I have previously blogged about my recent low lab albumin reading, about albumin itself, and how much daily protein is the norm to raise it. This blog is a little about what we are incorporating into my diet as a result.
I am eating a serving of smear case daily, usually with my evening meal along with a healthy serving of a fruit like strawberries. This provides about 21 g of protein. with supper plus. I have this along with a fortified drink with the stuff Fresenius provided which is another 16 g for a total of 37 g of protein for supper.
For breakfast, I’m having a cereal such as mini wheat (5g), a heaping tablespoon of peanut butter (4+g), and a Brazil nut (1/2g) along with 6 oz of V8 (2g).
For lunch, it varies. Today I’m having a shake consisting of vanilla powder with 31 g of protein, a little 2% milk, strawberries, and sucrose sweetener.
If you add this up, you’ll ascertain that I’m right at 72-80 or so as the recommended amount to raise albumin. I have labs on 9/6/2024 so we’ll see.
Those of you following this blog know that recently my labs indicated a low albumin reading of 3.1. To increase this reading to the desired over 4 result, it has been recommended by my dialysis team that I increase my protein intake. But the nagging question of how much protein to shoot for, and what is “enough” were not addressed. I should probably have quizzed my team’s dietician about this but I didn’t. This blog delves into the question posed below to Perplexity:
My albumin is 3.1. I’m on peritoneal dialysis. What is the maximum protein input per meal and day that I should input to bring albumin up and how long should it take?
Given your albumin level of 3.1 while on peritoneal dialysis, here are some recommendations to help increase your albumin:
Protein Intake Recommendations
Daily protein intake: Aim for 1.2-1.3 g of protein per kg of body weight per day[2][3]. I weigh roughly 64 Kg. So my daily allotment of protein is 77 to 83 g.
Per meal: Try to include 20-30 g of high-quality protein at each meal[4].
Strategies to Increase Albumin
Include a protein source at every meal and snack[2].
Focus on high-quality protein foods like lean meats, fish, eggs, and dairy products[4].
Consider protein supplements like Greek yogurt, protein powders, or renal-specific nutrition drinks if recommended by your dietitian[4].
Eat your largest meal when your appetite is best[1].
Have protein-rich snacks between meals and before bed[1].
Timeline for Improvement
Albumin builds up slowly in the body. It may take 3 weeks or more of consistent, adequate protein intake to see an improvement in your albumin levels[1]. However, individual responses can vary, so continue working closely with your healthcare team to monitor your progress.
Remember to balance your protein intake with other aspects of your renal diet, such as phosphorus and potassium restrictions. Consult your nephrologist and renal dietitian for personalized recommendations tailored to your specific needs and medical condition.
My Dialysis Team Meeting took place as scheduled this morning. We had a meeting that did not resolve my low Albumin reading from my latest lab. Recall that it dropped from 3.6 to 3.1 and an acceptable reading is over 4. We discussed six ways from Sunday what may have changed in my life and/or lifestyle to merit this change with no conclusions. As often happens in medicine, we’re now going to wait and see what my labs are as a result of my next scheduled lab on 9/6/2024. I will be doing an adequacy test at that time also so there will be a lot on the table.
One unique aspect of the meeting was that my dietician provided me with a 32 oz bottle of LiquaCel to try out as a protein supplement. My nephrologist also approved my use of protein powder to improve my protein intake. I’ve included a PR-type video below from the company that makes LiquaCel to familiarize readers with their products.
Unlike most posts, I am writing this short post the same day I post it. Tomorrow, Friday, I intend to write that blog and post it on the same day gathering together what took place in the 0915 scheduled dialysis team meeting at the clinic in Granbury. Recall that my last lab indicated several critical items such as Albumin being way out of kelter. So please drop in after noon or so tomorrow, 8/16/2024 to learn what my nephrologist et al had to say.
One of the many little nagging things that plague me as a result of kidney failure is bad breath. I do all the right things having to do with my teeth and mouth. I have my teeth cleaned three times a year and see the dentist like clockwork. I floss and brush every night without fail. Still, my wife informs me constantly that I have bad breath and to go brush my teeth. This leads to me wonder what the correlation is between being on peritoneal dialysis and bad breath. I quizzed Perxiplity about this with the following results:
There is a correlation between peritoneal dialysis (PD) and bad breath, also known as halitosis, in patients with end-stage renal disease (ESRD). Studies have shown that high blood urea nitrogen (BUN) levels and low salivary flow rates are associated with halitosis. Peritoneal dialysis can help decrease the level of halitosis by reducing BUN levels and increasing salivary flow rates over time[1][3][5].
Chronic renal failure, which leads to a buildup of waste in the blood (uremia), can result in halitosis. This condition is often described as having an ammonia-like odor, and it is one of the non-oral causes of bad breath in patients with kidney disease[4][5]. Additionally, oral health issues such as dry mouth and changes in taste are common in patients undergoing peritoneal dialysis, particularly those with diabetes[2].
Overall, while peritoneal dialysis can help reduce halitosis, the presence of bad breath may still occur due to underlying renal issues or other oral health conditions.
Of interest to all of us on PD, is today’s topic, “What’s the hottest and most recent topic in peritoneal dialysis?” I turned to Perplexity with this topic as a prompt with the following results. Read on to stay up-to-date:
The hottest and most recent topics in peritoneal dialysis (PD) focus on several key areas of research and clinical practice:
Peritoneal Membrane Biology and Physiology: Understanding the biology and physiology of the peritoneal membrane is crucial for improving PD outcomes. This includes studying how the membrane functions and changes over time with PD treatment[1].
Metabolic Disturbances: Researchers are examining metabolic disturbances that occur in patients undergoing PD, which can affect overall health and treatment efficacy[1].
COVID-19 Impact: The pandemic has influenced PD practices and outcomes, prompting studies on how COVID-19 affects PD patients and their treatment[1].
Infections Related to PD: Peritoneal dialysis-related infections, such as peritonitis, remain a significant concern. Research is ongoing to better understand and prevent these infections[1][2].
Technological Advancements: The use of physiological modeling and artificial intelligence in PD is an emerging area, aimed at enhancing treatment personalization and improving patient outcomes[1].
Volume Management: Evaluating and managing the volume status of PD patients is a current research hotspot, which is essential for optimizing treatment and preventing complications[4].
Patient Outcomes and Trends: Studies have shown improvements in patient survival rates and reductions in peritonitis rates over time, indicating advancements in PD care and infrastructure[2].
These topics represent the forefront of research and development in peritoneal dialysis, aiming to improve patient care and treatment outcomes.
esterday I blogged about my Albumin lab result being in the toilet. From my July 2024 labs, my Cholesterol was at 218 where the goal is less than 200. For the same labs, my Triglycerides were 191 where the goal is less than 150. As a side, my Creatinine for the current lab was 8.20 which maps to an eGFR of 6 which is par for the course for someone on dialysis.
So here’s the deal as I see it. My wife and are are concentrating on bringing Albumin up with diet. The diet to do this also tends to reduce Cholesterol and Triglycerides resulting in a win-win combination. We are going to start working more salmon, tofu, smear case, and such foods into our diet.
I have a meeting with my dialysis team this coming Friday during which I’m certain I will first, get raked over the coals, and second, receive firm guidance as to what steps to take. Stand by for action.
TYhe lead graphic is from Poe’s FLUX-dev bot with Prompt: Picture of Popeye standing by for action on a sailing ship.
The phrase “in deep kimchi” is a humorous expression in the US military slang meaning to be in serious trouble. Why am I in deep trouble you ask? Looking at one of my recent lab results, you may notice that my Albumin dropped from 3.6 to 3.1, a full 0.5. You may now further ask, so what? That’s what this blog is about.
The form of protein found in your blood is called albumin. You can think of albumin as your body’s mail carrier – it delivers nutrients, vitamins, minerals, and energy you get from food to the rest of your body. It also helps the fluid you drink to stay in your cells and blood vessels, and it helps fight infection. Dialysis removes some of the albumin in your blood which is why people on dialysis need to have a protein source at every meal and sometimes with snacks.
With this background, I asked several questions of Perplexity which are included in the following dialog. Read on for more info on this complex subject. The bottom line is that lower Albumin levels lead to a higher probability of death. Got your attention now?
In peritoneal dialysis (PD) patients, serum albumin levels below specific thresholds indicate increased mortality risk. A baseline serum albumin level below 3.0 g/dL is associated with a more than threefold higher risk of all-cause, cardiovascular, and infection-related mortality compared to levels between 4.00-4.19 g/dL[1]. Additionally, PD patients with serum albumin levels below 3.8 g/dL also face an increased mortality risk[1]. Maintaining serum albumin levels above these thresholds is crucial for reducing mortality risk in PD patients.
To raise albumin levels in peritoneal dialysis patients, a diet rich in high-quality protein is essential. Recommended protein sources include lean meats like chicken and fish, eggs, and dairy products such as cottage cheese and Greek yogurt[1][4][5]. It’s important to avoid processed meats due to their high sodium and phosphorus content[1][4]. Additionally, incorporating protein-rich foods like tofu and protein supplements can be beneficial[4]. Consulting with a dietitian can help tailor a diet plan that meets individual needs while maintaining kidney health[1][5].
To increase albumin levels in peritoneal dialysis patients, incorporating high-quality protein foods into the diet is essential. Recommended foods include:
Lean meats: Turkey or lean beef burgers provide high-quality protein and iron.
Chicken: Fresh chicken offers significant protein without excess sodium or phosphorus.
Fish: Options like salmon, mackerel, and rainbow trout are excellent protein sources.
Eggs: Deviled eggs and egg whites are easy protein-rich snacks.
Dairy: Greek yogurt and cottage cheese are good protein sources with lower potassium.
Tofu: A versatile protein alternative for meat, poultry, and fish[3].
Since I am on Peritoneal Dialysis, it is of interest to me as I have a background in strategic management to delve into what’s going on in the industry per se. To accomplish this I quizzed Perplexity with the following prompt and results: Prompt: “What’s the latest in research or to market in the world of peritoneal dialysis?”
Market Growth and Trends:
The global peritoneal dialysis market was valued at USD 4.52 billion in 2022 and is expected to grow at a compound annual growth rate (CAGR) of 5.86% from 2022 to 2030, reaching approximately USD 7.13 billion by 2030[1]. The growth is driven by factors such as increasing healthcare expenditure, the rising incidence of renal disorders, and the benefits of peritoneal dialysis over hemodialysis, including lower costs and greater patient mobility[1].
The Asia Pacific region has emerged as the largest market for peritoneal dialysis, with significant contributions from countries such as China and India[1][5].
Technological Advancements:
Technological advancements in devices, particularly automated peritoneal dialysis (APD), are anticipated to drive market growth. The device sector is expected to expand rapidly due to rising demand for APD[2].
Baxter International introduced Sharesource Analytics 1.0, an eHealth solution for managing peritoneal dialysis patients at home, which provides comprehensive treatment information to healthcare providers[3].
Market Segmentation and Key Players:
The peritoneal dialysis solution segment currently dominates the market, as solutions are essential for fluid exchange during dialysis[2].
Key players in the market include Fresenius Medical Care, Baxter International, and Medtronic, among others. These companies are focusing on product launches, innovations, mergers, and partnerships to enhance their market position[2][4].
Challenges and Opportunities:
Despite the growth, challenges such as the lack of skilled professionals, stringent regulatory policies, and technical failures in peritoneal dialysis remain[1].
Growth opportunities include increasing awareness of chronic kidney disease (CKD), government initiatives, and the development of independent dialysis facilities[2][4].
Overall, the peritoneal dialysis market is experiencing robust growth due to technological advancements and increasing demand for home-based treatments, although it faces challenges related to regulatory and technical issues.
The lead graphic was produced using the FLUX Rev bot of Poe with the Prompt: “Picture of Popeye looking at spreadsheets and charts and pondering the future of the peritoneal dialysis market”
My life on peritoneal dialysis continues to roll along nicely. Yesterday was more or less a day off for me. My wife and I traveled to a city about 25 miles north of us named Weatherford, TX to shop for items to put into two thank you basked for the kindness shown to us by our neighbors. One basket is for the couple who helped us lay sod on our former iris bed; the other is for our next-door neighbors who continue to drop off the most delicious food you have ever tasted just because they can. The same second neighbor also informed me that we have a broken sprinkler head along our property line. I checked it out and he’s right. I’ll fix it later today.
Speaking of today, at 0900 I have labs at Fresenius which will take a couple of hours counting travel time. I am not expecting anything out of the ordinary as I explained in the previous blog, my biometrics are currently locked in with good numbers. BTW, my weight this AM was again 141.0, in the grove.
From time to time I cite that I have used Perplexity or Poe to assist in writing this blog. Yesterday I received notification from Poe that they have made available a state-of-the-art bot to make pictures named Flux. There are three versions and two of them are free. I used Flux-dev with the Prompt: “Picture of Popeye eating spinach” for the lead graphic. Pretty cool.
