Can fasting slow disease progression in people with CKD?

Question

Hello doctor,

I am 74 years old and have chronic kidney disease (CKD). I am trying to slow its progression in any way that I can. Does fasting and maintaining good gut health at the age of 74 help someone with CKD slow disease progression?

I have read online about fasting and the microbiome, but I do not know what is safe. Skipping meals worries me because of my kidney condition and the possibility of weakness. Can meal timing really help, or is it risky at my age?

My doctors focus mainly on medications and do not discuss lifestyle measures very much. I do not want to harm myself while trying to help my condition. Now time seems important and I don’t want to waste it following incorrect advice or making things worse.

Kindly advise.

Answer 1

Hello,

Welcome to iCliniq.

I have read your question and understand your concern.

At 74 years old with chronic kidney disease, you have to be careful about fasting. Long periods without food have not been shown to slow the progression of kidney disease and may increase the risk of dehydration, low blood pressure, weakness, dizziness, and loss of muscle mass. Older adults are generally more susceptible to these effects, particularly if they have other medical conditions or are taking multiple medications.

A simple and balanced approach is often the safest and most sustainable:

•Eat regular, balanced meals and don’t go for long periods without eating.

• If your potassium and phosphorus levels allow, add in foods that are rich in fiber and work in your kidney diet such as vegetables, fruits, oats, and whole grains for gut health.

• Keep hydrated according to your kidney specialist’s recommendations.

• Control blood pressure and blood sugar and avoid excess salt, as these have the strongest evidence for slowing the progression of chronic kidney disease.

• Maintain a healthy body weight and exercise regularly as tolerated, as this may help promote overall kidney and cardiovascular health.

There may be some potential benefits to timing your diet, but at your age and with chronic kidney disease, any plan to fast should be discussed with your nephrologist or renal dietitian before you begin. They can determine whether it’s right for your level of kidney disease and overall health.

It is also worth remembering that interest in the relationship between gut health and kidney disease is growing. But the evidence is still emerging, and there is no strong evidence yet that fasting alone can significantly slow the progression of chronic kidney disease.

Aggressive fasting strategies are usually far less important than the basics of kidney care. Most benefit would likely come from focusing on a kidney-friendly diet, taking medication as prescribed, regular follow-up, blood pressure control and healthy lifestyle habits.

Thank you.