Sustained Reversal of Chronic Kidney Disease Stage 5, Type 2 Diabetes Mellitus, Hypertension, and Obesity via Whole Food Plant-Based Diet and Mild Exercise: A Case Report

Abstract

The trajectory of patients with chronic kidney disease stage 5 (CKD-5) usually requires imminent renal replacement therapy (RRT). This report details long-term (> 5 years and continuing) avoidance of RRT in an adult with type 2 diabetes mellitus (T2DM) and diagnosed CKD-5. The patient also had grade II hypertension, hyperlipidemia, class I obesity (body mass index of 34.3 kg/m2), gastro-esophageal reflux, depression, and legal blindness despite panretinal photocoagulation for diabetic retinopathy. A lifelong mild learning impairment afflicting both the patient and her spouse contributed to a sedentary lifestyle, poor dietary choices, and suboptimal medical compliance. The therapeutic intervention was a whole food plant-based (WFPB) diet and mild exercise. This intervention allowed for sustained avoidance of renal replacement therapy, improvement in renal function to CKD-4, improvement in diabetic control to a hemoglobin A1c (Hgb A1c) of 5.7 without diabetic medication, a 65-lb weight loss, normalization of blood pressure, and a reduction or cessation of various medications. To our knowledge, this is the first report of sustained reversal from CKD-5 for more than five years. It can be seen from our timelines (see timelines in graph and in text)  that health improvements began shortly after the lifestyle interventions were implemented and have continued. Prior to the lifestyle intervention the patient’s health had been deteriorating rapidly (e.g., trend for estimated glomerular filtration rate). This case study report demonstrates the potentially powerful role of WFPB nutrition and mild exercise in reversing renal disease, type 2 diabetes, hypertension/cardiovascular disease, and obesity.