I though this article was interesting especially in light of the fact that opponents of low-carb keep harping about potential kidney damage from the "high" level of protein supposedly consumed on low-carb diets.

CoQ10 and low-iron, carbohydrate-restricted, white meat-rich diets improve outcome in kidney patients.

Anthony Colpo,
August 2, 2004.

According to National Institutes of Health figures, about half a million Americans have kidney failure, with the number expected to surpass 660,000 by 2010.(1)

Even though they comprise just 12 percent of the U.S. population, blacks make up nearly a third of the 20 million Americans with kidney disease.

And because early detection of kidney disease is crucial to keeping patients healthy, a new federal government campaign is putting the spotlight on American blacks, to identify those at highest risk.


Substituting white meats like chicken for iron-rich red meats could improve morbidity and mortality outcomes in kidney patients



"African-American men between ages 20 and 40 have a 20-fold increased risk of kidney failure compared to white men," explained Dr. Thomas Hostetter, director of the National Kidney Disease Education Program, a project of the U.S. Department of Health & Human Services.

High blood pressure, diabetes or a family history of kidney failure can all raise the risk for kidney trouble.

Early detection can minimize the discomfort and medical care needed for those with kidney disease. The number of Americans on kidney dialysis or who have had a kidney transplant due to failure has doubled each decade for the past two decades, according to the NIH.

"There are a couple of simple tests," Hostetter said, including a blood screen called the serum creatinine test, used "to estimate the filtering capacity of the kidney."

Creatinine, a byproduct of muscle metabolism, is found naturally in the body. "If the kidney is normal, it is excreted," Hostetter said. "If it's not normal, creatinine builds up. It's not itself toxic, but is a marker [of toxicity]."

Another test recommended for those at risk is one that looks for protein in the urine, which also helps detect early kidney damage, Hostetter said.

Hostetter advises those with high blood pressure and some evidence of kidney disease to follow a low-protein diet. Before kidney patients adopt such advice (which is not unanimously agreed upon by kidney specialists) they should carefully read a study by Californian researchers published in 2003.

Low-protein...or low-carbohydrate and low-iron?

In this study, the researchers hypothesized that a diet with unrestricted protein intake, but low in carbohydrates and iron might reduce free radical and glycative damage in compromised kidneys (note: 'unrestricted' means eating as much protein as one wants until satiated, not until one's stomach is about to explode).

It's no secret that carbohydrates are the most effective dietary agent for inducing elevated blood sugar levels, which in turn increases glycative activity in the body. As for iron, an excess bodily concentration of this mineral has been implicated as a potent free-radical promoter and as an inhibitor of efficient glycemic control.

The researchers proceeded to place patients with diabetic kidney damage on a diet in which chicken and fish were substituted for red meat, the former being significantly lower in iron than the latter.

The patients were also advised to increase their intake of iron-binding foods, such as dairy and eggs, and polyphenol-rich items such as olive oil, tea, red wine (a maximum of 300ml daily, with meals). The only other beverage permitted besides red wine and tea was water.

Finally, the patients were instructed to halve their total carbohydrate intake. The composition of the white meat-based diet was 25-30% protein, 30% fat, 35% carbohydrate, and 5-10% alcohol.

A control group of kidney-impaired diabetics consumed a low-protein diet comprised of 10% protein, 25% fat, and 65% carbohydrate--a similar macronutrient profile to that recommended to kidney patients--and to the general population by mainstream health authorities.

Reduced mortality and need for dialysis

After an average follow-up period of 3.9 years, 39% of the control group patients either died or deteriorated to a point necessitating kidney replacement; in the unrestricted white meat-protein group, the corresponding figure was only 20%. Serum creatinine, a measure of kidney function, doubled in 39% of the low-protein controls, but only 21% of the high-protein controls.(2)

The results confirmed the findings of previous short-term studies showing improvements in kidney function on white-meat based diets;(3,4) in one of these, diabetics spent four weeks in random order on a low protein diet, a red-meat-containing diet, and a chicken-based diet. The chicken regimen produced superior improvements in clinical tests of kidney function than either the low protein or normal diets.

Interestingly, Swedish researchers recently found, in an epidemiological study, that diabetics consuming high amounts of fish protein suffered a lower incidence of microalbuminuria.(5)

CoenzymeQ10: potential lifesaver for kidney patients

In addition to eating more white meat, results of a recent randomized, double-blind, placebo-controlled trial indicate that kidney patients may greatly benefit from co-enzyme Q10 supplementation.(6)

Patients with kidney failure received either 180mg of CoQ10 or a placebo each day for twelve weeks. The CoQ10 group showed a significant decline in serum creatinine, blood urea nitrogen, and a significant increase in creatinine clearance and urine output compared with the placebo group.

While the frequency of dialysis and the number of subjects receiving dialysis was similar between the two groups at the start of the study, after twelve weeks the number of subjects requiring dialysis in the CoQ10 group was half of that in the placebo group.

In the CoQ10 group, measures of free radical activity significantly declined while blood concentrations of the antioxidant vitamins E, C, and beta-carotene showed a marked increase.

One-fifth of the patients in the CoQ10 group were non-responders. The researchers called for further trials using higher dosages; the kidney is one of the body's most CoQ10-rich organs, and the possibility exists that some patients may require higher dosages to effectively 'saturate' kidney tissues with this vital nutrient.

If you do have any sign of kidney impairment, be sure to work in conjunction with a competent and understanding medical practitioner who is prepared to regularly monitor your kidney function