by Dr. John Mouratoff, Interventional Nephrologist
While most people understand that controlling blood pressure and eliminating toxins such as nonsteroidals (Advil, Motrin, etc) are beneficial in protecting renal (kidney) function, few patients and physicians understand that limiting animal protein is fundamental, as well. What we eat has a large impact on kidney function. With a proper diet one can delay or reverse damage to their kidneys, lower blood pressure, reverse metabolic acidosis (the harmful accumulation of acid), reduce hyperlipidemia (cholesterol) and lose weight.
Before the advent of dialysis and antihypertensive medications physicians used diet to control blood pressure, reduce kidney disease progression, and for weight loss. In the 1980’s Dr. MacKenzie Walser at John’s Hopkins advocated a diet low in animal protein as a way to delay dialysis for up to 3 years in most patients.
In the 1990’s we were unfortunately taught that diet, especially protein restriction, was not effective in delaying renal disease. Based on the Modification of Diet in Renal Disease (MDRD) Study, several generations of Nephrologists along with myself, abandoned diet in favor of medical therapy.
I continued practicing under the modern paradigm that the desired goals could be achieved with pharmacology alone. Blood pressure control with the use of Angiotensin converting enzyme inhibitors (ACE) or Angiotensin receptor blockers(ARB), and avoidance of nephrotoxins was stressed. However, one day in 2014 a patient whose kidney function was rapidly deteriorating asked me for an alternative to either peritoneal or hemodialysis. As a last ditch alternative, I recommended trying a plant-based diet and limiting his protein intake. One month later, the patient’s renal function (eGFR) improved from 16 ml/min to 50 ml/min. That’s a huge change! Three months later his function continued to stabilize at 52 ml/min. This man avoided dialysis by simply changing his diet and opened my eyes to the benefits of nutrition.
In the last 6 years I’ve seen dozens of patients avoid or delay dialysis simply by adopting a plant-based diet. As an added bonus many of these patients were able to reduce their blood pressure medications, lose weight, lower cholesterol, eliminate gout, and reverse cardiovascular disease. Thanks to pioneering doctors such as Dr. Thomas Addis, Dr. MacKenzie Walser, Dr. Walter Kempner, Dr. Dean Ornish, and Dr. Bernard, we now understand how nutrition is fundamental in the modern treatment of kidney disease, cardiovascular disease and diabetes.
- Plant proteins alter the microbiome (gut bacteria), and promote healthy bacteria that decrease kidney and cardiac toxins.
- Plant proteins are associated with rich sources of alkali (bicarbonate) that counteract the accumulation of acids and decrease the work the kidney has to do to help protect the kidney against further damage.
- Plant proteins are lower in Methionine, an amino acid which is associated with leaky kidney cells and accelerated aging.
- Changing from an animal protein diet to a plant protein diet can delay or reverse kidney disease.