a 69-year-old man
stage 3 chronic kidney disease with type 2 diabetes, hypertension, hyperphosphataemia and borderline hyperkalaemia
He started a strict whole-foods, plant-based diet. He did not count calories or portions and was not told to exercise. He quickly cut his insulin by more than half. Over 4.5 months his eGFR rose from 45 to 74 mL/min and his microalbumin to creatinine ratio dropped from 414.3 to 26.8 mg/g. His phosphorus level returned to normal, and his weight, blood pressure and cholesterol also improved. The authors note that a creatinine-based GFR reading can be thrown off by large weight loss.
In one man with stage 3 chronic kidney disease and diabetes, a strict whole-foods, plant-based diet went along with a large drop in urine protein and a higher eGFR reading over 4.5 months.
- This is a single case report about one 69-year-old man, not a study of many people.
- He ate a strict whole-foods, plant-based diet with no calorie counting, no portion limits, and no required exercise.
- His eGFR reading rose from 45 to 74 mL/min and his microalbumin/creatinine ratio fell from 414.3 to 26.8 mg/g over 4.5 months.
- He cut his insulin by more than half, and his weight, blood pressure, cholesterol, and phosphorus level all improved.
- The authors themselves warn that big weight loss can make a creatinine-based eGFR number look better than the real change in kidney function.
Why it might work
The paper frames the diet as helping several problems at once. By eating whole plant foods without portion limits, the man lost weight and needed much less insulin, and his blood pressure and cholesterol got better. Since diabetes and high blood pressure are two of the main forces that damage kidneys, easing all of them at the same time may take pressure off the kidneys, which the authors suggest could explain the drop in urine protein and the better lab numbers.
The honest limits
- This is n=1: one person, no comparison group, so it cannot show the diet caused the change or that it would work for anyone else.
- The authors caution that eGFR is estimated from creatinine, and large weight loss can make that estimate rise even when true kidney filtering has not improved as much.
- The abstract does not report how long the improvement lasted or whether it held up beyond 4.5 months.
- The abstract does not state whether the authors had any conflicts of interest.
- Given my own numbers, could a whole-foods, plant-based diet be safe for me, especially with my potassium and phosphorus levels?
- If I lose weight, how will you tell a real change in my kidney function from a creatinine estimate that just looks better?
- How would we track my urine protein, potassium, and phosphorus if I made a big diet change like this?