HEALING Polycystic kidney disease one bite at a time.
Vegan Diets: The Deceptive “Lightning Bolt Effect” in PKD
Since I am seeing this story again and again in my PKD coaching clients, I guess its time to explain why vegan diets are a dead end for managing PKD, and can even cost you vital time to actually improve your function.
Many PKD patients go vegan for various reasons. While the intention is a good one, inadvertently this usually leads to a significant decrease in protein intake- which in turn leads to muscle loss over time, which is bad news for longevity. Lab tests will then show reduced creatinine levels, as less muscle requires less filtration. This is then often times misinterpreted as improved kidney function. It’s crucial to understand that creatinine levels are directly proportional to muscle mass, and lower values only reflect real improvement in kidney function when muscle mass is constant or increasing. After this initial decrease in creatinine, patients continue on the same slope of increasing levels, leading to the “lightning bolt” pattern on their creatinine and eGFR test graphs.
Additionally, the vegan diet requires including high-carb or processed foods to meet protein needs at all. This is what makes vegan whole-foods keto literally impossible. The only options in this case are processed vegan proteins that are filled with pesticides and lectins, phytates and phytoestrogens, poisoning the kidney further and accelerating decline. To add to this, protein bioavailability is about half compared to animal proteins, so protein needs are actually much higher when vegan proteins are consumed, making them an even worse choice when total protein intake is an issue.
Insufficient protein intake can not only lead to muscle loss, but also diminished functioning of the remaining healthy glomeruli, leading to further reduction in kidney filtering capacity.
Self-Monitoring Tip for Vegans with PKD: To really understand the impact of a vegan diet on your kidney health, consider a GFR test based on cystatin-C, not just creatinine, before and after adopting the vegan diet. Cystatin-C is a better indicator in this context and can provide a clearer picture of your actual kidney function. Needless to say, you should still calculate optimal protein intake levels and supplement if needed.
ย A healthier alternative is the Bulletproof Diet that we recommend in this community, which focuses on adequate protein intake. For those with high BUN levels, replacing some protein with essential amino acids can help lower nitrogen. The bulletproof diet and our focus on C8 MCT oil also promotes high ketone levels, which is the main focus for reducing cyst growth. Adequate protein intake encourages hypertrophy (growth) in the remaining glomeruli (a main component of nephrons), potentially leading to a genuine improvement in kidney function, which then is kept for a longer time or even continues to improve, resulting more in an “L” or “V” pattern on creatinine, cystatin C and resulting eGFR tests.
You can dive deeper into the issue by checking out this article investigating a low-protein diet:
https://www.kidney-international.org/article/S0085-2538(15)33696-6/fulltext
Quote:
“Muscle mass and plasma creatinine fell simultaneously in several patients. (remember, muscle mass index is a strong predictor of longevity) […]
Fall in plasma creatinine may not be due to improved GFR but instead to altered creatinine metabolism.”
An image from the study is also included below, showing reciprocal (inverse) creatinine levels, so higher is better. It is clearly seen that the illustration is mirrored here. At the onset of the low-protein diet, creatinine is lowered (so raised in the inverse graph), but continuing on the same slope on average.