How do you increase weight with Kidney disease?

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JoeB7700
Posts: 6
Joined: Fri Feb 07, 2020 4:54 pm

How do you increase weight with Kidney disease?

Post by JoeB7700 »

Hello All,

I am a 54 year old male. About a year ago, my GFR fell from 60 to 38 in a short period. The doctor wasn't sure what caused it, thought it was a virus (not the coronavirus). I drank a lot of water, and ate a kidney friendly diet. No fast food, low salt. My GFR went back up to 61, and said this was "normal' and healthy. Another doctor said it should be higher, but he wasn't clear as to how high it should be. The last doctor I saw said I could have fast food. I said how often? And she said "Once a month."

By eating very carefully, mostly salads, I am eating very healthily. But my fat intake is very low. I do get enough calories, but my weight fell to about 63-64 kilgrams. My height is 5ft 10 and 1/2 inches. My wife doesn't like this drop in weight, but I am not really sure what to do about it. I was told by one doctor (not the two I mentioned previously), that yes, the kidneys can bounce back, but they are never quite the same. I take that to mean that I should be careful, and that along with the other doctor said about fast food (probably a moderate portion) once a month, seems to also signify that I should eat with care. I have noticed when on a rare occasion I ate too much of something not good for me, that I can feel my kidneys (not pain, but I sense they don't like something).

My question is how can I increase my weight without hurting my probably damaged kidneys? I live mostly on gluten free pasta made of corn, some boiled potatoes, controlled amounts of lean meat protein, apple juice, and small pieces of toasted bread (made of rice) with egg white. Sometimes fish and tuna but controlled amounts and I watch the salt that is in my food. Mango and apples are the main fruits I eat.

I hope you can help. Thanks.

JoeB
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: How do you increase weight with Kidney disease?

Post by wagolynn »

The general guide lines are, about 80grams of protein per day (for a male a bit less for females), and 5 portions of vegetables or fruit.
Most of the kidney friendly stuff is just hearsay, best ignored.

Some fats are essential but take care with saturated fats for your heart and circulation.

Keep salt as low as you can for your heart.

Around 2 litres of fluids per day for your kidneys.

There is some confusion because when on dialysis patients have to reduce Potassium and Phosphate intake due dialysis not being very good at removing the excess, our normal range of foods contains well in excess of what our body's need, healthy kidneys will expel the excess.
Many patients think this reduction is for the benefit of the sick kidneys but it is for the patients health.
Some times, a consultant will ask a patient to reduce intake of foods high in these two before the patient is on dialysis.

Reduction in intake of either of these unless specifically told to by you consultant is not wise as both are essential to life.
JoeB7700
Posts: 6
Joined: Fri Feb 07, 2020 4:54 pm

Re: How do you increase weight with Kidney disease?

Post by JoeB7700 »

Thanks Wagolynn. I have had a stable diet since early this year. I get enough calories, but I do a lot of garden work. I was never fat, but I had some fat because of cola, and fast food. Nowadays, I don't eat any of that, and with the work I do, my weight stays at a constant. It's just a bit below the minimum range for my height. I'm not on dialysis. The hope is that my diet will prevent that. But with this healthy eating, I am really too thin. My weight is constant. I'm glad to be alive, and that my kidneys improved so much. The cost of this though was all additional weight was lost. For a time, my diet was so extreme that I suffered some muscle atrophy (and pain associated with it), but I increased my protein and that problem went away. Do you, or someone know, how weight/or muscle mass can be increased in such a situation safely, without harming my kidneys. My diet follows the basic needs of a male, but not in excess. The theory with the eating, suggested to me by doctors, was to keep the fats low (Like from potato chips, fast food) and eat salad like foods. I also don't eat refined sugars, etc.
wagolynn wrote:The general guide lines are, about 80grams of protein per day (for a male a bit less for females), and 5 portions of vegetables or fruit.
Most of the kidney friendly stuff is just hearsay, best ignored.

Some fats are essential but take care with saturated fats for your heart and circulation.

Keep salt as low as you can for your heart.

Around 2 litres of fluids per day for your kidneys.

There is some confusion because when on dialysis patients have to reduce Potassium and Phosphate intake due dialysis not being very good at removing the excess, our normal range of foods contains well in excess of what our body's need, healthy kidneys will expel the excess.
Many patients think this reduction is for the benefit of the sick kidneys but it is for the patients health.
Some times, a consultant will ask a patient to reduce intake of foods high in these two before the patient is on dialysis.

Reduction in intake of either of these unless specifically told to by you consultant is not wise as both are essential to life.
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: How do you increase weight with Kidney disease?

Post by wagolynn »

I suppose the simple answer is eat slightly more of what you are eating.

Kidneys can and do recover it all depends on what caused the reduction in function in the first place.
JoeB7700
Posts: 6
Joined: Fri Feb 07, 2020 4:54 pm

Re: How do you increase weight with Kidney disease?

Post by JoeB7700 »

wagolynn wrote:I suppose the simple answer is eat slightly more of what you are eating.

Kidneys can and do recover it all depends on what caused the reduction in function in the first place.
Basically, this is what I realised too, to try and eat a little more of what seemed safe. Recently, my wife in an attempt to get me to eat more, brought home grilled chicken, though I have told her many times I can't eat fast food, or food to rich in fats, oil etc. I ate too much of this and now am suffering for it. From my past experience, I know I will heal from this, but it is still scary to feel some of those symptoms, a slight shortness of breath, some irritation in the kidney areas. I'm pretty good about controlling what I eat, but one of my worst problems with food is that my wife just doesn't take it seriously. She is a smoker, and it seems that many a smoker has a nonchalant attitude towards health. Their lack of care for their lungs, transfers easily, and perhaps often, to a lack of care about food.

I tell her, be happy that I am alive and that my kidneys improved enough that I didn't have to use dialysis. That doesn't seem to mean much to her. She is only thinking about the loss of weight that I experienced. Being thinner is actually a mostly positive experience. I feel much better. My clothes fit much better, and I have the physique that is very similar to people from pre-obesity times. A lot of famous actors and actresses were slender in the past. That was much more of a norm, after all. But facts,and looking at the positive side of this has no effect on her. I am human, so when she brings, and pushes on me, something delicious (that is bad for me), it is hard to turn down. I have thought about tossing the super large pizza supreme or the grilled chicken into the garden the next time she does it. My life is more important.

Such a waste of money, but my life and future are more important. I have this serious problem, and the person who is supposed to be my biggest supporter on this does this to me. Probably, this happens to far more people than it should, they just don't show that in the movies.

That is a good question about what caused reduction in the first place. My kidney specialist theorised a virus (not coronavirus). It happened in June of last year when it was extremely hot weather. I have wondered if it was lack of sufficient water intake. He also wondered if there was already some problem before, that had been undetected, but old blood tests didn't have enough information to determine anything.

May I ask, Wagolynn, what precisely is your kidney problem? Are what actions are you taking to improve the situation? If it's too personal, you don't need to answer. Thanks for listening.
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: How do you increase weight with Kidney disease?

Post by wagolynn »

The clue is, "some irritation in the kidney area", kidneys do not usually produce pain unless they have a severe infection, and you would have other symptoms.
Chicken has a very low fat content, grilled chicken should be quite low, there is a tendency with pre cooked meals to go heavy on the salt, hence if you have a blood pressure problem you need to avoid them.

I think up to a point, your wife is correct, you have got hung up on, food for kidneys, and there really is nothing in our 'normal' range of foods that will bother your kidneys.
There may be foods that you are allergic to, and if you were to react strongly enough then you may temporarily or permanently damage your kidneys along with other organs, this damage is usually caused by our own bodies over reacting to the allergen, at this level of reaction you would be a emergency hospital case.

But if you think a food is bad for you, your brain will oblige, and produce the symptoms you want, the only way to prove you are allergic to foods is to go to the doctors, and have tests done.

On the face of it, you have had a viral infection which your immune system has overcome.

I have PKD, and am too old to have a transplant so I have been on dialysis for about 10 yrs now.

To deal with Potassium and Phosphate (both are water soluble) I boil all vegetables or soak them in water overnight (potatoes if I am making chips, vegetables if I am making a stew) most canned fruit and vegetables can be eaten if the canning liquid is thrown away.

Chocolate, potato crisps, and dairy products need to be reduced to 'special treat' level.

None of this is to 'cure' my kidneys but rather to compensate for the lack of kidney function, and to overcome the failings of dialysis.

Best wishes.
JoeB7700
Posts: 6
Joined: Fri Feb 07, 2020 4:54 pm

Re: How do you increase weight with Kidney disease?

Post by JoeB7700 »

Hello wagolynn,

Thank you for your answer. I really appreciate it.

I'm sorry to hear that you are on dialysis. It seems that you have a good handle on how to handle food given your circumstances.

The last time I had my kidneys checked (before the coronavirus epidemic) I had a 61 GFR. It had been 38 and had dropped over 22 points in a two month period or even less. When it improved, it happened concurrently with my major change in diet which had been suggested by my general practitioner (stay away from crisps, cookies, fast food, oily/fatty things - he suggested salads and lean meats, chicken, turkey, fish). Perhaps the rise in my GFR would have happened anyway from recovering from the virus. On another check, it had gone back down to 53 (when I was eating less carefully). And then went up to its highest recorded level when I ate very carefully, a 61 GFR. So, there does seem to be some connection with foods and kidney function. Of course, for the last year, if something is driving my GFR down, I try to avoid it: the threat of kidney failure from the rapid loss of kidney function is something I didn't and don't forget easily. But perhaps fluctuations of even seven or eight points are not so drastic.

I don't know, but as you can imagine, I like to keep the GFR high and stable.

I believe what an endocrinologist said to me. That kidneys can heal, but he found they were never quite the same.

I, too, boil a lot of things and soak the potatoes in water to leach out some of the negative kidney unfriendly elements.

The grilled chicken was cooked with its skin on. I removed the skin before I ate it. There must have been a lot of salt and seasonings, and I suppose some of the fats from the skin had marinated the chicken as it was grilled. It was delicious. But something about it did cause some negative feelings in my back, even internally (I could feel it) for a few days, and a few times I had that awful shortness of breath.

One thing is for sure. If someone wants to lose weight, just eat a kidney friendly diet. And also, generally speaking, these foods actually taste pretty good and are satisfying. I feel good.

Sadly, though, In Eastern Europe where I live, the local diet consists in part, of lots of sausages, and lots of foods that are by their nature very oily. My wife is a good cook, so this has not been easy for me and her.

I am still learning. I am aware that attempts of perfection with eating or anything, can sometimes go too far, sometimes way too far. So, I will continue to watch and learn and practise the best eating habits I can.

Thanks again wagolynn and I wish you the best of luck with your own situation.

wagolynn wrote:The clue is, "some irritation in the kidney area", kidneys do not usually produce pain unless they have a severe infection, and you would have other symptoms.
Chicken has a very low fat content, grilled chicken should be quite low, there is a tendency with pre cooked meals to go heavy on the salt, hence if you have a blood pressure problem you need to avoid them.

I think up to a point, your wife is correct, you have got hung up on, food for kidneys, and there really is nothing in our 'normal' range of foods that will bother your kidneys.
There may be foods that you are allergic to, and if you were to react strongly enough then you may temporarily or permanently damage your kidneys along with other organs, this damage is usually caused by our own bodies over reacting to the allergen, at this level of reaction you would be a emergency hospital case.

But if you think a food is bad for you, your brain will oblige, and produce the symptoms you want, the only way to prove you are allergic to foods is to go to the doctors, and have tests done.

On the face of it, you have had a viral infection which your immune system has overcome.

I have PKD, and am too old to have a transplant so I have been on dialysis for about 10 yrs now.

To deal with Potassium and Phosphate (both are water soluble) I boil all vegetables or soak them in water overnight (potatoes if I am making chips, vegetables if I am making a stew) most canned fruit and vegetables can be eaten if the canning liquid is thrown away.

Chocolate, potato crisps, and dairy products need to be reduced to 'special treat' level.

None of this is to 'cure' my kidneys but rather to compensate for the lack of kidney function, and to overcome the failings of dialysis.

Best wishes.
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: How do you increase weight with Kidney disease?

Post by wagolynn »

Hi JoeB7700,

I must point out that Potassium, Phosphate and Sodium (usually from Sodium Chloride Common salt) are all vital to life.

Our normal foods naturally contain more than enough of all of them, and our kidneys are involved in dumping the excess.
Reducing your intake below the natural level should only be done under medical supervision.
I am reducing the intake of Potassium and Phosphate because dialysis does not remove them, and of course my kidneys are no longer able to.

Salt is a problem because we tend to add salt to our food, as the amount of added salt goes up our taste buds do not register the increase effectively, so we can eat food with very large amounts of unnecessary salt.
I found I missed salt but I learned to use Black pepper, and played around with herbs to compensate on the taste front.
From the kidneys point of view, they try to maintain a constant healthy sodium level, their first reaction to excess salt is to reduce water output in an effort to dilute the salt, they also signal thirst to encourage more fluid intake to dilute the salt.
This then allows the kidneys to pass more fluid thus washing out the excess sodium.

Excess sodium causes the blood vessels to contract (our blood vessels have muscles) constricting blood flow causing high blood pressure.
High blood pressure destroys kidneys.

GFR is usually eGFR which is an estimated value, and is notoriously prone to error, so the best way to use this number is to look at trends over time rather than individual readings.

Dialysis, once your body gets acclimatised (takes a couple of months) is not that bad, and soon becomes a way of life - I suppose it is literally.

Best wishes.
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: How do you increase weight with Kidney disease?

Post by wagolynn »

Hi JoeB7700,
I meant to say, in my limited experience Doctors in the UK steer clear of recommending a diet for kidneys (other than the dialysis restrictions mentioned above).

I have searched the internet and found lots of stuff claiming to be diets to 'cure' failing kidneys but none of it has any scientific credibility.

One thing you may have found is, in the USA kidney patients are frequently advised to reduce protein intake, this is due to the USA diet tending to be very high in protein, the UK protein intake is much lower, hence reducing protein is not usually required.

Interestingly, excess protein is turned into fat by our digestive system.
JoeB7700
Posts: 6
Joined: Fri Feb 07, 2020 4:54 pm

Re: How do you increase weight with Kidney disease?

Post by JoeB7700 »

Thanks wagolynn for your two erudite messages. How often do you have to do dialysis and for how long on each occasion? If it isn't too much to ask, how old are you, and when did you start dialysis?


What I did, was I researched what some had done/claimed , to raise their GFR. This started out first with advice from my general practitioner and his general advice about eating healthy, lean meats, salads, no fast food, etc. seemed to make me feel a lot better. I looked at the potassium, salt, phosphorous, water, etc. requirements for a diet of someone with stage 3-4 kidney disease and followed it strictly. A few months later when I finally saw a kidney specialist, and he was impressed or at least happy with the drastic positive change in GFR (he said the drastic drop accompanied by all the classic symptoms, of difficulty breathing, tired at all times regardless of the amount of sleep, ankles that were becoming thicker. He said what I had experienced was "kidney failure"), well, he said to me to continue this diet to see how it would do. My goal was to see if I could get it to 70-90. The highest the GFR came to was 61, but coronavirus and chaos didn't allow for me to get another test to see how a big reduction of protein would affect my results, which is claimed to have a big impact. One would think from the videos that these people, whom I think are mostly sincere, have found something that has made their kidneys healthy, and to be sure, it is a very positive thing to be getting back positive blood test results, and high GFR results - one woman claimed that her doctor said she didn't have to be tested anymore - but I think it is a chimera for them or me to think that the kidneys have become healthy or that I can eat the way I used to. So, I think the special dieting can really help in some cases to maintain health, but it probably does not mean for my success or that woman's success, that it would be wise to eat in an unhealthy way. But if the diet really does maintain kidneys' health, it is worth it.

I found out why when I had the grilled chicken I felt breathing difficulty. Damaged kidneys can't handle salt as well. More fluid in the lungs can result when too much salt is digested by such a person, and that fluid can cause difficulty breathing.

So, generally, I feel great, better than in years. I eat lots of corn pasta, (and sometimes I add a big portion of rice in an attempt to increase weight), about a spoon of olive oil every day, lots of apple juice, mangoes, two or three apples a day, one or two large egg whites a day, measured amounts of turkey, chicken, or salmon (any one of these meats probably about 50 grams per meal). I have learned to stay away from chocolate, hot dogs, fast food chips, crisps,colas, refined sugar etc. though when my wife is having such an item I allow a smallish bite or two (to prevent the urge to eat too much of one of these things) and as an experiment, if it's a special month like my birthday, or just once in a four or five week period, to allow myself a small cheesebuger, or half a large one, or a small or medium siice of pizza, and at most, a small piece of cake. My body is pretty good about warning me if something isn't right, so I listen to it. I never gorge myself. Generally I have learned how much I can eat even of the pasta, which is quite a lot, but I never utterly stuff myself. One of the websites said something like that kidney disease can mean, in a way, like having half of the normal kidney function, or at least less than normal, so I don't want to overwhelm their abilities. I also take kidney vitamins every alternating month as recommended by my specialist.

Thanks for the idea about the protein. Some claim that limiting protein makes no sense, even base whole diets on this idea. I treat the idea with caution just in case they are wrong. But it is interesting, and I will watch the results of tests because I do eat more protein than before, and I will look to see if there is anything wrong in doing that. I am also going to look into if muscle building, increasing muscle mass, actually increased weight. It seems that it would.



wagolynn wrote:Hi JoeB7700,

I must point out that Potassium, Phosphate and Sodium (usually from Sodium Chloride Common salt) are all vital to life.

Our normal foods naturally contain more than enough of all of them, and our kidneys are involved in dumping the excess.
Reducing your intake below the natural level should only be done under medical supervision.
I am reducing the intake of Potassium and Phosphate because dialysis does not remove them, and of course my kidneys are no longer able to.

Salt is a problem because we tend to add salt to our food, as the amount of added salt goes up our taste buds do not register the increase effectively, so we can eat food with very large amounts of unnecessary salt.
I found I missed salt but I learned to use Black pepper, and played around with herbs to compensate on the taste front.
From the kidneys point of view, they try to maintain a constant healthy sodium level, their first reaction to excess salt is to reduce water output in an effort to dilute the salt, they also signal thirst to encourage more fluid intake to dilute the salt.
This then allows the kidneys to pass more fluid thus washing out the excess sodium.

Excess sodium causes the blood vessels to contract (our blood vessels have muscles) constricting blood flow causing high blood pressure.
High blood pressure destroys kidneys.

GFR is usually eGFR which is an estimated value, and is notoriously prone to error, so the best way to use this number is to look at trends over time rather than individual readings.

Dialysis, once your body gets acclimatised (takes a couple of months) is not that bad, and soon becomes a way of life - I suppose it is literally.

Best wishes.
wagolynn
Posts: 1322
Joined: Thu May 23, 2013 2:49 pm

Re: How do you increase weight with Kidney disease?

Post by wagolynn »

Hi JoeB7700,
I dialyse 3 times a week at the dialysis unit at the local hospital, it was for 4 hrs but since the pandemic it has been shortened to 3.5 hrs to reduce exposure time.
As to age, I have been ticking the over 65 box on surveys for a good few years.

As I see it, your GP gave you the dietary advice he would give almost any patient.

The five-a-day thing has to it’s credit, plenty of vitamins, and minerals, and the higher fibre will tend to absorb toxins, some fats, sugars, these are then carried away through the system.

I am surprised at the symptoms you have, this usually shows with much lower kidney function.

Tiredness can be caused by anaemia, (low red blood cell count), healthy kidneys produce a hormone, EPO, this makes the bone marrow produce more red blood cells, sick kidneys don't produce EPO or not enough anyway.
The way to test this is to have a blood count done on a sample of blood.

If you have water on your lungs, it must be dealt with at once, let your GP or consultant know straight away.

On the subject of retained fluid – Do you know about the dimple test?

Just in case, Press hard with your thumb where you think the water is, (I would practice around your shins or ankles) say count to 10, on letting go there will be a dimple where you thumb was.
If you have retained fluid in that area, the dimple will take a while to disappear say well over 30 secs.
If you do not have retained fluid in that area, the dimple will clear away within say 30 secs, using this method you can asses how far up your leg you have retained fluid, I would be asking the medics about taking a diuretic (water pills) if it was half way up my shins.

This retained fluid is called Extra Cellular Fluid, it got there by leaking out of body cells due to there being too much water in your circulatory system, the path is circulatory system – capillaries – cells – then out through the cell walls. It can flow the other way but this is quite slow. Normally the small amount of leakage is moped up by the Lymphatic system but it can only work slowly, and it relies one you flexing your leg muscles to power any pumping action.

Muscle mass – work the muscle regularly, and it will increase in size but only if you have sufficient protein available but excess protein will not build muscle, the muscle has to be worked hard.

I hope this is not confusing, I have simplified my comments so if you think there is something missing post, and I will try to fill in the missing bits.

Best wishes.
JoeB7700
Posts: 6
Joined: Fri Feb 07, 2020 4:54 pm

Re: How do you increase weight with Kidney disease?

Post by JoeB7700 »

Hello,

Thanks for your answers.

Most of those severe symptoms occurred about a year ago during the initial episode that the specialist believed was "kidney failure" due, in his words, to a "probable virus". He also added that kidneys are a mystery. So, on the very few times, about twice, where I had any of those symptoms recur, it was after eating too much fast food in one or a few sittings over a short period of time. This is why I became angry with my wife. She didn't just bring home a pizza, she ordered the largest pizza that I had ever seen. The same with the grilled chicken, not just one piece, she brought two whole grilled chickens and pushed it onto me to eat it. A kidney friendly diet is somewhat bland, and I was feeling pretty good due to the effects of careful eating; I was really hoping my kidneys had healed. Anyway, it does indeed, if I seriously overdo it with food that is bad for me, result in the beginnings of the old symptoms. Of course, what else would I or anyone expect?

You pointed out that I should contact my doctor right away about the breathing issue. You are right, that is a serious issue, and thus my irritation with my wife's casual attitude.

After the chicken, it was only a little, a tiny amount of the breathless feeling (a few seconds, once or twice in the next day or two after eating), and there was some discomfort (even some actual pain in the kidney areas), but this was only for a short period of about a week or two. I went back to careful eating, and now a few weeks later, the symptoms went away. I did the dimple test, the mark lasts a few seconds. I am having to drink a lot of water now, but it is the high point of summer, and I have dry eye, which as one doctor told me, such persons often have thirst.

So, generally if I am feeling well and that means not feeling any of the symptoms from kidney disease, generally my kidney test result reflect that. So diet and drinking water is incredibly important to me.

Yes, the doctors salad idea he might say to anyone. But just think how much more important it is for a person with kidney disease to take that simple advice seriously?

And these salads I eat are not the leafy kind. It is a large portion of gluten free pasta (sometimes with added rice), some egg white, 40 -50 grams of a lean meat, some times with a potato mixed in, some onion, and some cucumber or small bits of cheese (the last one or the other is what has the salt in it), and if I didn't add cheese (a lot of fat in cheese), I add a half spoon of extra virgin olive oil (a total of one spoon per day - this is basically the same that is recommended for people with healthy kidneys as well). The olive oil has calories in it, and it adds taste. The cucumber and onion also add some taste to it. With a glass of apple juice, and a glass of water, and a few slices of mango or an apple (I'm thinking of trying skinned apples as I sometimes feels some irritation in my stomach or somewhere from the apples), all in all, very tasty and filling.

I allow some flexibility, a small bit. If my wife is having one of the bad foods, I allow myself sometimes to have a bite (and I mean just that, a bite) of a hot dog or hamburger, a tiny bit of a french fry at most, and never coca cola or milk. For my birthday I would like a small piece of cake and a small cheeseburger. And if and when I do something special like that, I would have the cake as part of breakfast, and maybe the cheeseburger at supper. Since there would be a lot of salt in the burger no doubt, I would limit salt in my other meals that day, and I would assume there are oils in the cake, I would probably not add olive oil to anything that day. My liver was affected when I was taking too much olive oil, so I (and apparently people in general, have to be careful about too much olive oil).

I want to get tested soon to see how my kidneys are functioning.

Yes, I have increased my protein, and I do lots of push ups, so yes, I can see increased muscle mass. I was in the Army, so exercise does work if one is disciplined.

Take care and enjoy the Summer!
JoeB
wagolynn wrote:Hi JoeB7700,
I dialyse 3 times a week at the dialysis unit at the local hospital, it was for 4 hrs but since the pandemic it has been shortened to 3.5 hrs to reduce exposure time.
As to age, I have been ticking the over 65 box on surveys for a good few years.

As I see it, your GP gave you the dietary advice he would give almost any patient.

The five-a-day thing has to it’s credit, plenty of vitamins, and minerals, and the higher fibre will tend to absorb toxins, some fats, sugars, these are then carried away through the system.

I am surprised at the symptoms you have, this usually shows with much lower kidney function.

Tiredness can be caused by anaemia, (low red blood cell count), healthy kidneys produce a hormone, EPO, this makes the bone marrow produce more red blood cells, sick kidneys don't produce EPO or not enough anyway.
The way to test this is to have a blood count done on a sample of blood.

If you have water on your lungs, it must be dealt with at once, let your GP or consultant know straight away.

On the subject of retained fluid – Do you know about the dimple test?

Just in case, Press hard with your thumb where you think the water is, (I would practice around your shins or ankles) say count to 10, on letting go there will be a dimple where you thumb was.
If you have retained fluid in that area, the dimple will take a while to disappear say well over 30 secs.
If you do not have retained fluid in that area, the dimple will clear away within say 30 secs, using this method you can asses how far up your leg you have retained fluid, I would be asking the medics about taking a diuretic (water pills) if it was half way up my shins.

This retained fluid is called Extra Cellular Fluid, it got there by leaking out of body cells due to there being too much water in your circulatory system, the path is circulatory system – capillaries – cells – then out through the cell walls. It can flow the other way but this is quite slow. Normally the small amount of leakage is moped up by the Lymphatic system but it can only work slowly, and it relies one you flexing your leg muscles to power any pumping action.

Muscle mass – work the muscle regularly, and it will increase in size but only if you have sufficient protein available but excess protein will not build muscle, the muscle has to be worked hard.

I hope this is not confusing, I have simplified my comments so if you think there is something missing post, and I will try to fill in the missing bits.

Best wishes.
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