About kidneys and diet

[Dan F.]

Hi Mr. Rippetoe

I'm a 46 years old man from north-east of Italy (sorry in advance for my english), I started strength training after reading SS 2nd edition and PP in mid January (2008 of course) and happy with it: my first question to you is not a technical one but medical. I've now only one kidney ('cause a problem I had in 1991): have you experienced training persons in this same condition?

My concern is in particular about diet: doctors say to eat low protein meals not to stress kidney function but I think if I train for strength I need some more protein than a sedentary person in an equal condition to progress and that will not badly influence my renal function.

In the past years I had no problems training "cardio", slow cardio too but in particular interval sprinting and GPP drills for time: the real problem was that strength, upper body strength in primis, flied away... leaving me with shoulders pain, low back pain etc.

What are your thoughts about this? (Actually my one kidney function is ok, normally hypertrophic after so many years alone). Thanks.

[Mark Rippetoe]

What caused the loss of the kidney in 1991?

[Dan F.]

What caused the loss of the kidney in 1991?

Surgery, after that a doctor accidentally found with ecography that my right kidney was functionally dead. This was due to a particular type of slow and pervasive calculosis caused in the years by a congenital narrowing of the upper part of the right ureter. The cause was bad anatomy and it seems, by medical tests, that I'm not particularly prone to normal calculosis or other kidney problems.

Before kidney surgery I was an amateur soccer player and a decent track athlete without any symptoms of a problem. Doctors said this is not uncommon with that particular kind of calculosis.

My interest in strength training now is because after years of mixed sedentary/low activity or more intense cardio training I really need to improve strength (or contrast its decline in years) in primis for general health I think and also for improving my mountain biking

I don't aim to begin very big and very strong like a master powerlifter or similar (I believe my genetics are not for that) but, after reaching the novice plateu, to improve strength/BW ratio as intermediate trainee, in particular upper body strength that actually is not only absolutely but also relatively weaker than lower body.

So I don't think that some more grams of proteins each day for building muscle could be dangerous for a kidney that, at today, is in perfect health. Some doctors are with me, others not and so your thoughts and eventual experience on this will be very appreciated by me: last decision is obviously on my own

[Dano]

If your remaining kidney is functioning properly and you regularly have labs checked by a Doctor, you don't necessarily have to restrict protein.

I usually don't place people on a protein restricted diet until they have reached the very last stages of chronic renal insufficiency. Your average healthy individual would be hard pressed to destroy their kidneys with protein intake.

To repeat what Mark said, what happened to the other kidney? This could influence how the rest of the discussion goes.

Dan

[Mark Rippetoe]

Provided that no pathology exists that would predispose to problems with the other kidney, my expert staff tells me that a higher than normal protein intake is of no concern at all. If your GFR is normal, there will be no load on the kidney. This is prolly an example of CYA medicine. I'd proceed under the assumption that you're going to process protein like everybody else does unless they can show you why you won't.

[Dan F.]

Mr. Rippetoe and Dano thank very much for your answers and interest!

Yes, my GFR is normal (so creatinine levels) and I check them regularly. Actually I have no renal insufficiency at all. The one kidney is normally hypertrophic and working good.

For Dano: in the previous post I explained what caused my kidney loss. It seems you're a medical doctor, is it true?

For Coach Rip: What's the meaning of "CYA" acronym?
And now a youtube video of myself squatting... Noo! It's a joke!

Thanks again, I'm going working out now (in future I promise only questions about lifting and training).

[Mark Rippetoe]

CYA = Cover Your Ass. Refers to the best way to avoid getting sued out of existence. It is the cause of many silly recommendations uttered by medical professionals who actually know better.

[Dano]

Actually I'm a Clinical Dietitian(so I have authority to prescribe theraputic diets) and hopefully, a soon-to-be Physician Assistant. Most MD's, even specialists, are often dated when it comes to medical nutrition therapies for particular disease states. Some, not all...just keep an eye on things.

There's a really good article in the International Society of Sports Nutrition that summerizes the research supporting the higher protein needs for athletes and debunking the idea that high protein intakes damage healthy kidneys. Yes, I am NOT one of those dietitians that says we all need 0.8 gm/kg of protein per day. I prescribe higher amounts for geriatric folks for christs sake!

[Dan F.]

CYA = Cover Your Ass. Refers to the best way to avoid getting sued out of existence. It is the cause of many silly recommendations uttered by medical professionals who actually know better.

Ah ok... In italian there's a word that means the same and is almost a literal translation of CYA: "paraculo"...