What’s a kidney’s favorite food? Turns out there is vast observational and some experimental data on this. For context, 1 in 7 adults in the US have chronic kidney disease, costing Medicare alone $87 billion every year. Plant-based diets are highly associated with decreased incidence and delayed progression of CKD. Not only can plant foods prevent and reverse the major risk factors of T2DM and HTN, they also are considered to 1) decrease renal hyperfiltration via lower protein loads, 2) decrease uremic toxins produced by gut dysbiosis since plant foods promote gut microbial diversity, 3) prevent metabolic acidosis since plant food byproducts are alkaline, 4) decrease phosphate loads since plant phosphate is bound to phytate and less bioavailable. These benefits seem to considerably outweigh the theoretical risk of hyperkalemia in herbivores with CKD, which can also be mitigated with counseling on whole foods and avoidance of copious juice or dried fruit. Overall the fact that the average American consumes 200% of their daily protein requirement strains our glomeruli and the planet in an insidious tragedy that can be averted through our conversations with patients!
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