I was Diagnosed with Stage 4 Chronic Kidney Disease. Can Ornish Lifestyle Medicine Help Control CKD?

The simple answer is yes, most of the time.

Most chronic diseases, including CKD, have a component to them that can only be treated with changes to your lifestyle. In other words, medicines alone are effective at slowing down most chronic conditions, but it is the lifestyle changes combined with appropriate mediation that often allow the body to reverse the condition. I explored this theme in my previous article on diabetic neuropathy. The same is true for CKD.

Lifestyle changes help to heal changes to the kidneys as well as the heart

The rapid rise in Chronic Kidney Disease (CKD) is one of the most challenging issues we have in medicine. (See Ornish Living article, Improving Chronic Kidney Disease with a Plant-Based Lifestyle. ) CKD has many contributing factors; so finding a single cause is not common. Most treatments focus on contributing factors that include smoking, hypertension, high cholesterol and diabetes. Treating these risk factors with medicines alone, however, does not generally stop the progression of the disease. It just slows it down. There are other factors that lifestyle is more effective at treating than medications. These include systemic inflammation and poor nutritional states.

In all stages of CKD the degree of reversibility with Ornish Lifestyle Medicine depends on two things:

• What is the upstream cause of the kidney disease and is it reversible with lifestyle changes?
• How much scarring has occurred?

These can be measured by decreased renal function (increased BUN and creatinine) and leaking of protein (albuminuria or proteinuria).

Understanding Scarring

To understand this process, lets go to the level of the tiny blood vessels that are feeding the kidney cell when exposed to high pressures, high blood sugar and inflammation. These tiny blood vessels gradually get smaller. If the pressure, inflammation and sugar damage go on long enough, the blood supply to the individual kidney cell stops, the cell stops functioning, dies and creates a small scar.

Reversal of CKD with Ornish Lifestyle Medicine depends on what type of damage has occurred in the kidneys. Specifically, it depends on the level of scarring. The changes related to scarring are more difficult to reverse than the changes related to inflammation.

What about Stage 4 CKD?

Stage 4 kidney disease is a later stage of kidney disease. Patients in this stage are usually referred to a nephrologist and will likely be discussing the probability of dialysis or renal transplantation in the future. Patients with Stage 4 CKD often also have heart disease and other conditions. That is because the same root causes of CKD are lifestyle choices (lack of exercise, poor diets, high stress, smoking) that also contribute to heart disease and other conditions.

If you have a large amount of inflammation, high blood pressure and high blood sugar, and only moderate scarring, when you adopt Ornish Lifestyle Medicine and address the root cause of the problem, your kidneys will get better. There are many reasons why Ornish Lifestyle Medicine works, but here are a few:

• Plant protein is easier on the kidneys than animal protein.
• Exercise is helpful for people with all stages of CKD.
• Social Support is important in CKD.

In addition, our research has shown that by combining the four elements of Ornish Lifestyle Medicine, which include a whole food plant-based diet, exercise, stress management and group support, patients can lower their blood pressure, decrease blood sugar, lose weight, decrease inflammation and improve symptoms of depression. Together, these changes all help to heal changes to the kidneys as well as the heart.

We routinely see participants with stage 1-3 CKD (And often with stage IV CKD) who are following the four elements of  Ornish Lifestyle Medicine, improve their conditions in as short as nine weeks. Though this is common, it is not universal in stage IV. Some cases take longer, and in others, there is just too much scarring to reverse the disease or a different set of root causes for it.

Are There Any Modifications or Supplements I Should Be Taking?

Many patients and doctors are exploring supplement use in CKD. For example, your nephrologist may recommend vitamin D, Magnesium or baking soda (if acidotic). There are blood tests that can help your nephrologist decide if these are indicated.

They will also likely recommend a low salt diet. There may be additional benefits of a pure vegan diet, meaning no egg whites or dairy. And other supplements worth considering are probiotics, and anti-inflammatory herbs including curcumin and boswellia.