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Case 2
Bob, age 64, free-lance design consultant
Main problems
Severe kidney damage (membranous glomerulonephritis) shown by hospital biopsy
eight months previously. Kidneys stated to be 30% efficient. Condition deteriorating.
Other problems
High blood pressure, cramps (for which he would take more salt).
Current diet
Much cheese (very salty), much white bread, instant mashed potato or ready chips,
dried packet soups. Frozen ready meals, pork chops or burgers. Two portions of
vegetables a day. Used much salt in cooking and at the table, had Chinese takeaway
once a week. Liked malt bread and could eat a loaf at a time. Had always eaten a lot,
but did not put on weight.
Comment
This man had never been previously been given dietary advice though he was obviously
consuming a great deal of salt which would have overworked his failing kidneys and
contributed to raised blood pressure. On top of that, he had been told by his
nephrologist that he could eat whatever he liked. This is grossly untrue, as it is
essential to have a diet low in protein if the kidneys are underfunctioning. The
evening prior to seeing me he had eaten two pork chops and this was not unusual.
Conclusions following first consultation
Bob was feeling increasingly ill and said that he didn't know whether he would still
be alive in a few months time. He could only walk a couple of hundred yards without
feeling too tired to continue. He was frightened and felt that he had not been given
good enough advice by his doctors. His diet was making his condition worse.
Progress after two months
I had been very aware of the need to proceed carefully with a kidney case, and to
reduce his metabolic load by putting him on a low protein diet. I explained the
importance of cutting out salt. I did not suggest any supplements for the first
few weeks but treated him with diet alone. At first he felt better most of the time
but had an occasional off-day. On a routine visit to the hospital after two months
the nurse expressed such amazement at how his blood pressure had dropped since the
last visit that he said he burst into tears. His blood analysis figures had also
improved.
Bob continued to feel very well most of the time, and after four months on the nutritional therapy managed a ten mile hike!
Two years later, he continued to be well and very active as long as he did not eat much animal protein. If he did so, he tended to feel unwell and to get an attack of gout, which is the result of inability of his underfunctioning kidneys to excrete uric acid. He was very aware of what to do to keep well and knew that he would deteriorate very quickly if he did not pay close attention to the recommended nutritional treatment.
