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The Vegetarian's Kidneys

Ashok L. Kirpalani

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The normal diet consists of fat, carbohydrate and proteins. In structure, both fat and carbohydrate are very similar, in that they contain only carbon, hydrogen and oxygen; whereas the proteins differ by the extra content of nitrogen. When digested fats and carbohydrates are metabolised they breakdown into carbon dioxide and water, both of which are volatile and can be excreted by the lungs. Water is also excreted by the kidneys in urine and by the skin as sweat. The protein, however, metabolises to form non-volatile material called the 'nitrogenous waste', a mixture of many compounds of which urea and creatinine are most important and well known. One of the main functions of the kidney is to remove these poisons, urea and creatinine, from the body through the urine. It naturally follows that the greater the protein intake of a human being, the larger will be the nitrogenous waste load produced and greater the work demand on the kidneys to excrete it in the urine. Non-vegetarian diets have much larger protein content than the vegetarian diets. Eating a non-vegetarian diet produces a larger work demand on both kidneys. This has been clearly demonstrated by scientific methods.

Until recently it was thought that in health, the kidneys are able to meet this extra demand quite well and perform satisfactorily, but recent animal experiments have revealed quite clearly that when healthy kidneys are constantly exposed to very large protein loads, they seem to age much faster and may be tne cause of the development of high blood pressure in animals. With the appearance of this scientific data the whole world is now sitting up to realise that too much protein is deleterious to healthy kidneys. In fact the average adult western non-vegetarian diet consists of I - 1.5 gms/kg body weight of protein whereas the minimum requirement for good health is only 0.75 gms/kg body weight which is the requirement quite adequately met by the average Indian adult vegetarian diet.

In Renal Failure, where the kidney's efficiency slowly and subtly reduces from 100% to 30% without even giving a slight warning to the patient, it is quite obvious that a greater work demand on the kidneys put by a non-vegetarian diet would further produce a great strain on the already diseased kidney. This has been very exhaustively proved in patients of renal disease such as glomerulonephritis, chronic renal failure, renal disease due to diabetes (diabetic nephropathy) and renal disease due to high blood pressure (hypertensive nephrosclerosis). In these diseases, the patient suffers an initial mild and prolonged phase of "azotaemia" wherein life is possible without dialysis before reaching the stage of "uraemia" at which stage life can only be maintained by doing dialysis. The phase of "azotaemia" is best treated by a very strict dietary protein restriction and this is best achieved by a vegetarian diet containing 30 gms proteins of which 20 gms are supplied by milk and milk products while the remaining 10 gms comes from vegetable, cereals etc. 'Azotaemia" is best tolerated this way and the "uraemia" phasc may be postponed by years by this dietary principle in conjunction with other dietary restrictions of salt, water, potassium and the usage of certain drugs.

Gout is a disease affecting joints and causing kidney stones. It is due to deposition, in joints and kidneys, of uric acid which is both generated in the body and also derived from food products like all meats. Those suffering from gout and uric acid kidney stones benefit most by omitting meat from their diet and converting to a vegetarian diet. With proper adjuvant therapy the incidence of kidney stones reduces and the patient suffers less joint pains.

In Conclusion The Nephrologist, like the diabetologist uses diet as a major part of his therapeutic armamentarium most effectively and must prescribe the total diet of his patient taking into consideration the calories, fluid intake vis-a-vis urine output, protein, carbohydrate and fat intake, potassium and salt intake. Each patient will be given a different diet prescription but the one universal advice that will apply to all will be "It is better for you to become a vegetarian ". Nephrologists have come to believe that this advice is applicable even to those who have no renal disease so as to prevent normal kidneys from overworking and aging rapidly. In fact, many nephrologists in western countries have become vegetarians due to this belief !

SUGGESTED FURTHER READING

  1. Barry M. Brenner and Jay H. Stein. "The Progresslve Nature of Renal Disease" Churchill Livingstone Ed. Williarn E. Mitch, 1986
  2. Brenner B.M., Meyer T.W. and Host setter T.H. Dietary Proteins Intake and the Progressive Nature of Kidney Disease. New Eng Journal Medicine 1982, 307, 652.

 

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