The RenalTracker Team
August 17, 2020

How Chef Duane Sunwold Stopped CKD Progression Through a Plant-Based Diet

It was the year 2000. At 40, Duane Sunwold was on top of his game as a chef and culinary arts instructor at the Inland Northwest Culinary Academy at Spokane Community College. But one day, he had to step back from his bullish career due to a serious illness that would later on change his life.

Chef Duane was diagnosed with chronic kidney disease (CKD). This gradual loss of kidney function was zapping out his energy and reducing his quality of life. He knew he needed to do something to stop his condition from worsening.

Upon the advice of his renal healthcare team, Chef Duane eliminated animal protein from his diet and followed a whole-food plant-based diet. He has never looked back since.

Two decades later, he has put his kidney disease into total remission and has weaned himself off CKD medications. Today, Chef Duane serves as a beacon of hope to people living with kidney disease. 

In the third installment of our plant-based diet series, RenalTracker’s resident chef shares his CKD journey and how he discovered the path to wellness.

Living with Kidney Disease

Can you tell us about the time you got diagnosed with CKD?

Chef Duane:When I turned 40, I noticed that my energy level was draining. I knew something was wrong but I was in denial. I was in and out of the doctor's office for four months, being treated for symptoms, migraines, and high blood pressure. I was never being treated for the actual cause. 

Eventually a lab test showed that I was spilling a ton of protein in my urine. I had totally crashed, and ended up in the emergency room before I could even actually see a kidney doctor. I was hooked up to a morphine pump, and I was being tested for high blood pressure, I could hardly move. 

Just like how most chronic disease patients name their organs, I named my kidneys: Kevin and Karl. At one point, my creatinine level reached 4.99 [normal range for adult males is 0.9 to 1.3 mg/dL]. So those of you who are medical providers, kidney disease patients, or loved ones of kidney disease patients, you know that magic number of 5 triggers a need for dialysis. Kevin and Karl had hit the most dangerous point on this journey.”

What went through your mind when you were almost close to dialysis?

Chef Duane:  “I was an idiot, I had no idea what dialysis meant.  I even questioned if the life of a dialysis patient was going to be better than living with stage 4 CKD.  I had an internal counseling session with myself. 

“As a teacher, I expect my students to self-improve, so they become more employable. I need to do the same thing for myself.  I need to be a better patient.  I looked at contracting kidney disease like playing poker.  These were the cards I was dealt.  Successful poker players can win big on lousy hands of cards.  I need to figure out how to take my cards and make the best winning hand possible.”

When did you discover that your diet was a huge contributing factor to your condition?

Chef Duane: “So, my first nephrologist never talked to me about what I should or shouldn't eat. He put me on a high dose of prednisone and blood pressure medication. But my creatinine levels kept rising. And the prednisone created a craving in me for foods that I should never eat but I was never told not to eat them. 

“So even if I didn't know it at that time, my face was florid and puffy, and I looked bad and felt worse… . I eventually made my way to Dr. Katherine Tuttle, a respected nephrologist who was Executive Director of Research at the Providence Medical Center in Spokane. 

“She was the very first medical provider to mention to me that animal protein was hard on kidneys, ‘Duane, you seem to be a little stressed out. You might wanna think about cutting back on the animal protein.’ But of course, I'm a chef, a stubborn man, and I hear what I want to hear, and disregard the rest. And Dr. Tuttle is way too tactful. So, I needed to be hit over the head.”

How did you transition to a plant-based diet?

Chef Duane: “A colleague at Spokane Community College, my friend Erin, a Registered Dietitian, asked to see my labs and wants to take me off animal protein for 90 days. It wasn't easy, but it was the best thing I could have ever done. Within two weeks, I started feeling better. Kevin and Karl finally started doing their job again.”

What do you mean by “thinking of diet as treatment”? Does that mean CKD patients should stop taking medication from their doctor?

Chef Duane: “Taking control by making the necessary diet and lifestyle changes is part of self-management. But, don’t forget that this is meant to COMPLEMENT your medical team’s recommendations, not REPLACE them.”

What significant results did you observe in your condition since you switched to a plant-based diet? What changed?

Chef Duane: “In no time, I began to review my new kidney healthy eating plan as the greatest culinary challenge a chef could have. As time went by, this new plant-based cuisine brought my creatinine level from 4.99 to a 0.8. Today, I'm in complete remission. And I'm off all medication, with the blessing of my medical team, thanks to my diet."

Life as CKD Chef

How has your CKD journey impacted your career, expertise, and sensibilities as a chef?

Chef Duane: Years after I began this journey -- even though I wouldn't have chosen kidney disease -- I am so grateful for having kidney disease. It made me a better cook. It helped me learn how to be more creative with flavor. It forced me to become more organized at home, at work, and in the kitchen. And I'm still learning and still experimenting after all these years.” 

What’s the greatest challenge about kidney disease-friendly cooking?

Chef Duane: Keeping track of my sodium is the most difficult of challenges because sodium is in so many different foods, condiments, and combinations of seasoning mixtures. My Aha moment is the hidden salt found in supposed to be healthy meals. I removed garlic salt, onion salt, and celery salt from my spice rack and replaced them with garlic powder, onion powder, and celery seeds.

Some patients are struggling with diet recommendations. What did you struggle with in switching to a kidney-friendly diet? How did you solve those?

Chef Duane:  “Oh yes, I did struggle with diet changes. For me, I had to change a 40-year eating habit... . They have to remember eating is a journey. Plan how to make this the most pleasant journey possible, while following the guidelines of their medical team.  

“I started with reducing sodium and then worked on my next leg of the journey, reducing the amount of animal protein in my diet. I started with baby steps, changing one thing in my diet at a time. They should think about what will have the largest impact on their health and start with that change.

“I realized I had to stop using unhealthy food as a reward.  Why would I eat something that was going to make me feel bad, just because the 5-year old inside of me wanted to taste it? The taste was only going to stay on my tongue for a few minutes; the misery my kidneys made me feel would last for hours and sometimes days.”

For someone who is not ready to fully switch, how can they start small?

Chef Duane: “If they don't like to cook at all, they can start by filling half their plate with fruits and vegetables. Quarter the other half into the starch, rice, pasta. And the other quarter into protein. And if they really wanna be creative, and this is what shocked me as a chef, vegetarians are more creative than carnivores who eat meat. 

“When they grocery shop, they go through and they look at the meat section and then they pick their meal. I go through the produce section and choose whatever's fresh, it's such a more creative way to live.

But also, in their own menu planning, they can implement things like beans, how about lentils from the Palouse, they're locally grown here in our state [Seattle], Portobello mushroom, or tofu as a great protein source for your diet.” 

But not everyone has the cooking skills of a chef; many CKD patients may find it difficult to cook delicious, kidney-friendly meals.

Chef Duane: “When I developed kidney-friendly recipes, I had more failures than any chef in the history of this country. But I'm not giving up. Patients deserve flavor. So, you stick with your dietary changes, I'll stick with constantly making recipes and helping patients one recipe at a time. And together, we can make and raise the quality of life for kidney patients.”

How can CKD patients sustain their diet and plan their meals everyday?

Chef Duane: “If they don't like to cook at all, they can start by filling half their plate with fruits and vegetables. Quarter the other half into the starch, rice, pasta. And the other quarter into protein. And if they really wanna be creative, and this is what shocked me as a chef, vegetarians are more creative than carnivores who eat meat. 

“When they grocery shop, they go through and they look at the meat section and then they pick their meal. I go through the produce section and choose whatever's fresh, it's such a more creative way to live.

But also, in their own menu planning, they can implement things like beans, how about lentils from the Palouse, they're locally grown here in our state [Seattle], Portobello mushroom, or tofu as a great protein source for your diet.” 

How can CKD patients involve their family in successfully managing their condition?

Chef Duane: “I would suggest CKD patients to talk with them. CKD patients need to talk with their kids and/or spouse about how they feel about their disease. This will also help everyone see how they can help each other.  

“My son is not a cook, but he was an excellent resource for reading nutrition labels.  When I was sick and very tired, I still enjoyed cooking, but the thought of washing dishes made me not want to cook. 

“So my family members took turns washing dishes, so I could keep cooking. My children also helped research recipes online. They helped find dishes they thought tasted good. If I made them, they were more willing to eat them.” 

For people living alone, where do they get support?

Chef Duane: “I’m always amazed how much people are willing to help us patients.  I believe churches, community centers, retired groups are untapped resources.  People who know how to cook, would enjoy helping a patient; they just need to be taught how to cook for kidney patients. Little old ladies in our church have volunteered to bake salt-free bread for CKD patients.”

How will they know if they’re doing it right?

Chef Duane:How I monitor my progress is by my lab results and taste.  If my lab results show that my kidney function is progressing slower -- or in my case actually improving -- that would mean success.  If I was eating foods that I enjoyed, that were on my diet; that also meant I was being successful.”

Why did you join RenalTracker?

Chef Duane: “I joined RenalTracker because of their team’s mission: helping CKD patients with a multi-disciplined approach, using current technology to deliver information to patients, when they need it. I also was very impressed with the people who work for RenalTracker. They are experts in their field who respect a team approach to patient care.”

What’s your message for CKD patients who wish to pursue plant-based dieting to stop the progression of their condition?

Chef Duane: “You don't need to be a professional chef, you don't even need to be an excellent amateur cook to make small changes; to get food to taste good, and be healthy for your kidneys. Whether you already have kidney disease or you're hoping to prevent it. 

Take care of your kidneys by changing your diet. The key to making a perfect soufflé is knowledge and timing. Making your diet healthier also requires knowledge and timing. We can all make healthier choices. I look at food choices as a journey. Let's create the best journey for our kidneys.”

Chef Duane now devotes his time and energy in creating CKD-friendly recipes and educating people on how plant-based dieting is instrumental in stopping the progression of CKD and delaying dialysis. 

Regardless of your kidney disease stage (even if you’re on the verge of dialysis), it’s never too late to switch to a kidney-healthy diet. What you put on your plate today will determine the trajectory of your kidney condition tomorrow. Choose to eat healthy and your kidneys will thank you later. 

We want to help set you on the path to better health. So in the next installment of our plant-based diet series, we will share with you practical tips on getting started with a kidney-friendly diet. Stay tuned!

(NOTE: The information stated in this article does not replace professional advice from your doctor and renal dietitian. Please talk with your healthcare team before following any tips discussed here.)

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