This question has been a topic of debate for decades among top doctors and researchers in the world. With the advancements in technology, we now know more than ever how diet effects kidney disease and the impact of a vegetarian diet on chronic kidney disease.
It is important to make healthy food choices irrespective of your health status. If you are suffering from Chronic Kidney Disease, diet becomes of the upmost important. Since the kidneys regulate, so many nutrients the right diet can not only slow down the progression of kidney disease, but many times improve it.
With proper planning, full or partial vegetarianism is safe and highly beneficial to the kidney. Even if you only replace one meal with a vegetarian option this can provide benefit for chronic kidney disease.
That Said, What Does A Proper Diet Mean For A CKD patient?
Nutrition requirements differ based on the level of kidney function as well as the presence of cardiovascular diseases, diabetes, and hypertension. Whatever foods a sufferer of chronic kidney disease eats should have the goal to reduce the rate of progression of the kidney disease, if possible improve kidney function, maintain good nutritional status, decrease proteinuria (protein in the urine), reduce uremic (kidney) toxicity and minimize the chances of getting kidney disease-related secondary complications.
Research has shown that plant proteins may exert positive effects on blood pressure, proteinuria, and glomerular filtration rate, and results in milder renal tissue damage when compared to animal proteins. The National Kidney Foundation recommends complete or partial vegetarian diet for kidney disease patients.
Diet and its impact on people with CKD has been studied extensively and it has been asserted that improper nutrition has negative effects on the prognosis of kidney disease.
Over nutrition is linked with the development of too much sodium, hyperkalemia, hypophosphatemia and fluid overload as well as the elevation in uremic metabolic (kidney toxin) products and their various potential deleterious effects.
Vegetarianism and a CKD Diet
It has been wrongly assumed for several decades that vegetarianism and CKD cannot be combined. Plant-based diets, not minding that they have low protein levels; have rich phosphorus and potassium and as such, it is assumed to be unsuitable for CKD patients. Research has consistently shown that the phosphorus in vegetarian foods doesn’t absorb, nearly as well as animal sources of phosphorus. Choosing low to moderate sources of potassium will negate the worries of increasing potassium levels.
However, clinical studies have shown that this diet can be extremely beneficial to CKD patients if they can understand how to best put it into use. There are several vegetarian approaches today, some of which have a principle of mixing plant-based diets with animal products like eggs, milk and honey. Other forms focus on fruits or sprouts or juices. Irrespective of the approach you take, they all involve large amounts of whole-grain products, fruits and vegetable which are rich in dietary fibers, folic acid, vitamin C, vitamin E, magnesium, potassium, fatty acids carotenoids and many phytochemicals.
Protein-Energy Status
A certain level of protein is needed in patients with CKD to avoid both over nutrition and under nutrition. One of the major causes of negative outcomes in CKD is protein-energy malnutrition. Its prevalence increases linearly with decreasing renal function in non-dialysis patients and may exceed 50% in those undergoing maintenance dialysis therapy.
The National Kidney Foundation (NKF) recommends that patients with CKD consume diets containing 0.6 g protein/kg/day. The National Kidney Foundation: K/DOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease, recommended in 2007 that the restriction of dietary protein intake to 0.9 g/kg/day in patients with diabetes and CKD stage 2, as it was shown to be beneficial irrespective of the existing medical treatments.
Caloric restriction is recommended only in cases of obesity or overweight patients with CKD. Such people are advised to reduce their body mass index to a range of 18.5–24.9 kg/m2 and waist circumference ≤102 cm for men and ≤88 cm for women (2C).
Protein guidelines will vary depending on the source and what goals you are looking to attain. The guidelines mentioned are from the National Kidney Foundations, but are no means the authoritive source for protein amounts in your CKD diet
Vegetarian Diets Impact on Phosphorus Levels In CKD
Disturbances in mineral metabolism are common in CKD patients and they usually begin at stage 3 or 4. The capacity for kidney to excrete phosphorus becomes more and more reduced as the renal function decreases. As a result, compensatory secondary hyperparathyroidism and elevations in fibroblast growth factor-23 (FGF23) occur for urinary phosphorus excretion to increase and the phosphorus balance to be maintained.
This why phosphate consumption is restricted for CKD patients and this affects those who are into Western diet mostly because of the high phosphate content in dairy products and protein sources. Proteins from plants are richer in phosphorus than the animal proteins.
The plant-based phosphates are only 30 – 50% bioavailable, absorbed, while 70 – 80% of animal proteins are bioavailable. Studies involving human underline the importance of phosphate sources in general mineral metabolism.
Vegetarian Diets Impact On Insulin Resistance In CKD
People with CKD usually have insulin resistance. Studies have shown that it is closely linked with atherosclerosis, coronary heart disease (CHD), incident CHD, incident stroke, and cardiovascular mortality in the general population and it is seen as an autonomous predictor of cardiovascular mortality in patients suffering from different stages of CKD.
It has been observed that vegetarians are more sensitive to insulin than omnivores and this sensitivity can be associated with the period of the vegetarian diet. Therefore, vegetarian diets have a positive effect on insulin resistance.
Vegetarian Diets Impact on Metabolic Acidosis In CKD
Dietary acid load may lead to acidosis in CKD despite the normal serum bicarbonate concentration. It isn’t rare to find the complication called metabolic acidosis in CKD and this stimulates endocrine, metabolic, and musculoskeletal abnormalities.
This condition could be made worse by the constant consumption of meats and the consequent formation of fixed acid-producing cationic amino acids. Vegan diets are rich in organic bicarbonate producing anions such as lactate and citrate, thus yielding an alkaline load. Another positive benefit consuming a vegetarian diet.
Vegetarian Diet and Cardiovascular Risk Factors In CKD
Inflammatory cytokine concentrations and advanced glycation end products are usually high in CKD patients. These substances cause a constant inflammatory states which can lead to stroke, atherosclerosis and cardiovascular disease. A vegetarian diet has shown to reduce the formation of these substances.
Lower BMI, blood pressure, hypertension occurrence, risk of type II diabetes and improved lipid profile in the CKD population that consume plant-based foods has also been shown in research.
Plant based foods also contain less fat than the animal based foods, which are rich in saturated fat. Plant-based foods have high anti-inflammatory components as well as high capacity to neutralize free radicals (cell damage).
Other Effects of Vegetarian Diet In CKD
People with CKD have a lot to benefit from soy consumption because of its reduced proteinuria, cardiovascular protection and cancer prevention. A meta-analysis of 9 studies involving 197 subjects showed that the consumption of soy protein considerably reduced serum creatinine and serum phosphorus levels. More so, it significantly reduced serum triglycerides (a part of cholesterol) without affecting total cholesterol or calcium levels.
In vegetarian patients who are going through dialysis, the levels of indoxyl sulfate (IS) and p cresyl sulfate (PCS) were also significantly lower. Quite a few clinical experiments have been carried out with the aim of understanding the effect of vegetarian diet in CKD.
Specialized vegetarian diet in patients stage 3 or 4 CKD were linked with maintenance or increase in body weight, serum total protein, serum albumin, and transferrin in comparison to patients on a conventional low-protein diet.
The Safety of Vegetarian Diet
Vegan diets are also believed to be safer for patients of CKD who are pregnant. Because pregnancy induces hyperfilteration, foods with limited protein amounts ought to be beneficial for these patients. Piccoli et al. observed that pregnant CKD patients were placed on a diet in which the protein content was compromised between the goal of diminishing hyperfilteration and increased metabolic needs of pregnancy.
Although they were not able to pinpoint any beneficial effects of the diet, there was also no recorded negative impact on the health of the baby. Vegetarian diet complemented with a very-low-protein diet was shown to be safe for pre-dialysis patients, since it wielded no negative impact on the long and short term effects of patients, even the ones already placed on renal replacement therapy
Conclusions
From the studies and observations that were made by different scholars and medical professionals, we can ascertain that the vegetarian diet offers the adequate nutrition and offers several health benefits to CKD patients.
A properly planned diet is associated with cardiovascular benefits and correction of CKD accompanying complications. More so, people who adopt the vegetarian diet usually pick up healthy living habits like exercising more, quitting smoking and reduction in their alcohol consumption. Some of the positive effects of the vegetarian diet may be confounded by a healthier lifestyle and as a result, the adoption of the vegetarian diet seems to be a choice for some patients suffering with chronic kidney diseases.
If your looking to incorporate of vegetarian diet it is HIGHLY recommended to not go at it alone. Get professional help or resources to make yourself successful.
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Reference:
https://doaj.org/article/4dc874d488e6434a8e4178bb267e7780
