What Is the Main Idea?

How impactful can a healthy diet be? In the case study “Quality or Quantity of Proteins in the Diet for CKD Patients: Does ‘Junk Food’ Make a Difference? Lessons from a High-Risk Pregnancy” published in the journal Kidney and Blood Pressure Research, the authors show how switching a pregnant woman with chronic kidney disease to a healthier diet meant she could avoid dialysis during pregnancy. They suggest that plant-based fresh food diets with appropriate supplements are important for pregnant individuals with compromised kidneys.

What Else Can You Learn?

It’s important for pregnant individuals to understand their kidney health and talk to their obstetrician about it. It’s also essential to understand that health issues occurring during pregnancy can have longer-term impact.

How Does Kidney Disease Affect Pregnant Individuals?

Health issues occurring during pregnancy are obviously stressful for the patient. They can also have implications for the post-natal health of the pregnant individual and their child. For example, if hypertensive disorders (heart and circulatory problems related to high blood pressure) are present during pregnancy, that indicates a higher risk of future cardiovascular diseases.

Chronic kidney disease can increase the risk of hypertensive disorders during pregnancy, although the exact mechanisms are not fully understood. It’s challenging to manage severe kidney issues in pregnant individuals.

How Can Nutrition Help?

Interestingly, nutrition can play a role in managing kidney disease in pregnancy. Although there are no comprehensive reviews on the topic, there are cases that show that plant-based diets largely consisting of fresh foods have benefits. Conversely, patients with compromised kidneys seem particularly prone to adverse reactions to high amounts of dietary additives. Furthermore, unintentional contaminants (e.g., from packaging or polluted agricultural food chains) also present challenges for the kidneys.

Going from a Healthy Diet to a Risky One

In the case discussed in the above-mentioned open access paper, a 39-year old cisgender woman presented with chronic kidney disease during her second pregnancy. Dialysis was not an option, so the doctors chose a nutritional approach.

The woman’s first child had been delivered by caesarean section due to preeclampsia, which is a hypertensive disorder of pregnancy. Written records from the first pregnancy were not available, but it is likely that kidney disease had been detected because she was told to have periodic blood tests to monitor the organs’ function and to eat less meat. Reducing the animal protein in the diet is associated with better kidney health.

When she became pregnant again, she moved from her home (over 6 hours from the hospital) to her mother-in-law’s house (2 hours from the hospital). Her diet changed drastically. At home, she ate a largely fresh plant-based diet. At her mother-in-law’s, she had “a high-calorie diet, consisting mainly of sodas and processed, canned, and preserved food.” Her health worsened and she was admitted to hospital, where her kidneys were found to be in a chronic diseased state, although the fetus was normal for its gestational age.

Returning to a Healthy Diet

Because the fetus appeared healthy and dialysis was both expensive and logistically challenging, the doctors attempted to help with a nutritional approach, switching the woman back to a plant-based diet with vitamin and mineral supplements. One week later, her laboratory results had already improved.

The progress of the pregnancy was not entirely smooth. Logistical and economic challenges meant she was “overall adhering to a plant-based diet [but] had resumed a diet rich in packaged and junk food.” She was hospitalized for the remainder of the pregnancy. Caesarean section was performed after 37 weeks and 17 days later, both the mother and the baby were in stable condition.

What Is the Conclusion?

Although it’s not possible to generalize based on a single case, studies like this one are still valuable. They can indicate a direction for research or provide some guidance in challenging cases.

This case study suggests that dietary approaches to kidney disease should look at the macronutrient composition, the sources of those macronutrients, and the quality of the food. The ideal would be fresh food offering a balance of macronutrients with the majority of the protein coming from plants — and this is all the more important during difficult pregnancies.

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