Adjustments: Food and Diet

A big part of adjusting to a life with CKD was adjusting my diet.

I mostly felt and looked fine while at CKD stage 3, and didn't feel the need to tell many people about the specifics of my disease. I thought it'd be better to keep private about it, and not risk the appearance of sympathy-fishing. To be honest, I was probably also too full of pride to admit right away that I was not well.

However, the topic of my illness came up pretty frequently whenever food was involved. I had been known for having a voracious appetite, so when family or friends noticed it wasn't as inclusive of things like burgers and steaks, I would usually just say "doctor's orders" and then expand upon it if they inquired further.

"I have a chronic kidney disease," I'd say. "That means I have to watch what I eat a little more than before."

My nephrologist recommended that I eat more heart-friendly protein, like chicken and fish and tofu. These protein choices were also to be limited in quantity, to about the size of my closed fist. As a result, I started eating more of a vegetarian diet. 

Potassium was another concern, as was phosphorus. The kidneys remove excess amounts of both, but when they're not doing in good shape, potassium and phosphorus buildup can occur. Too much potassium can lead to nausea, weakness, and numbness. Too much phosphorus can eventually pull calcium out of your bones, making them weak.

I also started to be more conscious of eating less sodium. Kidneys also help regulate blood pressure, so when they're not healthy, one's blood pressure tends to go up. Watching your salt is good for your blood pressure, so I started reading food labels and eating blander foods.

Now that I'm at CKD stage 5 and on dialysis, my dietician recommends that I actually eat a little more protein. The dialysis process removes protein from your system, so it helps to have more. After a couple years of a more vegetarian-heavy diet, I was pleased to switch to more healthy meats. I'm also allowed to eat a little more potassium and phosphorus than before, since dialysis removes these minerals as well.

Discovery

Up until my early 30’s, I’d always thought of myself as fairly healthy. In 2009, my cholesterol, blood pressure, and BMI were in the normal range. I was a skinny guy who enjoyed lower-impact activities like beach volleyball and yoga. I didn’t smoke and wasn’t diabetic. I drank occasionally, ate omnivorously, and felt pretty good overall. I consumed a good share of veggies and fruits, but I also ate meat.

In my late 20s, I was feeling healthy enough to skip on a couple years of physical exams, but I had recently gone in for a checkup. 

And so, I happened to be at a Five Guys chomping on a huge cheeseburger when I got the call.

“Hello, Mr. Tran,” said the receptionist. “We need you to come back and do another blood and urine test."

“Really? Why, what happened?"

“Well, the doctor thinks your numbers for the protein level in your urine were above the normal range. He wants to double-check to make sure it wasn’t an anomaly.”

“OK.”

This didn’t sound good, I thought. I put the cheeseburger down, looked at it, and told my friend Omar sitting across from me what I’d just heard.

Another blood and urine test yielded similar results, so my doctor determined that I probably had a Chronic Kidney Disease (CKD) called IgA nephropathy. After a biopsy of my kidney tissue confirmed it, I tried to settle into the news. It was a serious, but treatable disease. No known cause or cure. I was at Stage 3, meaning about 40% of my kidney function remained. It was likely that my kidney function would diminish over time, and I could try to manage it with diet and exercise to slow the disease's progression. My symptoms of the time weren’t so bad: foamy urine, some dry, slightyly itchy skin. As I said, I felt fine.