Tales of a One-Kidney Fencer

In the limited pre-donation meetings I had with the transplant team, the one I most looked forward to was the transplant team nutritionist. Being 50+ years old and not being able to take in anti inflammatory medicines posed and poses a real problem. So, I was eager to hear about solutions for that and how nutrition was going to help form a solid foundation for recovery.

I was very disappointed. All the nutritionist told me was that I should limit all future protein to 1 gram per kilogram of bodyweight. At that time, I was taking in closer to 2.2 grams per kilo. There was no discussion of recovery nutrition or competition level nutrition. In fact, I asked whether that was the same advice the nutritionist would have given a 400 pound asthmatic who just sat on the couch all day. The nutritionist said that the advice is the same. So, I made plans to dramatically reduce my protein intake.

Five weeks into recovery, I brought on my own sports performance nutritionist experience with living donors. We discussed protein and came up with a plan. So, we are going to start with 1 gram per kilo, and then slowly increase my protein intake to up to 1.6 grams. In conjunction, I am going to undertake monthly testing of kidney functions to ensure no adverse results.

In week six, so that I understood and could explain the increased protein intake to others, I sent my nutritionist the following question:

“Sorry to bother.  I was explaining something to someone and I realized that I am making assumptions.  I would rather be accurate.  So, I have a protein question. 

I know protein is used by the body, with the excess gotten rid of.  So, is it accurate to state that protein is absorbed as needed, and then the remaining processed by the kidney and removed through micturition? 

In other words, if I work out, and need protein to recover, and take in 1.4 grams per kg, that excess does not get to the kidney until the body takes what it needs?

Thank you for your time.”

My nutritionist quickly responded with:

“Great question.

Ingested protein can be:

1. used to build the body (muscles, immune cells, etc
2. burned for fuel (amino acid converted to glucose) OR
3. excreted via the kidneys.

Strictly speaking, one healthy kidney can process the same load as two healthy kidneys.

It’s not a ‘strain’ on the kidneys (unless you have chronic kidney disease).”

So, there it is. I will slowly increase my protein intake but undergo monthly testing to check creatine, protein, and EGFR on a regular basis.