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The two kidneys are shaped like beans but are much larger. Approximately 1 million microscopic filters in each kidney remove waste products from the blood through the urine. In addition to the glomeruli, the kidneys are mainly made up of blood vessels.
It is expected that over half of American adults between the ages of 30 and 64 will develop chronic kidney disease, most of which is caused by atherosclerosis (hardening of the arteries). Because kidneys are so vascular, they are particularly sensitive to atherosclerosis. Causal risk factors include high blood pressure, smoking, sedentary lifestyle, obesity, diabetes, high cholesterol, inflammation, and a diet high in animal products.
According to Dr. Michael Greger, in his book How Not to Die and his website NutritionFacts.org, researchers have found three specific nutritional components associated with decreased kidney function: animal protein found in meat, poultry, seafood, eggs and dairy; Animal fat; and cholesterol (all animal products including seafood contain cholesterol). Animal protein damages the kidneys mainly because it causes acidity and inflammation. A fourth kidney-damaging substance are phosphate additives in cola drinks and meat, which are used to enhance the color.
Kidney function is determined by: serum (blood) creatinine, normally 1.22 or less; GFR (glomerular filtration rate), which is normal above 60. The results of these two kidney function tests are part of chemistry panels that are conducted in doctor’s offices, hospitals, and health fairs.
Another important test for kidney health is a urinalysis, which is not done at health fairs due to collection and storage issues. Any protein in the urine is abnormal. The most sensitive test for urine protein is the microalbumin / creatinine ratio, with the normal value being 7.5 or less for a woman and 4.0 or less for a man.
if you have protein in your urine; an increased microalbumin / creatinine ratio; have a blood creatinine greater than 1.22 or a GFR less than 60, you have chronic kidney disease that requires evaluation and treatment (treatment includes addressing the risk factors for atherosclerosis in the second paragraph). Chronic kidney disease varies in severity. For example, a GFR between 15 and 29 is classified as severe, i.e. towards dialysis or kidney transplantation.
Now a vivid patient story: AS is a man in his 70s who was referred to the Center for Disease Prevention and Treatment through Nutrition / The People’s Clinic by a friend. He presented himself on July 12th, accompanied by his wife. He had been on a high sodium diet recommended by doctors for low blood pressure for years (note that sodium not only increases blood pressure, but also directly damages the endothelial organ system that lines our arteries). He has also been on the Paleo diet, which is rich in kidney-damaging animal protein, for over three years. A year before last month’s visit, he was diagnosed with chronic kidney disease for which a kidney ultrasound was normal (usually the pathology that causes chronic kidney disease does not show up on ultrasound). He was not given any dietary recommendations, but decided to increase his daily intake of animal protein even further.
AS’s lab results on June 23 showed a serum creatinine of 2.63 and a GFR of 25, placing him in the severe class of chronic kidney disease heading toward dialysis or kidney transplantation. His total cholesterol was 232 (“normal” is <200, but ideal is <150); LDL or bad cholesterol 173 ("normal" <100 but ideal <50).
The patient was encouraged to follow a wholesome, wholesome, plant-based diet with no sugar, salt, or added oil. With the support of his wife, he did this. Repeat lab on July 31, after two weeks of diet, showed creatinine value of 1.55; GFR of 46; Total cholesterol 181; and LDL 132. Just making these dietary changes for two weeks – although his kidney function is abnormal and his cholesterol levels are not ideal – he is overturned on both issues. Hopefully, both problems will continue to improve and potentially resolve over time.
Unfortunately, the US medical system is not designed to prevent or treat disease through simple measures such as lifestyle changes. Medical schools fail to educate students about the power of unhealthy foods that can cause disease; or healthy food for the prevention, treatment and often reversal of diseases. And most practicing physicians are unaware of the vast medical literature that supports food as medicine.
Dr. Feinsinger is a retired family doctor with a special interest in disease prevention and reversal through nutrition. Free services at the Center for Prevention and People’s Clinic include: hour-long consultations, shop-with-a-doc at the Carbondale City Market, and cooking classes. Call 970-379-5718 to make an appointment or send an email to gefeinsinger@comcast.net.
