Kidney Care

In a modern world the rate of chronic kidney disease continues to climb. The general medical approach is "wait and see" but that is not good enough. Adrian Harper describes how he avoided renal dialysis for decades with natural medicine and diet. Also how he later used diet and supplements to minimise the side effects of dialysis to improve his quality of life, A truly inspirational and very timely story.

Transcript

Daniel Baden: 0:06

Your kidneys are a filter, and they remove the toxins and waste from your blood. About 11% of the Australian population have kidney disease, and the number increases with age. Kidney Disease is known to be very under diagnosed, the rate of kidney disease is increasing due to the aging population, but also due to many lifestyle factors. The kidneys ability to perform can be

Adrian Harper: 1:49

Thanks, Daniel. Thanks for having me here.

Daniel Baden: 1:50

Today. You were diagnosed as a child with renal tubular acidosis, where your kidneys don't filtrate the acid in your blood through what age was that diagnosis made?

Adrian Harper: 2:02

So I was diagnosed around 15 years of age, I developed a kidney stone and at that time and was hospitalized. And so they ended up doing a lot of kind of investigations around why that had happened at such a young age. And they discovered that I had to have renal tubular acidosis, which is a fairly rare genetic condition.

Daniel Baden: 2:23

Anybody else in your family have it?

Adrian Harper: 2:25

No, no history of the condition in the family. So just not sure whether that may have been more of a recessive gene that occurred.

Daniel Baden: 2:34

And Kidney stones are usually the first warning sign for this condition, are they?

Adrian Harper: 2:40

Yeah, normally, because the kidneys functioning more of an acidic date with renal tubular acidosis. At it's a really good environment for kidney stones to form. And normally, there's also kind of low potassium, which also kind of puts you at risk of stone formation

Daniel Baden: 2:58

with low potassium, which I believe is common with the condition. Do you see any other cardiovascular issues such as irregular heartbeats or anything like that?

Adrian Harper: 3:10

Not that I saw, I think you know, those things start to kick in a bit later as the disease progresses and function starts to deteriorate.

Daniel Baden: 3:20

Okay, typically, in a hospital environment, I guess the attitude is to try to alkalize the blood as much as they possibly can using things like sodium bicarbonate or some sort of citrate, sodium citrate or something along those lines. Was that the case with you?

Adrian Harper: 3:36

Yeah, so after saying a specialist, really like the only recommendation that I got back then was to supplement with potassium citrate.

Daniel Baden: 3:48

Yeah, and was that helpful.

Adrian Harper: 3:50

Hard to say, like, I think particularly the early ages, I wasn't really consistent with the dosing. But definitely, when I was the blood results definitely improved with the potassium levels.

Daniel Baden: 4:03

So as a 15 year old, being diagnosed with this type of condition, which is you know, fairly significant. Do you have the maturity to understand and deal with what the implications are?

Adrian Harper: 4:16

I guess like in terms of the age it's something that didn't really take that seriously to start with and you know, when it's or a dietitian got some recommendations around diet that was pretty basic. Really, the main recommendation I was called was just to avoid salt but not really to change my diet much more than that. Yeah, it's not something I really took on board all that much.

Daniel Baden: 5:00

Where do you go to find that sort of information? Is it available.

Adrian Harper: 5:04

So I did find information on kidney stones in some books and like nutrition books, natural health books, I really didn't get a lot of information from medical system on how to manage my condition, it was really more of a case of just monitoring over time, which tends to be the general approach for kidney disease is there's not like a lot of recommendations. Early on, it's more just

Daniel Baden: 5:49

So grateful you did because the understanding of how to manage dialysis is limited, to be honest. And so what you've done is really fantastic.

Adrian Harper: 5:59

Yeah, well, it's interesting, because I think it was a second or third year we had a class on kidney disease. And basically the the class was don't treat kidney diseases too complicated. Found like I ended up in this course first, because of my condition, but I really didn't get any answers within the course. So it really became more me researching things outside of what

Daniel Baden: 6:30

at some point you got a stent put into your kidney. Why was that stent put in?

Adrian Harper: 6:35

So the stent was put in after a kidney stone episode. And it's pretty standard to put a stent in the ureter after stones just to make sure that it's staying open. But there was yeah, a stent put in that I wasn't aware of. And so I and I had it left there for, I think was about 18 months, it was sitting there when they're normally you know, and when it's supposed to be there for a

Daniel Baden: 7:44

did it lose a lot of functionality with the atrophy.

Adrian Harper: 7:51

Yeah, essentially, I lost all function on that right side,

Daniel Baden: 7:54

at 25 years old, your GFR or your glomerular filtration rate, which is the rate measured to measure your kidney function how well it's acting as a filter was around 19. And for a healthy individual, it's around 116 for a 25 year old. And at 15. If a GFR drops to 15, and they want to consider you for dialysis. So you were just skirting along from on a fine line there.

Adrian Harper: 8:23

Yeah, definitely. And in terms of at that age, my nephrologist told me that I would probably be on dialysis within a few years, the way that my function was tracking. At that stage, I really can like threw everything at it just really tied it up like diet and lifestyle. I was seeing a naturopath the time as well as studying a naturopath at that age. So really, yeah, looked at all

Daniel Baden: 8:58

Your diet and your lifestyle, improved your GFR, which is pretty unusual to 30.

Adrian Harper: 9:05

Yeah, managed to slowly kind of push it up over a few years from 19 up to 30. And the admire specialists pretty surprised with that. And then it was able to keep maintaining it for a number of years that 30 Share made a big difference. And in terms of increasing it that far really kind of gives you a lot more of a buffer than when he's sitting at 19 as well. Yeah,

Daniel Baden: 9:31

absolutely. Can you elucidate any fundamental changes you made to get that jump from 19 to 30?

Adrian Harper: 9:38

So I guess like what are the main things that I did was have a fairly strict vegetarian diet client focused on a diet that was more alkaline included a greater amount of alkaline foods and acidic foods as well. And then looking at things like lifestyle interventions, just things like exercise, particularly I was doing a lot of Yoga and focusing on poses that supported circulation

Daniel Baden: 10:57

And so you're going along quite well. And looks like things were remarkably on the improve. But then, seven years later, you had a kidney stone, is that correct? And that caused a septic condition?

Adrian Harper: 11:13

Yeah, I had a kidney stone that occluded the left ureter. And at the same time, I developed septicemia, from the stone. And then they gave me a combination of Catholics and Ciprofloxacin to trade it and I had an allergic reaction to one of those antibiotics. And that kind of combination of events caused my function to plummet down to about 5%. Right. Yeah, never

Daniel Baden: 11:48

So I guess at that point, you're forced to go into analysis?

Adrian Harper: 11:52

No. So at that point, like you normally would be forced to go on to dialysis. But I looked at really changing my diet. And I put myself on a like a low protein diet to reduce the uremia on my system. And I was able to stabilize my health that at that point through largely diet and some supplements support, I managed to maintain general wellness for about six years without dialysis,

Daniel Baden: 12:32

Okay. Wow, that's pretty impressive. Within there six years, did you see any change in the GFR? Did it go up at all?

Adrian Harper: 12:42

It did go up. But it was just a matter of just kind of trying to maintain things as long as possible. I wanted to say how long I could potentially push things without needing dialysis. That's probably something that I pushed a lot more than most people would just having come from a practitioner perspective as well. Yeah, it was kind of interesting to say how, generally well, I could

Daniel Baden: 13:12

And did you have any symptoms at all developed over that time?

Adrian Harper: 13:15

Definitely, in terms of like fatigue was something that I kind of experienced from time to time, particularly if I wasn't tight with protein intake. So I definitely could feel symptoms of uremia. If I wasn't keeping to the diet, and that was a bit of my guide, as soon as some fatigue would come might be coming on, I'd know that I wasn't keeping quite as strict as I needed to be with

Daniel Baden: 13:41

How do you change the way from being a vegetarian? With your protein? Are you still focusing on food, vegetarian protein sources

Adrian Harper: 13:48

are still on vegetarian protein sources. And I definitely think in that late stage kidney disease, you really need to be predominantly having vegetarian sources of protein because it's less of a burden on the kidneys, and it's very hard. We've already got quite a strong acid load on the body. So definitely keeping the diet more collided plant based, again, helps to counter the acid

Daniel Baden: 14:17

Okay, so what were a couple of key protein rich vegetarian foods that you would consider.

Adrian Harper: 14:23

So things like soy products, soy, tofu, 10. Pe, there's evidence to suggest that fighter estrogens have a protective effect on the kidneys. And there's been some studies using things like soy protein as an alternative to meat protein in white kidney function that's had beneficial outcomes as well. So that was probably like the main vegetarian sources of protein hours, including,

Daniel Baden: 14:53

You also mentioned earlier that you adapted your diet to balance the alkali acid load? Could you give me an example of what a couple of alkali foods and a couple of acid like foods would be?

Adrian Harper: 15:07

Yeah, so essentially, most alkaline foods or fruits or vegetables, and acid forming foods tend to be more so protein foods, particularly animal proteins, like meat, poultry, and fish. But then also things like grains as well. So overall, like the balance idea is trying to keep about the acid forming foods to about 20% of the meal and the remaining alkaline foods.

Daniel Baden: 15:35

Okay, interesting, I guess there's two parts of this conversation that we're having for our listeners out there. One is what you've done so far, to keep yourself off dialysis by adjusting your diet and your lifestyle, and exercise. And that's been pretty impressive. But there's also a huge number of people heading towards dialysis, because of modern life. And I guess a lot of

Adrian Harper: 16:23

starting dialysis was a real challenge, because it was obviously something I was trying to avoid for a long period of time. And in a way, I guess I felt a little bit like I'd failed its practitioner going on to it. The other thing that was quite challenging around dialysis is there's really not any support. So you can start dialysis, but there's very little support around you to help

Daniel Baden: 17:48

it's definitely or the increase because of as you know, the association with metabolic diseases. So hypertension, obesity, liver function, those sorts of things. And I guess what, statistically it is the older group, that group, that age is coming down and down every year. So the burden on the government must be absolutely enormous. At this point, we're probably talking about a

Adrian Harper: 18:18

Yeah, and I think it's unfortunate because I say a lot of kidney patients through my practice, and the general recommendation from nephrologist and the medical system, is that we'll just monitor you. And then when you're ready for a transplant or dialysis, we'll organize that and there's no real intervention. There is in some conditions, but yeah, it's fairly limited. So I think

Daniel Baden: 18:52

Yeah, so dialysis has fairly significant impact on somebody's life, from patients that I've seen in the past. And everyone deals with it differently. So would you mind just discussing with us, from your experience, what people's first mood is or understanding of dialysis, if they understand the impact it will have on them? If there's any fear or associated other emotions, and if

Adrian Harper: 19:25

I think there's definitely in terms of commencing dialysis, there's a lot of fear around that people really don't want to have to go down that pathway. They really can, like willing to look at ways to avoid it. The problem is a lot of the time that they're looking at trying to avoid dialysis, it's too late. And that may be due to either them not kind of having done much early on,

Daniel Baden: 20:21

When people first go onto dialysis, there's usually a lot of associated side effects, pain headaches, low blood pressure, muscle cramps, apparently quite common things like itching sleep problems, Did you experience any of those?

Adrian Harper: 20:37

Yeah, a lot of a lot of those early on, they set your dry weight at the start when you start dialysis. And the dry weight is essentially their estimate of your weight without additional fluid, because Deema very common with late stage kidney failure. And so my dry weight was set too low. And so they were trying to take more fluid than was essentially on my body off and

Daniel Baden: 22:24

There's also some relationship to the side effects between the number of times you're going through dialysis a week. And if you can cut down the times yo in believe that can help with some of the severity of the side effects, is that correct?

Adrian Harper: 22:39

It was correct for base. Like the standard treatment for hemodialysis is three sessions a week on the sofa near somewhere between like four or five hours, I was really struggling with it. So I discussed with my nephrologist whether I could try a reduced frequency of treatment, because I had read a few small studies that were done internationally looking at reduced treatment with a

Daniel Baden: 24:14

But you know, you wouldn't advise doing dropping your dialysis numbers without the dietary changes, I would imagine.

Adrian Harper: 24:21

The key is that like, if you're not adjusting the diet, you're likely to kind of overload on a lot uremic compounds in the body and because it's really a matter of balancing what you're putting into the body and what you're taking out of the body.

Daniel Baden: 24:37

At the end. There's an option for people to run dialysis at home as well if you come across that very much.

Adrian Harper: 24:45

It was the more predominant approach several decades ago with dialysis was doing more in the home and then there's been a shift more to in center treatments but definitely now I think there's more of a sound a bit more of a shift that To claim dialysis, a lot of people are doing that. And the benefit with it, I guess is that it's a lot more flexible about when you can do it. And

Daniel Baden: 25:17

Does that help people with side effects by by having shorter more frequent runs?

Adrian Harper: 25:22

Yeah, often people can kind of tolerate a shorter run, but you can also look at doing a slower run as well, where you essentially do a slower filtering at home than what you can do at the

Daniel Baden: 25:36

centers. Okay, so when a patient comes in to see you, and they're on dialysis, what are the things that you're looking for particularly, do you go through a typical naturopathic assessment looking at bowel patterns and dietary input? Obviously, patient history, in terms of family history, all those sorts of factors? Are they relevant?

Adrian Harper: 26:00

Yeah, we're looking at all those things. And then also look at focusing more on like the presenting symptoms and looking at how people can like tolerating dialysis, and what might be something that, from their perspective is the most concern either from the treatments or with their health, particularly with digestion, that's something that often take a big focus on, there's a lot

Daniel Baden: 27:09

For those patients, and many, I'm sure there's many in that cohort is a really looking liver function and in bowel transit times and the microbiome, would they be the three critical aspects to that?

Adrian Harper: 27:22

Yeah, definitely. There's lots of evidence to suggest that using things like probiotics, or prebiotics that kind of encourage the growth of good bacteria can help with clearance and detoxification of uremic products via the bowel. And just also, I guess, working on the gut also improves things like absorption of nutrients, which can also be often impaired with light like kidney

Daniel Baden: 27:57

Do you find any issues with compliance with patients around significant changes to diet or supplementation regimes?

Adrian Harper: 28:05

It's definitely something that is challenging. And I think in late stage kidney function, particularly aware, people are trying to avoid dialysis. For a certain extent, the diet can be really quite challenging, because it looks very different to a standard diet, and particularly reducing the level of protein can be quite a challenge. When you step on to dialysis. Definitely the

Daniel Baden: 28:53

You're getting great results with your patients. Do you get any feedback from the nephrologist or the hospitals or the dialysis nurses?

Adrian Harper: 29:02

I definitely get feedback from time to time from nephrologist that they don't tend to be that interested in what I'm doing with patients, but they might say to the patients, I'd keep doing what you're doing, because it's obviously working for you. And then had some meetings with the dialysis nurse where I'm doing dialysis. And yet, it's very kind of interested in what I'm doing

Daniel Baden: 29:36

it must be quite empowering for people knowing that they can make changes to maintain good health.

Adrian Harper: 29:41

I think probably the biggest focus particularly with dialysis patients is just looking for that level of wellness day to day and just feeling Come on, making sure that energy cognition, passivity, some exercise, things like that. I kind of maintain because If you can kind of maintain those types of things, yeah, it makes a big difference to your life in general.

Daniel Baden: 30:06

Yeah, that's what we're about, can you give us any sort of take home hints as to how people who have kidney issues to start with may arrest or not develop any worse issues?

Adrian Harper: 30:21

I think in terms of kidney disease, the best thing that people can do is get onto it early on, and look at some type of naturopathic intervention to really low or adopt the decline in function, quite definitely find patients that kind of start to address things early on really makes a big difference to the outcomes. And I've definitely seen people at those early stages be able to

Daniel Baden: 31:26

And for those patients who are already on dialysis, it's somewhat trickier. So they definitely want to work with a practitioner who has some idea of what they're doing with that.

Adrian Harper: 31:36

Yeah, it's very important because there's obviously live the dialysis and then there's normally a number of medications people are on. And there's a lot of things that can potentially react to either the dialysis or the kind of medications. And so you really need to kind of be cautious if you're looking at using supplements, there's definitely an indication for some types of

Daniel Baden: 32:34

Off the top of your head, can you think of one or two nutrients that are particularly at the top of the list of deficiency after dialysis?

Adrian Harper: 32:42

Yeah, so B vitamins, probably one of the key ones, so B vitamins will often be cleared through dialysis. So that's a good one to be taking on ongoing basis, there's some evidence that Vitamin C is also cleared, but also vitamin C, you have to be careful with dosing because possibly it can collide contribute to stone formation as well. And there's also evidence of zinc is lost

Daniel Baden: 33:41

guess B vitamins and zinc are implicated and just about every enzyme system in the body. Yeah, exactly. So we're pretty dependent on them. I didn't how do people get in touch with you?

Adrian Harper: 33:51

Easiest way to get in touch with there's just at my website, which is Adrian harper.com.au.

Daniel Baden: 33:57

Yep. Mike, thank you so much for this. i There are so many people that need this sort of advice. And there's not enough practitioners who work in this particular area. Because when they were students they told they were told don't. But you know, what you do is just it's just gold. So thank you so much, mate. And I'm really grateful you're out there.

Adrian Harper: 34:18

No problem. Thanks a lot, Daniel. Thanks for having me.

Daniel Baden: 34:21

Take care mate.. Bye.