“If I can do it, you can do it,” says Lubna Akbany, as she serves up a dish of confidence to those dealing with kidney disease. Lubna always loved to cook, and nutrition became the natural choice of study for the young and healthy college-bound woman. “I studied nutrition to learn more about food,” she explains, and in 1984, Lubna graduated from Shreemati Nathibai Damodar Thackersey Women’s University in Mumbai, Maharashtra. She found work as a clinical dietitian at King Khalid Hospital, in Najran, Saudi Arabia, where she provided nutritional support to patients in the hospital’s intensive care unit. As one who loves to travel, Lubna then came to the United States, where she continued her studies at California State University, Los Angeles. Soon she was married and the couple looked forward to the birth of their first son.
Lubna’s new journey into motherhood presented challenges in light of the results of the routine tests performed at the five-month mark. Doctors found protein in her urine. Lubna’s studies suddenly took on a sharper focus when she became a kidney patient herself.
Today, as a board-certified renal nutrition specialist, Lubna helps others meet the challenges of chronic kidney disease by teaching them how to improve their overall health. And for those who have not yet had a kidney transplant, she instructs them on how to manage their disease to prolong renal functionality and helps them prepare for surgery. She does this from the perspective of one who went through the process herself.
Lubna, why did you choose to study nutrition originally? It was because of my passion for cooking. But then it became clear to me that I could use my knowledge to help others as a clinical dietitian. I began to see myself as a liaison between patients and their food.
Tell us about your experience while being pregnant and diagnosed with kidney disease. I was hospitalized for two months before my doctor performed a C section to save both my life and the life of our son. He (Asad) came into the world prematurely, weighing only 4 pounds. My second pregnancy was about the same, only our second child (Saakib) was only 3.5 pounds when he was born. You would never know it by looking at them today! They both function at 100 percent. But each pregnancy did more damage to my kidney. That was when the doctors took a biopsy my kidney and learned that I had IgM Nephropathy and Focal Segmental Glomerulosclerosis (FSGS).
Why did you choose to specialize in renal nutrition? I was told I would be on dialysis within six months after the birth of my second child. I was doing some freelance work at the time when I realized I could help myself, as well as others, by specializing in renal nutrition. I started working at the Renal Center at St. Joseph Hospital, Orange California. I did a lot of research and worked with my kidney management team to apply the principles to my own body. I experimented on my own body, and through both diet and exercise, I managed to go for six years before starting peritoneal dialysis. It so mind boggling to me that this one little organ [The kidney] controls so much.
What was that like? Dialysis was not easy in any way. I had a peritoneal catheter in my abdominal cavity which helped me do my dialysis daily. Until my body was able to adjust to the dialysis it was a very painful and a cumbersome process. I worked 4 days a week and was also the primary caregiver for my 2 young boys 10 and 6 at the time. I was on Peritoneal dialysis for four years before my opportunity came in 2008 to have a kidney transplant. The surgery went well; I had no complications, no infections. It still amazes me how I could handle everything on my own. I got through it all with a good diet, a strong trust in God, and a very supportive husband. It has been a journey!
What role do you play in caring for people with kidney disease? First, you have to understand that about 70 percent of patients have other diseases besides kidney disease. Heart disease and diabetes both negatively affect the function of the kidneys. My role comes into play from the time the patient is diagnosed with having Stage G3b kidney disease, which translates to a eGFR < 45. I discuss with my clients the importance of following a diet and how it can help them slow down the progression of the disease. Together, we take everything into consideration to achieve the best outcome for each patient.
How does your experience with kidney disease help you to help others with the disease? My life revolves around kidney disease. I teach what I call my “kidney community” to help them improve their lives. I have worked with Chronic Kidney Disease (CKD) patients, for about 19 years. I help take care of patients through all stages of the disease to dialysis and transplantation. The renal diet is one of the most difficult diets to follow, and by having gone through it myself I can talk to patients about the restrictions I needed to adhere to because of my own kidney disease. By sharing my story, I help them to understand that If I could do it, they can too. I am proactive as a kidney care advocate not just to teach patients about their diet but also to prepare them for dialysis and beyond.
Typically, renal diets are low in sodium, potassium, protein, and phosphorus, right? But those are found in so many foods. How do those with kidney disease know what to eat? A person’s lab results will show what is needed. Next, the patient’s doctor, together with the rest of the team, will devise a care plan for that person. It is my job to tailor a diet specifically designed for that patient. It’s chemistry; I have to consider each ingredient in a recipe and understand how it affects the body. But I must also consider the patient’s cultural preferences to formulate recipe modifications to make it easier for the patient to follow the diet.
Take, for example, someone whose normal diet includes a weekly meal of spaghetti and tomato sauce. That’s a problem because tomato sauce is high in potassium. If I advise that same person to eliminate that meal from their diet, they may wonder what’s left in life, and it becomes very difficult for them to follow my advice. So, hypothetically, I may modify the recipe to substitute red bell peppers for tomatoes, while still using the same spices. The taste may be compromised slightly but the meal is basically the same. And that makes it easier for the patient to stay on the diet. That’s how I piece the puzzle together to tailor a diet specific to the unique physical, mental, and emotional needs of each patient.
Having the perspective of being both the patient and a member of a medical team, how do you see the study of kidney disease and its relationship to food? A lot of disease is preventable, but the study of the kidney is still in its infancy. Humans were gatherers first, before they were hunters. If people learn to eat well, it will be a much better place.
More Articles and podcasts featuring Lubna Akbany:
Skin Deep
Choosing and Preparing Kidney-Friendly Holiday Foods
Treatment Options Taught from Personal Experience
More Articles by Mary Nesfield:
Managing a High-risk Pregnancy During a Pandemic with Joanna Galeas Lee
Meet Michael Anthony Hermogeno: A Father on a Mission
Say Hello to Lili A Warrior Who Replaced Fear with a Sense of Purpose
Rachel Cluthe: A mother determined to raise a happy family
Mary Nesfield has enjoyed a long career in magazine publishing. She is a freelance writer and editor for Renal Support Network and works from her home in Columbia, South Carolina.
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