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Kidney Week

Abstract: PUB305

Delaying Progression of Kidney Diseases in Patient with FSGS with Dietary Interventions

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Justus, Haley D., Strive Health, Hendersonville, North Carolina, United States
  • Sohaib, Muhammad, Strive Health, Princeton Junction, New Jersey, United States

Group or Team Name

  • Strive Health.
Introduction

Plant-based diets along with lowering dietary protein intake can lower production of uremic toxins and may provide protection in advancing chronic kidney disease.
Nutrition education should be provided via Registered Dietitian to optimize potassium and phosphorus intake in patients following plant-based diets in later stages of chronic kidney disease.

Case Description

50-year-old male with histoy of chronic kidney disease stage V, hypertension, and cardiomyopathy. The etiology of his chronic kidney disease (CKD) is biopsy proven FSGS with IgA glomerulopathy. The patient was diagnosed with CKD in 2019 and had an AV fistula placed in 2022 in preparation for a dialysis start and is actively listed for kidney transplantation.

On initial RD visit, patient voiced he follows a whole food and plant-based approach and reads food labels to limit inorganic phosphorus.Interventions to reduce serum phosphorus and potassium included: Continuance of lower protein diet by limiting animal-based protein portions to 3 oz., starting tums as a phosphate binder per nephrologist and double boiling potatoes and sweet potatoes.

The patient had maintained GFR < 10 without start on dialysis as of April 2023. He reported no uremic symptoms and continued with good appetite. His proteinuria also improved from nephrotic range to non-nephrotic range with dietary interventions.

Discussion

High consumption of protein intake is associated with increased incidence and progression of kidney disease. Plant based diets have shown to slow down the progression of kidney disease by lowering intraglomerular pressure in patients with diabetes and hypertension however literature is lacking to support their use to delay progression in patients with glomerulopathies associated with proteinuria. Our patient has biopsy proven FSGS with Ig A nephropathy with rapid decline in kidney function which was stabilized after adopting plant-based diet and limiting protein intake. Additionally, proteinuria improved from nephrotic range to non-nephrotic range without the use of any antiproteinuric medication. Typically, normal recommendation for protein intake is 0.8-1.0g/kg body weight. CKD recommendations are 0.55-0.6 g/kg body weight non-diabetic and 0.6-0.8/kg body weight for diabetic patients. Side effects include elevated potassium and phosphorous levels, and early dietitian intervention can help mitigate these complications.