in my 32 years in working with dialysis patients and almost 40 working with kidney disease in general. I cannot offer much more without knowing more about you which I would have to do in a private consultation.