Intermittent Fasting with Chronic Kidney Disease

@m1rmiller Welcome to Mayo Connect. You ask an interesting question. I am Stage 4 CKD at 24%. Have you spoken to your nephrologist about the intermittent fasting plan? Some studies have shown those with polycystic kidneys may benefit from that type of eating. It seems the cause of your kidney disease would be a factor in success or advisability of a IF plan. How have you seen your labwork change since changing your eating plan? I invite @johnbishop, another mentor here on Mayo Connect, to share his IF plan with you. While he does not have kidney disease, he has had great success on the IF plan.

The American Society of Nephrology posted this article about IF and kidney disease https://www.asn-online.org/education/kidneyweek/2020/program-abstract.aspx?controlId=3448574

While we are not medical professionals here, we all share a desire to gain better health!
I look forward to your continued participation,
Ginger

Thanks for your prompt reply. My creatinine went up slightly from 3.8 to 4.5 with fasting. My nephrologist pointed out that is within the range of what it has been for the past 8 years. I was at 4.5 about 3 or 4 years ago also. I ran the idea past him before I started and he said he didn't see anything wrong with trying the fasting program. He's the second nephrologist I've worked with and that's because the first one wanted my to go on hemodialysis immediately (8 years ago).

@m1rmiller Keeping kidney function has basic guidelines, and then we need to tweak them as each of goes. Getting to/maintaining a healthy weight/blood pressure is critical. As is getting exercise and eating healthy for you. Taking meds as directed.

What is your eGFR? That should determine when/if you start dialysis. My husband had his kidney transplant 10/1/16. Before starting dialysis, he attended class to educate him the types of dialysis available, and his nephrologist never pressured him which modality to go for [he ended up as peritoneal for 5.5 years].
Ginger

My eGFR is 12. When I asked my first nephrologist about peritoneal he told me "that doesn't work" and insisted that I needed to have surgery to put a fistula in my arm immediately. I'm not going to go into naming hospitals, but this was at one of the major teaching hospitals in New York City. I get lots of exercise. I am a nationally ranked competitive fencer. I am 5 ft. 9 in tall and weigh 138 lbs. I have hypertension but I take several meds and my nephrologist feels that my blood pressure is "fairly well controlled". It is reactive and more labile than I would wish. My A1C is always in the low 5's (last time 5.3) so I'm not diabetic. I have been registered for a kidney transplant but in a special status where I am accumulating time but they are not offering me kidneys now until I decide I want to go for transplant. I have about 7 years on the list already. When I first registered they discovered that I also had Hepatitis C so they told me that if I was fortunate and they would give me a kidney from a Hep C donor right away. I turned that down.

@m1rmiller I would like to add my welcome to Connect along with @gingerw and other members. I've been doing intermittent fasting since late March of this year. I do it mostly for a life long struggle I've had with my weight and it's the first thing I can say has made a difference for me. I did well with Weight Watchers and other plans but they were a struggle for me and I was never able to get my weight where I wanted it to be. What started me looking at intermittent or alternate fasting was a health blog entry by @LeeAase - An Unfortunately Named Book (The Obesity Code): https://social-media-university-global.org/2020/02/an-unfortunately-named-book/. The blog had a video link by Dr. Jason Fung the author of the book that explained fasting in a way that made a lot of sense to me and then not long after that @LeeAase had another tip on alternate fasting using the Zero app which made it so much simpler to keep track of the fasting for me on my cellphone - https://www.zerofasting.com/

@m1rmiller Good for you! I daresay that your kidneys are working less strenuously due to your body mass being low, so you have been able to keep your eGFR hanging in there for quite a while. Even though high blood pressure may be controlled with meds, exercise, weight control and lifestyle, there is still the inevitable damage done to your kidneys.

I am sorry you had a negative experience with your first nephrologist but found someone who addresses your needs. Not everyone is a good fit. Within the transplant discussion group and here in kidney and bladder group, there are discussions about kidney transplant. I am curious regarding your hesitation and decision previously to not take an offered kidney? Years ago I was told transplant is not a viable option for me because of the rare autoimmune kidney disease that has caused my issues.
Ginger

Regarding transplant: When I was first diagnosed with CKD (my ESRD diagnosis started right there, I had never been told about CKD before I was diagnosed at ESRD), I went to another state where an old friend was head of Nephrology at a major hospital to ask his advice. I told him about getting an offer to get a Hep C donor kidney and he told me, "don't get a kidney transplant before you absolutely have to". He told me that I would feel awful for the first year after the transplant. That was 8 years ago and with COVID 19 raging now I pretty glad that I'm not having to suppress my immune system right now. I'm hoping to continue on. My nephrologist feels that whatever was attacking my kidneys has stopped and I'm just left with dealing with the damage that was done.

Thanks for your reply. I too started experimenting with intermittent fasting this Spring. I started with trying for 14 hours/day. It was initially tough, but doable. As I adapted to it I went up to a 16/8 schedule. Then I read about the possibility to induce autophagy by fasting 18 hours so I set that as my goal. For the past few weeks I've been on a pretty steady 18 or 19 hours/day fasting schedule. Basically I just wake up and don't eat until I have dinner around 7:00 pm. I sleep late (I'm retired) so at 7:00 pm I'm usually at about 19 hours of fasting. I spend a big chunk of my day exercising and meditating so it's actually become a lot easier than it was initially. I can't tell if the autophagy part is actually happening, but my weight is certainly OK if nothing else. I too have always struggled with gaining weight easily.

@johnbishop. Thanks for posting this. The surgeon who is going to do my surgery in May said things would probably go more smoothly if I lost 40 pounds. I started a 16-8 intermediate fast eliminating sugar, processed carbohydrates, fried food, etc. in October and have lost 20 pounds. My weight loss has slowed dramatically, in spite of tracking calories and staying between 1000-1200 calories a day and tracking points through WW. I need to do something different and am am glad I came across your post. I downloaded/uploaded? Dr. Fung's book this morning and will check out the other sites you mentioned. I've also been reading about the 20-4 Warrior Diet on the internet to see their eating plan.... I haven't gotten that far in Dr. Fung's book. All of the totally contradictory advice about weight loss is baffling, so I hope this will work for me. You've inspired me -- thanks! Nancy

Hi Nancy @nla4625, Currently I'm mostly doing the 20/4 fasting diet for 3 to 4 days and then sometimes have a day or two of the 18/6 and it has worked well for me. If you didn't see the tip about using the Zero app for your phone (https://www.zerofasting.com/), you may want to give it a try. It makes keeping track of the hours and when you can start eating so much easier. Good luck on your journey!