- With Mayo Clinic urologist
Erik P. Castle, M.D.
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Erik P. Castle, M.D.
Erik P. Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research Building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancers.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is past president of the international Society of Urologic Robotic Surgery. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
Tests and diagnosis (1)
- MRI: Is gadolinium safe for people with kidney problems?
Treatments and drugs (2)
- Kidney donation: Are there long-term risks?
- Kidney dialysis: When is it time to stop?
Lifestyle and home remedies (1)
- Renal diet for vegetarians: Which protein sources are best?
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Question
Renal diet for vegetarians: Which protein sources are best?
I have end-stage kidney failure. I'm not on dialysis, but I do follow a special renal diet and I'm a vegetarian. What are the best sources of protein for someone like me who must also limit phosphorus and potassium?
Answer
from Erik P. Castle, M.D.
The answer depends on what type of vegetarian you are. It also depends on your level of kidney function and how restrictive you need to be with protein, phosphorus and potassium.
A proper renal diet is an essential part of any treatment plan for chronic kidney disease. Although a renal diet limits protein, you still need to eat some high-quality protein every day. Your kidneys are responsible for preventing too much potassium and phosphorus from building up in your blood. Therefore, it's important to have the right amount of potassium and phosphorus in your diet in order to avoid overwhelming your kidneys' ability to maintain healthy levels.
In general, dairy foods are the main sources of phosphorus in the diet. So by limiting or avoiding dairy products, you may be able to control blood-phosphorus levels. You can make up for dairy products by choosing milk and yogurt made from rice or soy-based products.
The majority of potassium comes from fruits, vegetables and dairy products. So by limiting the dairy in your diet and keeping the amount of fruits and vegetables in check — and choosing ones that are lower in potassium — you can control blood-potassium levels.
Because vegetarian sources of protein also contain varying amounts of potassium and phosphorus, you'll want to limit — or avoid — some of the foods in the table below. Your dietitian can provide you with information about which foods and how much you should eat each day.
| Type of vegetarian diet | Protein sources for renal diet |
|---|---|
| Vegan — allows only plant-based foods |
|
| Lacto-vegetarian — allows plant-based foods, milk, dairy products | Foods listed above plus:
|
| Lacto-ovo vegetarian — allows plant-based foods, milk, dairy products, eggs | Foods listed above plus:
|
| Pesco-vegetarian — allows plant-based foods, milk, dairy products, eggs, fish | Foods listed above plus:
|
| Pollo-vegetarian — allows plant-based foods, milk, dairy products, eggs, poultry | Foods listed above plus:
|
Note: Depending on your need to restrict sodium, avoid smoked fish, chicken and turkey, which are high in sodium. Look for unsalted varieties of canned tuna, salmon, chicken or turkey. In addition, because fresh poultry may be injected with sodium, look for "natural" on the label — which indicates no added sodium.
Next questionMRI: Is gadolinium safe for people with kidney problems?
- Nutrition and chronic kidney disease. National Kidney Foundation. http://www.kidney.org/atoz/content/nutrickd.cfm. Accessed Oct. 20, 2010.
- Vegetarian diets. U.S. Department of Agriculture. http://www.mypyramid.gov/tips_resources/vegetarian_diets.html. Accessed Oct. 21, 2010.
- Protein (g) content of selected foods per common measure, sorted by nutrient content. USDA National Nutrient Database. http://www.nal.usda.gov/fnic/foodcomp/Data/SR20/nutrlist/sr20w203.pdf. Accessed Oct. 21, 2010.
- Frequently asked questions: Definitions. International Vegetarian Union. http://www.ivu.org/faq/definitions.html. Accessed Oct. 21, 2010.
- Brookshyer J. Eating vegetarian foods while living with kidney disease. American Association of Kidney Patients. http://www.aakp.org/aakp-library/Vegetarian-Kidney-Disease. Accessed Oct. 21, 2010.
- Nelson JK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 22, 2010.
- Gonyea JE (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 2, 2010.
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