Chronic Kidney Disease (CKD) and Plant-Based Diets

Is a plant-based diet the right choice for you? Dr. Deborah Clegg, a lead study investigator on plant-based diets in people with chronic kidney disease (CKD), shares vital information for patients whose kidneys are not functioning properly. She discusses newer treatment options that may help balance potassium levels.

Dr. Clegg is a known expert in the field of sex hormones and metabolism with a specific interest in nutrition and how it interacts with physiology.  She has authored over 150 articles in impactful journals such as The New England Journal of Medicine, JAMA, American Journal of Physiology, and the National Kidney Foundation. She is a clinical dietitian and in this role, she has advocated for personalized nutritional approaches and liberalization of diets to enhance patient compliance and satisfaction. Dr. Clegg is a Distinguished Visiting Professor at American University and holds faculty appointments in the role of Professor at Cedars-Sinai Medical Center and the University of California Los Angeles (UCLA).  Dr. Clegg and her research has been featured in many forms of media, to include the television program The View, and HBO series entitled ‘Weight of the Nation’, as well as in the popular press to include magazines such as Vogue, Mademoiselle, Ladies Home Journal, and Nature.

Transcript

Neal Howard: Hello and welcome to the program. I’m your host Neal Howard here on Health Professional Radio, thank you for joining us once again. Now, is a plant-based diet the right choice for you? Our guest today is Dr. Deborah Clegg and she’s joining us with some vital information on the potential health benefits and some of the risks associated with a plant-based diet for patients with chronic kidney disease. Welcome to the program Dr. Clegg, thanks for taking the time.

Dr. Deborah Clegg: Thanks.

Neal: A bit of background about yourself if you if you would.

Dr Clegg: Yes. So I’m a registered dietitian and I also do research on metabolism, so I focus on understanding how our nutrients interact with our body.

Neal: Now I did mention plant-based diets specifically for patients with chronic kidney disease. Kidney disease and chronic kidney disease, what is chronic kidney disease? Is that something that you’re just going to have it from now on and there’s no treatment?

Dr Clegg: Not necessarily, but it is an indication that your kidneys are not necessarily working perfectly and it’s time then to stand up, take stock and make sure that we’re taking care of our kidneys – they are very vital organs within our body.

Neal: What is it about chronic kidney disease that sets us apart?

Dr Clegg: So chronic kidney disease can actually be caused by having elevations in blood pressure or happening hypertension as well as diabetes and cardiovascular disease. And again as I indicated, the kidneys are incredible organs within our body that maintain normal homeostasis and so when they started not to work properly we lose that homeostasis and one of the specific areas that we lose the homeostasis is related to potassium. So having higher blood potassium or hyperkalemia is actually considered to be lethal and it’s one of the concerns with individuals who have kidneys that are no longer functioning perfectly correctly.

Neal: So obviously keeping these potassium levels balanced or at their proper level even with kidney failure or damage is of utmost importance. So why is this potassium level so important? What is it about potassium?

Dr Clegg: Exactly. So potassium is one of those bits in a very critical element or nutrient within our diet. It actually helps regulate blood pressure, it decreases stroke risk, it decreases fluid accumulation and enhances nerve function. And the interesting thing about potassium is that when you have enough potassium in your diet, it actually can protect your kidneys however when all of a sudden your kidneys are no longer functioning adequately and all of a sudden potassium becomes very dangerous. So it’s sort of a yin and yang effect of potassium and so what we’re here to talk about today is that there are some newer treatment options for people whose kidneys or who have chronic kidney disease may allow them to seek diets that are loaded with fresh fruits and vegetables and these diets are also the types of diets that are loaded in potassium.

Neal: The plant-based diets that we’re talking about, what is it about the plants, the potassium in the plants – is it different from what a person may be taking if they’re not eating this plant-based diet

Dr Clegg: Well not necessarily. So what we’re talking about is that enduring chronic kidney disease, when the kidneys are no longer functioning perfectly, then all of a sudden we have to watch or monitor the amount of potassium we take in our diet. And the fresh fruits and vegetables tend to be products within our diet that are loaded with potassium and so with these newer treatment options, what we now believe is that there’s opportunities for people who have CKD or chronic kidney disease to actually enjoy the benefits of fresh fruits and vegetables. Not to say that one fruit or one vegetable is better or worse than the other, what we’re trying to do is we’re trying to encourage individuals who have chronic kidney disease talk with their doctor and see whether they might be eligible for these newer treatment options that can maintain potassium homeostasis within their body.

Neal: So what are some of these options specifically and how do they differ from patient to patient?

Dr Clegg: Right. So not every person, this is one of the really interesting areas in research actually and that is that we’re just beginning to understand that not everyone actually has the same concerns with respect to hyperkalemia, with high blood pressure or high blood potassium levels and then it varies between individuals. But this is something that people need to go to  specifically to their physician to discover and see whether they might be individuals who could benefit from these newer treatment options.

Neal: So there are obviously some risks involved with any type of treatment especially when we’re talking about the kidneys, such as a vital organ. Talk about some of the risk, we’ve discussed the benefits, balancing the potassium levels, things of that nature – what are some of the risks associated?

Dr Clegg: Right. So having hyperkalemia, elevated blood potassium levels is actually lethal. Also having too low blood potassium is also lethal, so these are two different extremes with potassium homeostasis that people who have chronic kidney disease need to watch out for. So just having a nice right … or the right amount of potassium in the body is absolutely critical and then when your kidneys start to fail, it becomes even more critical to monitor very carefully and that’s when we encourage individuals to seek the care of physicians.

Neal: So is it because there are different causes of the kidney disease? Is that why it’s so crucial to have an in-depth conversation with your healthcare provider rather than just go and do a shotgun effective treatment?

Dr Clegg: Exactly. So it’s really really important. It’s not fun to sort of self manage any of these types of diseases especially once when there the disease affecting the kidneys so we really encourage individuals if they have any of these preconditions such as hypertension, diabetes or cardiovascular disease to really monitor their kidney health with their physician and then talk with their physician about whether they might be considered to be eligible for trying these newer products which again will allow them to eat the fresh fruits and vegetables. It’s this unusual balance between fresh fruits and vegetables are wonderful for your kidney but as soon as your kidney function just starts to decrease, all of a sudden you have to be very careful over the same fruits and vegetables. So with these new products, what we’re hoping is that individuals will be able to enjoy the health benefits of fresh fruits and vegetables while maintaining kidney function.

Neal: Through the years and this is just my own observation, I have noticed kidney dialysis centers, kidney treatment centers in cities almost every 2 or 3 blocks or so. I mean they’re everywhere. In your opinion, is that because there are so many advancements in kidney treatment or because we have been negligent as a society in some of the things that we’re eating? Neglecting these plant-based diets that seem to be so in the forefront of everybody’s in mind these days.

Dr Clegg: Absolutely. So there’s about 30 million people who suffer from chronic kidney disease. And again, I think that your questions are right on, I think that our diet has contributed to chronic kidney disease as well as our diets’ contributed to hypertension diabetes and cardiovascular disease and those were those three main diseases that actually impact the kidneys. So now is a time again when I think that we need to go back to the basics, try to enjoy fresh fruits and vegetables, shop in that perimeter of the grocery store rather than in the middle aisles where all the foods are processed in order to preserve the function of our kidneys.

Neal: Where can our listeners go and get some more information about kidney health in general and about possibly what you do?

Dr Clegg:  Exactly. So this month actually happens to be National Kidney Function Month and so we encourage individuals to go to the National Kidney Foundation website which provides some beautiful information about chronic kidney disease and hyperkalemia as well. This is just an important time, not only is it National Kidney Function Month but it’s also National Nutrition Month which reminds us that to take good care of our kidneys, we also need to eat a healthy diet so that’s really what we’re trying to encourage individuals to do.

Neal: Well I thank you for joining us here on the program today Dr. Clegg.

Dr Clegg: Thank you so much.

Neal: You’ve been listening to health Professional Radio. I’m your host Neal Howard in conversation with Dr. Deborah Clegg with affiliated with Cedar Sinai-UCLA and the American University, also lead study investigator on plant-based diets and folks with CKD or chronic kidney disease. We’ve been talking about plant-based diets and the benefits and possible risk. Transcripts and audio of this program are available at hpr.fm and healthprofessionalradio.com au

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