Test results 2016

About 15 months have zoomed by since my last lab tests and so I was delighted to find no significant change in today's test results. My blood creatinine level remains at 2.0mg/dl, which is right where it was when I was first diagnosed with chronic kidney disease almost seven years ago. Kidney disease tends to progress so I consider avoiding progression an achievement!

I can't say if my attempt to live a healthy lifestyle has been a factor in avoiding progression of the disease but it probably doesn't hurt (and has other benefits), so here's what I do:

Diet

  • Relatively low protein (protein is believed to damage kidney nephrons). In my particular case this means no meat; fish about once or twice a months; eggs once or twice a week; dairy a few times a week; tofu a couple of times a month; rice and beans quite often, etc.
  • Very little sugar or salt (my theory is that these encourage unhealthy eating by making undesirable foods seem tempting).
  • Very little wheat. Around the time of my diagnosis with kidney disease I would often have large, hard, balls of gas in my intestines (these were visible on an ultrasound but the doctor I saw at the time couldn't think of any reason for them so just told me to chill out more). Avoiding wheat and/or too many simple carbohydrates seems to keep the problem at bay.
  • Light breakfast: Bananas and almonds usually.
  • Snacks of fruit and nuts (especially pure cacao).
  • Filling lunch (dinner): Usually a small amount of protein, some carbs, vegetables and salad. Avocado and beetroot feature quite often.
  • Light supper: Sometimes amaranth and yogurt, sometimes humus and carrots, sometimes an apple.

Exercise

I still don't do as much exercise as I think I should but probably more than most people as I cycle about 40 minutes a day and generally try to go out of my way to be active (despite having a desk job). I manage to maintain a reasonably slim physique but could probably lose a couple of pounds around the waist…

Sleep

I don't sleep as well or as much as I would like to but do get close to at least 7 hours of sleep a night.

Meditation

Have tried and failed several times to incorporate some form of meditation into my day as many people seem to enjoy great benefits from this. New habits are hard to form!

Blood test results 2014

After over a year with no tests, I decided to subject myself to the needle again and have my blood analyzed.

The good news: no change

The tests show no signs of kidney function degradation. Serum creatinine is 2.0mg/dL, exactly what it was when I was diagnosed with Chronic Kidney Disease over five years ago. All other parameters are pretty consistent with the results obtained over the last five years and are within, or close to, the normal healthy range.

This either means that:
a) My hard work watching my diet and trying to live a healthy life is paying off and protecting my kidneys from further damage, or,
b) None of my lifestyle changes have made any difference whatsoever!

Truthfully I don't know which statement is correct but there are other benefits to being healthy and I'm convinced that in the long run it will help me extend my life. In any case my dietary choices are more about moderation and avoidance rather than total exclusion… though I haven't had any pizza in a really, really, really long time…

View lab results (5 year history)

GFR: Glomerular Filtration Rate

Kidney function is measured by their GFR, basically how much filtering power they have. Normal is over 90mls/min/1.73m2 and “failure” (inability to filter sufficient toxins from the blood) is 15mls/min/1.73m2.

Previously I've a few creatinine clearance tests to estimate my GFR. These tests require collecting ones urine over a 24 hour period so the lab can measure how much creatinine has been filtered from the blood, compared to the level remaining in the blood, and use this to estimate the GFR. Unfortunately it's apparently not all that accurate and my own lab tests have shown a lot of variance: as high as 52.5 and as low as 30.0, which frankly is a bit an emotional roller coaster ride. Given the questionable utility of the results and the inconvenience and cost of the process, I decided to give it a miss.

This interesting article suggests that estimates based on serum creatinine levels adjusted for body weight, etc. have proved to be more accurate than creatinine clearance tests and I believe it given the that my serum creatinine level has been fairly constant: 1.8mg/dL to 2.4mg/dL. Variations in the serum creatinine level are probably due to variations in protein intake. Unfortunately they say the estimation formulas may not work well in cases where the subject differs significantly from the population used to develop them, giving the example of a vegetarian diet. I don't eat any meat or chicken but I do it fish and eggs, so hopefully the formulas will be somewhat accurate.

In my case the MDRD calculator gives a worst case estimate of GFR of 30mls/min/1.73m2, which is consistent with the creatinine clearance tests.

Apparently GFR tends to decrease by around 1mls/min/1.73m2 every year. If this happened to me it would imply that I have around 15 years of  healthy life left before reaching kidney failure (15mls/min/1.73m2). Hopefully I can beat the “average” and extend my mileage by looking after my body.

Lifestyle

As a reference, my current lifestyle, which may or may not be optimal, is as follows:

Exercise:

  • Sedentary office job 8 to 10 hours a day. I try to get up and move around during the day however to avoid sitting for long periods.
  • Cycle everywhere. About 40 minutes a day.
  • Occasional moderate exercise (body weight exercises, swimming, etc.). I should probably do more of this.

Diet:
No meat or chicken. Occasional fish and eggs. No gluten (I feel I may have sensitivity to gluten, though I'm not 100% sure). Very limited consumption of products with added sugar and salt. Limited starch, mostly rice and potatoes. Lots of nuts (almonds, pecans, cacao), fruits and vegetables.

Sleep: Try to get enough sleep so I wake naturally shortly after dawn. For me this is around 8 hours.

Medications

I've been taking 50mg/dL of Losartan (Cozaar), an ARB, fairly steadly since diagnosis of CKD. This was initially prescribed to reduce my blood pressure. A month ago I fasted for a day as a kind of  “body reset” and found that my blood pressure dropped to around 100/60 so I stopped taking the medication. Since then I have been checking every day and my blood pressure has remained below 120/70 even without medication (or further fasting). I will probably start taking the medicine again at some point, as the experts seem to think that it is beneficial to conserving kidney function for reasons other than blood pressure reduction.

Progress report

It's now been three and a half years since I was diagnosed with Chronic Kidney Disease (CKD) and began my quest to cure myself. Although I have not achieved the dramatic recovery I was hoping for my condition appears to be generally stable and this can be considered an acheivement given that the tendency for CKD patients is to gradually lose kidney function until replacement or death becomes necessary. Here are my findings and tips to date so that others may benefit from them (none of which should be construed as medical advice!):

Comments on this blog
Thanks to all the people who've taken the time to comment on this blog. I have just noticed I had almost 2 years of comments pending my approval. These have now been posted and I will try to answer them.

Background information and lab test results
For anyone interested in the technical details, I have a 40 year old male of British/Dutch/Austrian ancestry living in on the caribbean coast of Mexico. Height 1.82m, current weight ~76kg (previously 85kg). You can review my complete lab test result history here:
https://docs.google.com/spreadsheet/pub?key=0AhX6YZKS2qpCdFpObVlQQXNmMjBfT19kUUdxUHAxaEE&output=html

UK consultation
In April I consulted with a nephrologist in England, Dr. Rowe, and also took blood tests. The UK test results were consistent with all my previous test results done in Mexico. The nephrolgoist provided the following information:
  • Natural decline: The natural tendency of a healthy kidney is for a reduction in function with age of around 5 to 10mL/min per decade, so based on my current estimated GFR (glomular filtration rate) of 30 to 40mL/min, he would expect “renal replacement therapy” (kidney transplant) to be necessary in 10 to 20 years, as a GFR of 15mL/min is the level at which toxins are no longer adecuately removed from the body.
  • Ultrasounds: Ultrasounds don't provide good diagnostic information for kidney disease and the measurements are highly variable, depending on the operator, etc. I have had three ultrasounds (one a year) but in his opiniĆ³n they can't be used to observe any changes, just to confirm the presence of damage (scar tissue). He also doubted that the number of kidney stones had changed as no stones have been passed (the first ultrasound showed 4 stones, the most recent only 2).
  • Diet: In his opinion diet options should be based on reducing the kidneys workload and for this reason salt should be avoided as much as possible as well as excessive protein. He noted that protein reduction may reduce the measured serum creatinine levels but this doesn't necessarily indicated improveed kidney function, it may just indicate less creatinine in the blood due to less protein consumed.
  • Blood pressure: He believes strict blood pressure control to be very important and recommends continuing to take 50mg/day of losartan.
No miracle cure
My research and experiences to date have reduced my expectations of finding a “miracle cure”. Even though kidney tissue does not normally regenerate I had originally hoped to somehow (through some “alternative” therapy) find a way to turn on the gene responsible for kidney growth and achieve miraculous regeneration of the damaged tissue. However, I have found little evidence of this type of miracle, even among people involved in advanced spirtual/meditive practices. My focus, therefore, has shifted away from looking for a cure and more on accepting the cards I have been dealt and playing them the best I can. This means striving to be as healthy as possible and trying to enjoy as much as possible whatever time I have left. More on this below.
Patient involvementI think it's very important for anyone with any kind of disease to get involved and learn about the disease and your body, and not just blindly follow your doctor's orders. I have consulted with three Nephrologists, as well as reading a wide range of materiales, and there have been significant differences in their treatment recomendations. This doesn't mean any of them are “wrong” but the reality is that a doctor is just a human being and the state of medical science is advancing all the time. However well trained your doctor is, and however much experience he has, he has never experienced what it's like to be you and live inside your body. He also doesn't have as much time or interest to think about your case as much as you can.
Staying healthy
Probably the best defence against any disease is maintaining your body in as healthy condition as possible. I always considered myself healthy before but now I am much more so. After much research and reading of conflicting opinions and experimentation, I believe the pillars of health are:
  • Sleep. Make sure you get enough of it and wake naturally every day.
  • Happiness.  Make sure you enjoy what you do every day.
  • Diet. There are so many conflicting messages regarding diet that the area has become a veritable minefield. After looking at the evidence of healthy people living on an extremely wide variety of diets, my personal philosophy is to eat whatever you feel like provided it contains no added sweeteners or salt, as I believe these substances trick your body into believing a particular food is nutritious regardless of its real benefits or otherwise to the body. I also think there is a lot to be said for eating foods as close to their natural form as possible. My personal diet contains nuts, fruits, vegetables, yoghurt, some rice, some corn, some low-salt cheese, some fish/shrimps, no wheat, no meat.
  • Excercise. There is also lots of conflicting advice about types of excersise but I think everybody agrees that at least 30 minutes a day of some sort of excercise is important for your health. In my case excercise is limited to walking at least 30 minutes a day and maybe once a week doing something more streneous but I feel like I would benefit from doing more! Yoga is probably an excelent option for people suffering from chronic disease as it may help your whole body (and mind) to work better.
  • Immune system. I've read that a large part of your immune system resides in your gut (intestines) and therefore to have a healthy immune system you need to have a healthy intestinal tract. If you are intolerance to a certain food (e.g. gluten or wheat) its consumption may cause damage or inflammation of your intestines and weaken your immune system. It could be coincidence but since avoiding wheat, and being careful about my diet in general, I have not missed a single day of work due to illness. I have certainly been 'sick' and been aware of having a virus but have only experienced mild symptoms. Previously I would usually miss one or two days a year due to colds or flu (at least that's my perception).
Blood pressure
Most experts believe that avoiding high blood pressure is a very important for conserving kidney function.
At the time of my diagnosis my blood pressure was in the 140/90 range (and often higher). For the last few months it has been in the 120/70 range. I was prescribed losartan (cozaar) but didn't notice any effect from this until I made changes in my diet. Without medication my blood pressure would be in the 130/80 range and taking 50mg of losartan a day keeps it in the 120/70 range (often less). It's hard to be very specific as exactly what foods increase or decrease blood pressure but I would recommend trying the following to see what works for you:
  • Avoid/reduce foods with added sugar 
  • Avoid/reduce foods with added salt (cheese, for example)
  • Avoid/reduce starchy grains.
  • Avoid excess fruit consumption (after eating 4 bananas one morning I noticed a spike in my blood pressure. Since then I have cut back on bananas and enjoyed low blood pressure).
  • Unsalted peanuts with the skin (I eat a fair amount of these and some sources say the skin contains something which reduces blood pressure).

Sodium Bicarbonate

There a few e-mails going around touting sodium bicarbonate (baking soda) as a 'cure-all' for all sorts of things. They say that the one of the signs of a 'quack' treatment is if it claims to work for lots of different ailments and this has certainly been my experience in general. I have experimented with taking half a spoon of sodium bicarbonate daily (mixed with water and a little grape juice) for extended periods with no obvious impact (positive or negative). Lately I have stopped taking it regularly but I do still take it now and again if I feel like it. It could be my imagination but I feel it like it helps ward off common colds.

Diuretics
There are any number of natural cures for kidney problems, e.g. dandelion tea, or things that are “good for kidneys” that are really just diuretics that excercise your kidneys by making them generate more urine than normal. Some of these cures talk about cleaning your kidneys and removing the 'sludge' but I have never read anything about kidney sludge in any serious medical literature. It is possible that some diuretics may be good for some kidney conditions, or for healthy kidneys, or for passing kidney stones, but I am unaware of any benefit for chronically damaged kidneys.

That's all folks
That's everything I have for you now. The bad news is that if you have damaged kidneys there is no known way of repairing them. The good news is that it may be possible to prevent further damange if you make an effort to live a healthy life. This blog has been written to share my experiences with other people with kidney problems in case it helps them in anyway. If you want to ask me a question please leave a comment and I will respond (eventually!)

Test results – the complete history

I finally had the brainwave of putting all my test results into a spreadsheet to make it easier to view changes over time.

You can view them here if you so desire:

https://docs.google.com/spreadsheet/pub?hl=en_US&hl=en_US&key=0AhX6YZKS2qpCdFpObVlQQXNmMjBfT19kUUdxUHAxaEE&output=html

The progress points are:
  • Serum Creatinine back to same level of 18 months ago.
  • Proteinuria (protein in urine) way down.
  • Increased Serum Hemoglobin (reduction of anemia)
  • Blood pressure reduced.

The “lack of progress” points are:

  • Serum Creatinine and Creatinine Clearance unchanged (i.e. no improvement in kidney function)
  • Uric Acid high (being controlled by Alopurinol)

After experimenting with many different things, I believe the main factors responsible for the progress are:

Healthy, balanced diet
I ate pretty healthily before but I've improved some areas and feel like I could improve some more. After researching and experimenting, my personal advice is to eat whatever foods you feel like in their natural form. This means avoiding anything with added sugar or salt (which I believe trick you into thinking the food is better for you than it really is). I recommend experimenting with removing wheat from your diet for a month to see if you notice any improvements.

Sleep
I try to make sure I get just enough of it.

Happiness
Possibly your mental state is the most important factor in your wellness, so I recommend trying to only do things that make you feel good and avoid things that make you feel bad. Again, I recommend experimenting to see what really makes you feel good and what doesn't. It may not be what you expect. Sleep is probably very important for feeling happy as any parent of small children will tell you…

Test results

Just did another 'full-blown' set of lab tests.

The results are basically the same as those of 7 months ago, which can be considered good news as they show no decline in kidney function.

The general prognosis for Chronic Kidney Disease is a gradual worsening of the condition until dialysis, so avoiding disimprovement can be considered progress.

Here is a summary of the results:
* Serum Creatinine 2.0mg/dL (same as it was when my condition was discovered 18 months ago, and lower than the high of 2.5mg/dL of about a year ago)

* Creatine Clearance is calculated at 41mL/min. This can roughly be interpreted as meaning my kidneys are functioning at 35% of normal, which is asymptomatic. Below ~15%, however, and death (or Dialysis/Transplant) is not far away… (and frankly, provided my children are grown, I think death may be preferable to dialysis or a transplant)

* Protein in 24-hour urine 375mg, about the same as the last test and way down from 1,800mg when my condition was discovered. I understand that this is important as because proteins leaking through the kidneys may damage them further. Normal is less than 225mg.

* Uric Acid 7.6 mg/dL. This should be kept below 7 according to my first nephrologist. Taking Alopurinol controls it pretty easily but I'd prefer to be controling it naturally through diet. Will have to research this a bit.

Next Steps:
* I've been taking Co-enzyme Q10 for 3 months and this doesn't seem to have had any effect so I'll stop that.

* I'll probably continue taking a half a teaspoon of bicarbonate of soda every day. I'm not sure if it's helping but it doesn't seem to be doing any harm and it's cheap and easy to take.

* I think I need to work harder with my diet. I have a little more body fat than I'd like yet I'm often hungry, which suggests I'm not eating the nutrients my body requires, however I'm not sure what I should be eating (and it's frustrating not being able to eat many of the things I crave because of protein/salt/gluten restrictions).

* I'm tempted to dedicate 15-30 minutes every day to “mental programming” activities for a month to see if it helps.

Sonic Healing

Apparently listening to this “harmonic overtone” style of singing can help your kidneys regenerate and generally help you to be healthy:

http://www.sonic-healing.com/store/index.php?act=viewProd&productId=61

The program can be downloaded but costs $99 USD. If they offered a money back guarantee I might try it!

Update and reflections

Lab results

Creatinine
My latest creatinine tests show no change at 2.1mg/dL. This level has remained constant since about january.

Ultrasound
An ultrasound scan revealed:

  1. Three of my four kidney stones have disappeared (without specific treatment). This is a relief as it's something less to worry about. My first nephrologist had prescribed what I felt was an aggresive course of 3 different drugs to try and clear the stones, and I decided against taking them (I stopped consulting that nephrologist). The remaining stone is 6mm and apparently it's position is favorable for “passing” (although I wasn't aware of passing the others, one of which was about 8mm).
  2. There is now good definition corticomedullary differentiation (previous it was poor). I'm not sure of the significance of this but it's supposedly a good sign.
  3. My kidneys are now smaller than previously: 8.2cm and 9.1cm (compared to 9.9 and 10.6cm previously, and “normal” kidney size of around 10 to 12cm). The ultrasound doctor mentioned that the kidneys were no longer inflamed and 'back to normal', so maybe lack of inflamation is the reason for the smaller size.
  4. The kidneys still show “moderate to severe chronic inflamatory changes”.

Reflections
When I started this blog I was hoping to be able to document the spontaneous recovery of my kidneys by drawing on the healing power of the universe or something. While this hasn't happened (perhaps because I couldn't get into any kind of meditation), I have at least halted the progress of the disease and in the field of chronic kidney disease this is considered a victory.

Based on all the test results, the suggestion is that at some point in my life something was causing damage to my kidneys and now it no longer is. Exactly what that “something” was is what caused it to go away is very hard to tell. Maybe not too important as I think the same cure probably applies to various causes:

The “Cure” (based on the personal, non medical, experience of one person)

  1. Become healthy. The basics of health are the same for everyone (exercise, eat in moderation, don't be overweight, don't smoke or drink in excess) but I strongly believe that different people have very different needs (and this explains why there is so much conflicting advice out there). Try and listen to your own body and figure out what's right for you. I found that juice-fasting for a week was a great way to “reset” my body's food cravings and to figure out what my body really needs. Just for reference, my diet is quite simple and consists principally of: Avocados, White Rice, Tuna Fish, Amaranto, Raisins, Almonds, Pecans, Bananas, Beans, Peas, Mushrooms, Corn Tortillas, Potatoes, White Fish, Shrimps, Grape Juice, Pineapple Juice, Grapefruit Juice, Eggs, Seaweed, Lettuce. I specifically avoid meat and gluten, and moderate my consumption of milk products, refined sugar and salt.
  2. Get plenty of sleep. I discovered my blood pressure becomes elevated if I don't get a good nights sleep. I recommend sleeping as much as your body needs. In my case about 8 hours a night.
  3. Enjoy life! I believe that genuinely happy people are naturally healthy as they instinctively make the right choices for their bodies. Worrying about the future doesn't help you today and today may be your last…

Gluten?
In my particular case, I have a suspicion that an intolerance to either gluten or wheat could be responsible for my kidney damage. The reason I suspect this is that:

  • I discovered that removing bread from my diet resolved long time problem I've had with “balls of gas” in my intestines. These actually felt like hard lumps in my belly. This suggests that my intestines at least are affected by gluten and it isn't a complete stretch to imagine that the problem is an auto-immune one where the body's own response to detecting gluten (or some other component of wheat) in the blood causes damage to its own organs.
  • The gas problem first occurred at the same time that high levels of protein were first detected in my urine.

It is a bit annoying not knowing for sure if wheat is the problem, as I LOVE the taste of bread but I love my children more so I'm going to play it save and avoid it as much as possible.

The future
Short of achieving regeneration of my kidneys (something medical science believes to be impossible) I don't think there's too much more I can do for them, so my experiments will probably reduce (and with them, the amount of blood tests and blog updates).