Updated 9/1//24
Nick is on a strict diet because of his chronic kidney disease, diabetes, and reflux. His diabetes is controlled with diet alone. There is a day’s worth of food at the bottom of the page that he does very well with.
Nick’s food is pureed to almost a smooth consistency. I find a stick blender with the container that comes with it works best.
Nick eats a whole food, mostly plant-based diet. Research is showing that eating a Whole Foods, Plant-Based diet can help maintain kidney function longer. Calorie for calorie, beans, grains, fruit, and vegetables have less protein, and the phosphorus in plants is less absorbable. Also, his kidney has to deal with less acid than it does with animal products. I spoke with his kidney transplant doctor about this. He said that they are starting to approve of this diet for their patients, whereas before they told patients to avoid high-potassium foods like beans.
Guidelines for daily intake of phosphorus, protein, potassium, and sodium. Spread the intakes across the day to not overwhelm his kidney.
I use Cronometer to calculate his meals. I work with a dietician from the UMASS transplant team on Lake Ave. in Worcester.
Limit phosphorus intake for the day to 800mg -900mg (he’s currently at 1,000)- this helps with keeping his parathyroid level down. Phosphorus stimulates the parathyroid to produce more parathyroid hormone (PTH). This contributes to osteoporosis.
Keep protein intake to 48g – 50g. Protein is very hard on the kidney. Excess protein will cause more protein to spill in his urine. Not good.
Keep potassium under 2,250 3,000 mg per day (waiting for labs to be sure this is okay). Nick’s potassium level has come back high in the past. A high serum potassium level can be deadly. It can cause an irregular heart rhythm.
Don’t add salt to anything, and don’t feed him salty foods like olives. I don’t purchase low-sodium beans. His sodium has gone too low when I do that. Rinse his canned beans well, then soak them for a while in water, drain, and then use them.
Canned beans have less phosphorus than freshly cooked beans. Sodium contributes to the protein being spilled in the urine, which causes further damage and leads to dialysis/kidney failure faster.
- Give him D3 every day. This helps keep his parathyroid level down.
- He needs to take B12 at low doses, not 2,000 per week like a lot of people do. Test his B12 level regularly with his primary doctor. B12 supplementation is required because of his mostly plant-based diet.
- He gets just a little bit of kelp for the iodine. Between 1/32 tsp and 1/16 tsp.
Here is a video that explains PRAL (potential renal acid load). And here is some more information on PRAL with a list of different foods and their PRAL values.
Full-grown dark leafy greens need to be REALLY well cooked. Stay away from high oxalate leafy greens like spinach and chard. Kale bothers him. Collard greens, pressure cooked on high for 7 minutes is one that he does really well with. Up to 40g of arugula.
You will notice that his blood sugar goes up higher on the days that he has his prednisolone (every other day). T
Nick never, ever eats junk food. Just whole or minimally processed foods. Black beans, mung beans, Vegetables, low glycemic fruit. Organic if possible, always organic with leafy greens, strawberries, and apples. A few soaked nuts and seeds, VERY LITTLE liquid oils, and NO nut/seed butter. His gut doesn’t like a high, liquid fat diet or butter/nut butter. Check out EWG’s Dirty Dozen, Clean Fifteen when deciding what produce needs to be organic.
All of the food he eats is chopped up fine to a near-pureed consistency in a stick blender container.
Diabetic
Nick has drug-induced diabetes. He is not on any medication for his diabetes. It is controlled through a whole food, plant-based, low glycemic index, low glycemic load diet. His serum potassium level went up too high once when eating potatoes. I suspect he didn’t have enough insulin to handle the high glycemic index/load and potassium of potatoes, which can cause a high serum potassium level. This can be deadly, so please be very careful about this. I’d avoid potatoes altogether.
Reflux
The example meals below work well for him. Lemon may make the body more alkaline, but in the stomach, it’s still acidic so please avoid foods like lemon, tomato, and vinegar. I also avoid foods that relax the lower sphincter, like onion and garlic, and foods that produce more pepsin.
Kidney Transplant
Please follow the guidelines for phosphorus, protein, potassium, sodium, D3, and B12 that are listed at the top of this page.
Vegetables
Nick needs to have all of his vegetables fairly well cooked (unfortunately) so they are easier to digest, except for arugula. Arugula is my go-to dark leafy green for him. He does well with it and he really likes the flavor.
Calcium
Nick gets kidney stones. They’re mainly uric acid stones, but they are also a little bit calcium/oxalate as well. Because of this, avoid calcium supplements. He doesn’t tolerate tons of dark leafy greens for the calcium. He can drink lactose-free milk.