In order to understand what types of foods are best for kidney health, it is first important that you understand what the kidneys are designed for in the first place. The kidneys are designed to filter waste out of the blood, in the process absorbing some nutrients found in it and excreting the waste through urine output. The body is best designed to filter out waste products that are easily extracted, serving as a less taxing task on the kidneys themselves. Taking in processed foods with added preservatives as well as meats that are dense in saturated fats (red meat, most notably) will add strain to the kidneys in addition to their already difficult job.

Many people have been led to believe that you can’t be a vegetarian or follow a mainly plant-based diet if you have kidney disease. However, we now know that people with kidney disease can follow a plant-based or vegetarian diet if they know how to do it wisely.

At Vascular Care Specialists of Los Angeles, Dr. Mathew Cheung and Dr. Peter Lin discuss certain plant-based diet or vegetarian diet may help lower the chance of getting kidney disease, or even keep early kidney disease from getting worse.

It means eating mostly whole grains, fruits, vegetables, legumes (beans, peas, and lentils), unsalted nuts, and healthy oils, while reducing animal foods such as dairy, eggs, fish, meat, and poultry. To make a plant-based diet as healthy as possible, you also avoid processed foods like many types of canned foods and soups, refined grains (white breads and pasta, highly processed or high sugar cereals, white rice), snack-foods (potato chips, cookies), and sugar-sweetened beverages. Foods that have animal products like pizza, meat or cheese-based soups, and mayonnaise are also avoided.

Plant-based diets have become very popular in recent years. They are rich in fiber, vitamins, and minerals that help lower your risk for heart disease and other health problems. Studies suggest they may even help keep your kidney disease from getting worse. Some popular, well-known plant-based diets are:

1. The Mediterranean diet. This is a diet typical of many Mediterranean countries, such as Italy and Spain. It consists mainly of cereals, grains, vegetables, beans, fruits, and nuts, along with moderate amounts of fish, cheese, olive oil, yogurt, and little red meat.
2. The DASH diet. This diet is often recommended for people with high blood pressure. It consists of eating fruits, vegetables, low-fat dairy foods, whole grains, fish, poultry, and nuts.  It also limits sodium (salt), sweets, sugary drinks, red meats, and foods that are high in saturated fat, cholesterol, and trans fats.
3. The MIND diet. This diet combines the Mediterranean diet and the DASH diet to create a diet that focuses on brain health. Green leafy vegetables, berries, nuts, olive oil, whole grains, fish, beans, and poultry are the main focus.

Consuming plant-based products is a great way to make sure that the body is taking in a wide variety of essential nutrients and vitamins, providing for overall health benefits with normal systemic functions throughout the body. Through taking in all of these nutrients, we are adding a lot of natural and easily absorbable ingredients to our bloodstream.

By subtracting processed ingredients, such as processed sugars and preservatives, a plant-based diet places far less of a strain on the kidneys because they do not need to work as hard to filter the blood. If we think of the kidneys as an engine of sorts, consider using a healthy fuel that the engine can process well without being overly taxed. This will prevent the engine from overheating and breaking down due to firing on all cylinders around the clock.

This transition in diet is especially helpful for individuals who are already suffering from chronic kidney disease. The removal of added harmful wastes in the diet ensures that the kidneys will have a natural means of recovery in addition to the interventions already in place.

Removing other harmful wastes such as alcohol and smoking can further help prevent added stress to the system, helping to promote overall health benefits in the process.

1. Help you keep a healthy weight. Plant-based foods usually have fewer calories than animal-based foods.
2. Lower blood pressure and cholesterol, which helps reduce your risk for heart disease. Did you know that having kidney disease puts you at risk for heart disease? In fact, over 50% of people with kidney disease develop heart disease. Why?  Among other things, healthy kidneys help control blood pressure. But if your kidneys cannot do this well, you may get high blood pressure. Over time, high blood pressure can lead to heart disease and cause further damage to your kidneys. A plant-based diet also helps your heart in other ways – by lowering “bad” cholesterol and helping control weight gain.
3. Lower your risk for diabetes. Healthy, plant-based foods have been shown to help your body use insulin better. Insulin is a hormone that controls how much sugar (called “glucose”) is in your blood. Having too much sugar in your blood can lead to diabetes. And having diabetes can make your kidney disease worse. What if you already have diabetes? Plant-based diets have been shown to help keep blood sugar in check.
4. Improve antioxidant levels. Antioxidants are compounds found in food that help protect your cells from damage. They are abundant in plant-based foods, such as fruits and vegetables. Vitamin C and E are examples of antioxidants.
5. Help keep your kidney disease from getting worse. When you have kidney disease, acid can build up in your blood. This acid load can make kidney disease worse. Eating less animal-based foods can lower the acid load and put less stress on your kidneys. Plant-based foods that are not highly processed, such as fresh vegetables and whole grains, have phytates. Phytates can bind phosphorus, so you don’t absorb as much phosphorus as you would from highly processed foods, or from dairy-based foods such as cheese and milk. In kidney disease, phosphorus can build up in the blood and cause harm to bones and blood vessels.

When considering the mechanisms through which plant-based diets are helpful, there are a couple of major factors to consider. First, healthy plants with a high dietary index contribute less dietary acidic loads to the system, preventing acidic damage throughout the digestive and urinary systems. Secondly, many of these foods are rich in fiber and micronutrients, causing a better flow throughout the system and less waste that needs to be removed during the filtration process.

Because of the decrease in processed sugars, hypertension throughout the system is decreased causing for an increase in blood flow to the kidneys themselves. Water levels throughout the blood also increase, adding to the flow through the kidneys and urine outputs that are healthy and regular.

Yes.  In fact, you may benefit from a plant-based diet if you have early kidney disease. While the transition over to a plant-based diet may seem challenging at first, it is a switch that your kidneys and body as a whole will thank you for. By starting with subtle changes such as adding vegetables to every meal, even to a small degree, in place of preservative dense foods will help you see and feel the benefits.

As kidney health is improved, you will also see increases in energy and improved mood in response to the influx of vitamins and micronutrients being introduced to the body.

Before you begin a plant-based diet, you should consult with all members of your care team including your nephrologist. Because diet and nutrition are an important part of your treatment plan, he or she may recommend that you work with a registered dietician.

If you have kidney failure, you may still be able to follow a plant-based diet – if that is what you want. But you must make sure you are getting the right nutrients in safe amounts. Nutrients are chemicals you get from food that help you stay well.

A dietitian can help you create a meal plan that works for you. Studies suggest that a plant-based or vegetarian diet may have certain health benefits, but it may also have some risks for people with kidney failure. Having kidney failure puts you at risk for poor nutrition (called “malnutrition”). One reason this happens is from the dialysis process itself. Unfortunately, some proteins are lost during dialysis. Weakness, low energy, loss of muscle mass, poor health, and decreased quality of life can result. To lower the risk of poor nutrition, you may have been told to include some protein-rich animal products in your diet. You may also have been told to limit fruits, vegetables, and whole grains, which helps control  potassium and phosphorus levels in your blood.

That’s good advice. But what if you have religious, cultural, or ethical reasons for wanting to follow a plant-based or vegetarian diet? That’s where a dietitian can help. By planning your meals carefully, you can still get the right nutrients in safe amounts. In fact, there may even be some advantages to plant-based meals for people with kidney failure. According to one recent study, dialysis patients who followed a vegetarian or plant-based diet had:

• Lower blood pressure
• Higher antioxidant levels, especially vitamin C, vitamin E, and B-carotene
• Less protein in the urine
• Less inflammation (swelling)
• Better insulin sensitivity (able to use their body’s insulin better)
• A lower risk for heart disease

Talk to your healthcare team if you are interested in a vegetarian or plant-based diet. By working together, you and your healthcare professional can create a meal plan that works for you.

At Vascular Care Specialists of Los Angeles, we strive to provide the best service, care, and results possible. If you have end-stage renal disease with dialysis access related problems, give us a call at 626-275-9566 to schedule an appointment. You can also visit us at www.vcsla.com for more information.