After CKD diagnosis about 5 years ago my nephrologist suggested a vegetarian diet. I actually went "almost vegan" because I stopped eating meat of any kind and being sensitive to dairy I eliminated most dairy except for small amounts of "cooked" dairy milk in some breads and certain other products. (For me trying to avoid using animal products any more was as much a personal ethical decision as a health choice but I did and still do have free-range eggs.) My CKD improved.

But after a bout of shingles over two years ago, kidney function dropped dramatically and I was on dialysis for a short time then gradually recovered enough to move from stage five back to stage four and stop dialysis.

Recently, though, I developed gastroparesis, the diet for which conflicts with a renal diet and a diabetic diet, so I've had to pick and choose and modify and compromise with all 3 diets - quite a challenge and much less than ideal.

Here are my daily nutritional parameters, to which I cannot always adhere, depending on gastric issues and varying absorption rates: 1000-1200 calories, 700-800 mg phosphorus, 1800-2400 mg potassium, 1500-1700 mg sodium, 33-36 Gm protein, 150-260 Gm carbohydrates, 10-15 Gm fiber, 22-50 Gm fat, 8 mg iron. (I've read on various websites several months ago that the new sodium recommendation is 1000 mg daily, especially for stage 4 CKD.)

I have found that many vegan dishes such as highly processed vegan bowls or processed meat analogs contain too much sodium and too much protein for my remaining kidney to deal with and I have to limit soy as well.

I also found I could not afford many "basic" vegan ingredients to make my own burger patties, for instance (as well as other vegan foods.) Then, too, the vegetables comprising home-made veggie burgers have too much potassium per serving for a compromised kidney to process.

I have had to resort to ready-to-cook commercially prepared meat analogs for the protein but have half or even a fourth of a serving and so far kidney function is relatively stable at 27 to 30 eGFR and creatinine is less high.

However, since I've added Miralax to my medications for gastroparesis and acidophilus lactobacillus along with resorting to processed meat analogs, I've noticed edema across the tops of my feet (not much in the mornings but increased to marked "puffiness" by evening - docs are aware and we are monitoring this.) Although my labs show acceptable serum sodium levels I know I am taking close to 1500 mg Na daily (sometimes a little more,) instead of the recommended 1000 for stage 4 CKD. I'm watching closely for increased edema and have tried to reduce sodium intake the best I can but if it gets worse I may have to back off some of the higher sodium foods with the unfortunate consequence of increased anemia and decreased stamina and energy and more weight loss. (Since hospitalization and a gastroparesis diagnosis then going on a gastroparesis diet over a year ago I've lost 80 pounds.)

I welcome comments and suggestions.

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