Keeping Kidneys Healthy With a Plant-Based Diet
By: Suzanne Morris, DVM, MWC
I’ve started exploring the relationship of plant-based diets to various organ systems and disease states affecting those systems. Specifically, my goal is to take an evidence-based approach in showing how a plant-based diet can play a role in disease prevention and in slowing disease progression. The easiest way to tackle this is by letting each month pick the system and/or related disease state. For February, that was American Heart Month, and I covered what the guidelines say about plant-based eating for better heart health. Now we’ve moved into March, which is both National Kidney and Colorectal Cancer Month, thereby offering an occasion to delve into the role that a plant-based diet plays in kidney and colon health and disease prevention.[1,2]
Here, I’ve highlighted guideline recommendations on plant-based eating for kidney health. To begin with, National Kidney Month, and World Kidney Day (March 9) were created to increase awareness of kidneys and their importance to our health.[3-5] Chronic kidney disease (CKD), according to the National Institute of Diabetes and Digestive and Kidney Diseases, is often referred to as a silent disease because individuals with early stages of CKD are often asymptomatic. Consequently, as much as 90% of the people in the US with CKD are unaware of having the disease until it progresses on to later stages.[1,6] Kidneys filter uremic toxins from blood and when kidney function is compromised by disease, those waste products accumulate in the blood, and can lead to high blood pressure (hypertension), stroke, and death.[6] In addition to feeling sick from developing uremia, individuals with kidney disease can experience complications like anemia, nerve damage, and weakened bones. Diabetes and hypertension are health conditions that can lead to the development of CKD. Other risk factors for developing CKD include having a family history of kidney failure and being an older adult.[7]
The National Kidney Foundation (NKF) recommends plant-based dietary patterns including the dietary approaches to stop hypertension, or DASH, diet, the Mediterranean diet, and a combination of the 2 diets, known as the Mediterranean-DASH intervention, or MIND, diet.[8] A plant-based diet, according to the NKF, emphasizes plant-based foods, like grains and vegetables and reduces the intake of animal-based foods. Choosing a plant-based diet may help reduce the risk of CKD and slow not only CKD progression, but also the progression of type 2 diabetes, heart disease, and hypertension.[9,10] Unsure of the difference between plant based and vegetarian or vegan diets? Although vegan and vegetarian diets are types of plant-based diets, the NKF distinguishes a plant-based diet as having some flexibility compared with vegan or vegetarian diets in terms of animal consumption. Also, whereas vegan and vegetarian diets do not necessarily exclude unhealthy foods such as processed or refined foods, or foods with a high salt or sugar content, the plant-based diet, as defined by the NKF, avoids these types of foods and limits the intake of animal-based foods to small, infrequent portions.[10]
Although there has been some concern about individuals with CKD developing elevated blood potassium levels (hyperkalemia) on a plant-based diet, there has been little evidence to support this. Incidents of hyperkalemia in case report studies have resulted from the consumption of foods high in potassium, including fruit juices. Similarly, analysis of other types of studies revealed 1 case of hyperkalemia resulting from the consumption of raw edamame, which is high in potassium.[9]
The NKF website addresses some of the common misperceptions of plant-based eating, including “I won’t get enough protein, vitamins, calcium, and other nutrients.” (Answer: not true.)[11] For those who have kidney disease and are unsure of how to go about getting those nutrients, the NKF website has a beginner’s guide for starting a plant-based diet and pointers for stocking a plant-based pantry.[12,13]
For additional support in getting started on a plant-based diet and recipe ideas, visit MeatlessMonday.com.[14]
Next plant-based stop: Colorectal Cancer Awareness Month.[2]
References
1. National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK). National Kidney Month 2023. March 2023. Accessed March 8, 2023. https://www.niddk.nih.gov/health-information/community-health-outreach/national-kidney-month
2. National Colorectal Cancer Alliance. Raise awareness during National Colorectal Cancer Awareness Month. Accessed March 13, 2023. https://www.ccalliance.org/
3. American Society for Nephrology. World Kidney Day. Accessed March 13, 2023. https://www.asn-online.org/worldkidneyday/
4. National Today. World Kidney Day, March 9, 2023. Accessed March 8, 2023. https://nationaltoday.com/world-kidney-day/
5. World Kidney Day. 2023 Campaign. Accessed March 9,2023. https://www.worldkidneyday.org/2023-campaign/
6. Centers for Disease Control. Chronic kidney disease in the United States, 2021. Reviewed July 12, 2022. Accessed March 16, 2023. https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html
7. National Kidney Foundation. Chronic Kidney Disease (CKD). Accessed March 9, 2023. https://www.kidney.org/atoz/content/about-chronic-kidney-disease
8. National Kidney Foundation. What is a plant-based diet, and is it good for your kidneys? Accessed March 13, 2023. https://www.kidney.org/atoz/content/what-plant-based-diet-and-it-good-kidney-disease
9. Joshi S, McMacken M, Kalantar-Zadeh K. Plant-based diets for kidney disease: a guide for clinicians. Am J Kidney Dis. 2021 Feb;77(2):287-296. doi: 10.1053/j.ajkd.2020.10.003
10. National Kidney Foundation. Plant-based diet or vegetarian diet – what is the difference? Accessed March 9, 2023. https://www.kidney.org/atoz/content/plant-based-diet-or-vegetarian-diet-difference
11. National Kidney Foundation. Myths and misconceptions about plant-based diets. Accessed March 13, 2023. https://www.kidney.org/atoz/content/myths-and-misconceptions-about-plant-based-diets
12. National Kidney Foundation. The beginner's guide to starting a plant-based diet (when you have kidney disease). Accessed March 9, 2023. https://www.kidney.org/atoz/content/beginners-guide-to-starting-plant-based-diet-when-you-have-kidney-disease
13. National Kidney Foundation. How to stock a plant-based pantry. Accessed March 9, 2023. https://www.kidney.org/atoz/content/how-to-stock-plant-based-pantry
14. The Monday Campaigns. Meatless Monday. Accessed March 9, 2023. https://www.mondaycampaigns.org/meatless-monday