Category Archives: Diet/Nutrition

Is an 87 year old man with CKD and GFR of around 30 allowed to to engage in a religious fast. More precisely,what would be the danger in not drinking and/or eating for a 24 hour period?Would an individual in such a medical condition be allowed to abstain from food for 24hrs if he drank liquids?

Chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) of 30 milliliters per minute per 1.73 meters squared should be able to go without food and water for limited amounts of time.  This partially depends on other medical … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney-Related Health Questions, Symptoms and Side Effects

I need to know how many grams of protein I should aim for DAILY. I am a level 5 Hemodialysis dialysis patient. I HAVE the information in OZ, but want it in grams, Please!

The diet for a hemodialysis patient is usually recommended to be between 1.0 and 1.2 grams of high quality protein per kilogram of body weight.  You should review this with the dietitian who is assigned to you at the dialysis … Continue reading

Posted in Ask the Doctor, Dialysis, Diet/Nutrition, Kidney-Related Health Questions

I have a family history of Polycystic kidney disorder seen only in males in my father’s side. I am the only daughter to my parents. I had taken a dip test as part of tests for checking my kidney function. Dip test showed microscopic particles of blood in my urine along with a high amount of protein. I have not yet received the results for other tests. Does this indicate anything?

Blood in the urine (hematuria) and protein in the urine (proteinuria) can certainly be seen in patients with polycystic kidney disease (PCKD), however, both hematuria and proteinuria are seen in many other diseases of the kidney and urinary tract.  I … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, Kidney-Related Health Questions, Laboratory Testing, Polycystic Kidney Disease, Symptoms and Side Effects, Treatments

Hello Dr. Spry, My CKD has progressed to ACR = 23,42 mg/mmol, eGFR-EPI = 40 (mL/p/1.73m2), p-urate = 559 umol/L (230 – 480), p-standard bicarbonate 21 mmol/L (22-27). Should I be concerned about a high risk of further progression and therefore 1) Should I ask for referral to a nephrologist? 2) Should I ask for the high urate to be treated? 3) Should I ask for bicarbonate therapy to be started?

I am not able to recommend medical therapy unless I am able to perform a complete history and physical examination.  I generally recommend referral to a nephrologist when the estimated glomerular filtration rate (eGFR) is less than 30 milliliters per … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

I started a lower protein diet (60g/day) in April. In past month hair is thinning rapidly. Do you see this in pts on low Protein diets? There are other factors: hyperthyroid w/ Tapazole, age 73, other meds include coumadin-beta blockers, Any suggestions to counter act? Have just started scalp RX of. castor oil-coconut oil-oils of rosemary & sage. My endocrinologist okayed Biotin and Evening primrose oil if ok w/ nephrologist. I will call him, he is hard to reach

I tend to see hair loss in patients who are protein malnourished.  I am not an advocate for a protein restricted diet. Thyroid disease is also associated with hair loss.  I suggest that you follow a DASH diet.  You can … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Kidney-Related Health Questions, Laboratory Testing

I am a patient in Stage 2 of CKD, should i follow a vegan, vegetarian, or all protein base diet? There is a lot of confusion information about this topic on the web.

I am a strong proponent for the DASH diet.  You can review the DASH diet at: https://www.nhlbi.nih.gov/health/health-topics/topics/dash  

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Kidney-Related Health Questions

Hello Dr. Spry, I was diagnosed with FSGS in 2014 after a routine labwork showed diminished kidney function. Creatinine levels have remain between 2.1 – 2.4 for the past 2 yrs, with kidney function between 35 – 40. Currently taking BP medications with avg reading of ~135/88. My only other ailment is my cholesterol being high, but so far I have not been able to tolerate the statin medication my doctors have provided me. I’m 37 yrs old and need to know what happens next? What steps can I take to prevent kidney failure? Is there any new health technologies that provide alternative treatment for my condition? Thanks.

Currently, the recommended treatment for focal segmental glomerulosclerosis  (FSGS) is based on the kidney biopsy and subtype of the disease.  In most cases, the basic treatment is to use ACE-inhibitors or ARB agents to treat and control blood pressure.  The … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, FSGS, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Treatments

I’m stage 3. I have a high count of protein in my urine, really high. My doctor said to cut way back on protein. Where do I go for help on this. I need to lose weight as-well. I thought a DaVita dietician could help me but she said no, only if your on dialysis. I’m trying to avoid dialysis! (Lol). Thank you for any help.

I suggest that you follow the DASH diet.  The most important part of the diet is to maintain a low salt diet and the sodium intake should be less than 2300 milligrams per day.  You can review the DASH diet … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Kidney-Related Health Questions, Laboratory Testing, Treatments

Is Stevia a safe sugar substitute for Peritoneal Dialysis patients to use?

I am unaware of any problems with sugar substitutes in patients who are on peritoneal dialysis.  Stevia is a sugar substitute that has limited use in the United States.  I am not aware of any reports of problems in kidney … Continue reading

Posted in Ask the Doctor, Dialysis, Diet/Nutrition, Kidney-Related Health Questions, Treatments

My BUN level in Dec 2016 was 23 (range is 8-27). In June of this year it was 30. My microalbumin/creatinine in Dec. 2016 was 74.7 (range is 0.0 – 30). Is there food, supplements or medications that will lower these two levels? I am Type II diabetic but I am not on insulin. I have Stage 3 CKD

In general, patients with elevated microalbumin in the urine should be treated with either an Angiotensin Converting Enzyme Inhibitor (ACE-I) or an Angiotensin Receptor Blocker (ARB) agent.  This would be the standard treatment for your diabetic kidney disease.  I suggest … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Diet/Nutrition, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments