10 replies to this topic

[Michael Lustgarten]

In the video:

 

Data for changes in kidney function during aging, kidney function values that are associated with an increased risk of death for all causes

 

What's my data for kidney function, 2006 - 2020?

 

Can diet impact kidney function?

 

Within my data, which foods are correlated with good kidney function?

 

How are the individual components of these foods (fiber, protein, omega-3 fatty acids) correlated with kidney function?

 

[Oakman]

I like how you test/evaluate/research over the long term! Nice video, thanks! This topic is of specific interest to me now. We have two elderly (16 & 20 yrs) cats with kidney disease. The older has a BUN of 86.2, BUN/Creatinine ratio 33.2; the other a BUN of 43.9, BUN/Creatinine ratio of 22. I understand these are dangerously poor readings, although not sure if feline reading correlate with human readings exactly.

 

Yet all I experience is their extra thirst for water, and would never realized their condition without blood tests they got before teeth cleaning. I have hope there is something to do besides the 'special diet' (low protein, low phosphorus) that they don't like, that we could do for them, if only to prolong the inevitable. Maybe sardines not sure if they'd stomach that after so long on canned food?

 

My own BUN is currently 22, eGRF of 64, which is apparently somewhat better for my age than shown on your graph. No red meat, but fish, regular nut intake, veggies, daily fruits (apples/blueberries/pears) are a staple, all enjoyed, but also with fiber intake in mind for my microbiome. You take even more!  I do try to help/adjust my microbiome with prebiotics/probiotics, and so the butyrate discussion is interesting. Quite a bit of info such as https://atlasbiomed....ntain-butyrate/ and https://atlasbiomed....w-brain-cells/ offer suggestions.

 

That may be the easiest angle to do a dietary change to get some improvement. What do you think?

Edited by Oakman, 06 February 2021 - 02:27 PM.

[Michael Lustgarten]

Kidney function also declines during aging for cats, but it's tough to say what can it improve it for them. You'd need to try different dietary interventions and regularly monitor their BUN, creatinine/cystatin C, etc to see what works and what doesn't. 

in terms of your kidney function, as I mentioned in the video, the strongest correlation was for my (fibrous) vegetable intake. I'd increase that, and see if your eGFR improves. Also note that what works for me may not work for others, but finding out what works for each of us is the fun part (at least for me!).

[albedo]

Thank you Michael for another insightful video. I normally comment in your blog but allow myself to do it here for convenience.

 

Comments and questions:

• very good insight into SCFA (butyrate) correlation, hinting to beneficial impact of fiber intake
• I do not have data on fish, which you look for but, wrt vegetables, I recollect an interesting paper cited by Dr Michael Greger on the almost immediate impact on eGFR after a tofu intake (here min 3:00 on)
• which is the eGFR formula you or your lab are using? I normally run both Cystatin C and Creatinine based formulas. I run typically 4-5 different eGFR methods and average between them. When I ask my lab for Cystatin C they normally return the values of eGFR based on that (vs. Creatinine based). Cystatin C is a relatively recent, independent and more sensitive biomarker of kidney health than Creatinine. Refer to https://www.kidney.org for the various eGFR formulas
• remember also that the age is included in the eGFR formulas
• watch your liquid intake, if you drink lot of water the day before and before your test your eGFR tends to rise notably, I do not have data but tested on myself

[Michael Lustgarten]

Thanks albedo. In terms of the tofu-eGFR link, although that might be the acute effect, I wonder if chronic tofu consumption would continue to benefit eGFR. I don't think there's any data for that, i.e. the longitudinal eGFR correlation with tofu consumption.

 

The eGFR data is based on the CKD-epi equation. I've considered using cystatin C, as creatinine-based eGFR can be impacted by age and muscle mass. Nonetheless, there's published data that eGFR with creatinine is similar to eGFR with Cystatin C.

Yes, I'm aware that age is included in the eGFR calculation, and considered talking about that in the video, but to keep it relatively simple, I didn't mention it. I may raise it in another video, though. For ex., if your creatinine is the same at 20y as it is at 80y, just because of the age inclusion for the eGFR equation, your eGFR will be 40 units lower at 80y, which seems ridiculous.

I'm always hydrated/peeing a lot, especially considering all the veggies that I eat. On the day on the test, I drink 20 oz of water 2-3h before the test, to make sure that I'm not dehydrated. I do that for every blood test, to be consistent.

 

[Thingsvarious]

GH/IGF1 seem to improve long-term kidney health and function; as do SGLT2ihibitors. I am taking both at very low doses

[Bike_to_120]

My N=1 experiment showed rapamycin changed both my eGFR and creatinine in positive directions

from 2014 to 2019 annual blood tests for creatine ranged from 1.4 to 1.48, eGFR ranged from 60 to 49

After rapamycin all tests have been within range

eGFR 86-89

creatinine 1-2 to .88

[Paravani]

I was just reading that NAC (N-acetylcysteine) was effective at protecting/promoting kidney and liver health.

Do you have any comments, Dr. Lustgarten? Can you refer us to any studies on NAC and kidney function?

[Michael Lustgarten]

I was just reading that NAC (N-acetylcysteine) was effective at protecting/promoting kidney and liver health.

Do you have any comments, Dr. Lustgarten? Can you refer us to any studies on NAC and kidney function?

 

Hi Parvani, unfortunately I don't. For me, supplements are a secondary approach for improving organ function, whereas I attempt to modify diet+exercise as the primary factor.

[albedo]

I think you might find of interest this study on the ratio eGFR_{cystatin C}/eGFR_creatinine. Below 0.60 in a patient is risky for a specific syndrome. I also know there is a link to all causes mortality for healthy seniors:

Anders Grubb,
Shrunken pore syndrome - a common kidney disorder with high mortality. Diagnosis, prevalence, pathophysiology and treatment options,
Clinical Biochemistry, Volume 83, 2020, Pages 12-20, ISSN 0009-9120,
https://doi.org/10.1...hem.2020.06.002.
(https://www.scienced...009912019312329)

 

And you can also check this convenient site from the author:

http://www.egfr.se/eGFRen.html

Edited by albedo, 07 January 2022 - 10:46 AM.

[Zarathrustra]

I have data o my kidney function stretching back over decades, but I now concentrate on the past 13 years or so, during which my CKD went up to stage 4, thankfully now about stage 3a. I use creatine as my biometric, as eGFR is derived from this (hence the 'e' for estimated). I have 110 measurements for this period.

 

I have refrained from doing a multiple regression analysis so far, as I understood one needed an average of 10 or more (preferable >20) records per variable for adequate significance testing. However, with 110 events, I could do an MRA for the nine nutrition groups I presently track and will look into that.

 

My data does show that vegetable protean is probably the strongest correlation for improving my kidney.

 

A problem i have is that more exercise correlates with worsening CKD (presumably because of the increase in creatine), but improves my cardio-vascular fitness.

 

My CKD sudden rise to CKD4 in 2014 is somewhat of a mystery, as it its decline; I suspect my taking the hypertension drug atenolol was the cause - I took it for a few months before, ending it just before the rise.

 

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