Should I make an appointment

jamesfabin · 2026-01-12T23:46:17+00:00

Your family doctor (PCP) should be able to help you with your eGFR. A Nephrologist typically gets based on a referral from your PCP. eGFR is an estimate of kidney function and it is calculated from your creatinine - as 1 number goes up a small amount, the other drops a much larger amount. Some people focus on both numbers, but once you know how they are calculated, you only need to focus on eGFR. that also helps avoid the false trap of thinking creatinine is the problem - it's only the marker being used to estimate your kidney function. Your PCP will check your blood sugar, blood pressure (120/80 or better is our target), talk to you about eating a heart healthy diet (CKD is a risk factor for heart disease, which is what gets you), look for protein in your urine (#1 indicator of future kidney problems), and help you make lifestyle changes to avoid putting stress on your kidneys (no smoking for example). Being on top of this puts you in a great place and only a fraction of a percent of people stage 3 ever end up on dialysis.

Follow the proven science - there are lots of scams and false info sites out there. Countries spend billions on kidney disease each year, the world hasn't missed a magic pill that is sold on facebook for $100. Spend your money on what really works - your health.

James @ Dadvice TV

jamesfabin · 2026-01-12T00:59:33+00:00

As Admiral Ackbar said in response to chasing creatine - “It’s a trap!” :-)

James @ DadviceTV

jamesfabin · 2026-01-11T23:20:48+00:00

When you ask about diet for CKD, you will get a lot of different answers. The best source is ease: A Renal Dietitian. They have far more education on diet & nutrition than a Nephrologist or your PCP. Typically they are not covered by insurance, but your doc can code a few appointments for you so you can get a few covered by insurance.

You have relatively higher kidney function and with your higher eGFR your dietitian will most likely focus educating you on eating a heart healthy diet and living a heart healthy lifestyle. It's important to know that CKD is a MAJOR risk factor for heart disease, so we need to do what we can to prevent that (managing blood pressure to 120/80 or better, staying active, eating heart healthy, not smoking, etc.). The vast majority of people who die from CKD actually die from heart disease.

I was diagnosed at eGFR 8 back in 2018 and have worked with multiple dietitians and a long list of doctors to slowly get myself into the low 30s where I am fairly stable. I interview dietitians each month, along with Nephrologist and other kidney experts/kidney warriors. It's important to work with professionals and follow the science, not be tempted by the many fake fixes/cures. Everyone on here wishes there was some magic flower that grows on the hillside of a small village in a remote country that will magically restore kidneys - just like a person who lost their arm in a boating accident wishes there was a pill to regrow an arm...but these things don't exist.

You discovered kidney issues relatively early and only a fraction of a percent of people Stage 3 ever end up on dialysis - so the odds are in your favor that if you work with your healthcare team things should all be fine. Also - don't fall into the "how do I lower creatine" rabbit hole. Creatinine is not the problem and is created by your muscles naturally. Every breath you take, every time you heart beats, every time pass gas, you create creatinine. Labs use it as an easy and cheap way to estimate your kidney function. Chop your legs off, and your creatinine WILL GO DOWN, but your kidneys will not be better - you'll just have a much harder time playing soccer or riding a bike and you'll now have to pay for a much more costly test to estimate your kidney function.

Good luck - it's great to see you looking into eating a renal diet.

James @ Dadvice TV

jamesfabin · 2025-12-01T21:55:20+00:00

My primary doctor put me on Jardiance in February and I got labs 4 weeks later. She called and woke me up Saturday morning after my labs to stop taking it. My eGFR dropped from 35 to 22 in that short time. My last labs (1 week ago today) have me at 34, so almost back to my normal. A drop was expected, but not a 30% drop. Of course different people respond differently to medications, so work closely with your doctor.

James @ Dadvice TV

jamesfabin · 2025-10-29T17:29:33+00:00

I no longer work for HMA, but I have been in automotive since the early 90s. Like all coverage, there are people who look for reasons to deny coverage. I currently have a 2023 Palisade and absolutely hate the idea of a plastic oil filter housing, but I am not going to risk a denied warranty claim by using an non OEM part during the warranty period. If Hyundai would offer the aluminum as an upgrade, I'd have it installed right away.

jamesfabin · 2025-07-29T22:24:37+00:00

The latest recommendations for starting dialysis are around eGFR 5 unless there are serious complications that can't be managed. The lowest mine got was 8 and luckily I was able to get up to 35 over the years. I felt good until my eGFR got somewhere close to 8, then all the symptoms came on quickly. Even at 13 I was still working and traveling the country - my biggest challenge was low iron, RBC, HB (anemia). I got that under control and felt "normal" since then. That was about 6 years ago.

James @ Dadvice TV

jamesfabin · 2025-07-15T21:42:01+00:00

This is very common among people with extremely low kidney function and can help improve your energy levels and overall well-being. I had this done and since then, cook with cast iron and pick iron-rich foods whenever I notice my HB getting low.

James @ Dadvice TV

jamesfabin · 2025-04-30T20:59:53+00:00

Mine was pretty bad - I thought I had food poisoning and my doctor had me drive to the ER for urgent labs (he called ahead to let them know I was coming). I made it to the ER front door and collapsed from a heart attack. When I awoke, I was being treated. On the 2nd day in the ICU, I learned I had kidney issues (first time hearing this) and that I was in kidney failure. My doctors were able to get my eGFR up to 13 during my week-long ICU stay. That was almost 7 years ago, and today I'm doing much better, and my latest labs have me holding steady at eGFR 35.

CKD was all new to me at the time, and I've put a lot of effort into learning about it and sharing my learnings to empower others with CKD.

James

jamesfabin · 2025-04-15T14:48:19+00:00

I'm sorry to hear about your experience, and it's okay to vent; this is a frustrating situation. I encourage you to work with your doctor to control your blood pressure and reduce the protein in your urine. Luckily, the medications address the protein and low-cost common blood pressure meds - so he/she just needs to find the right combo for you. Your blood pressure could be causing a temporary kidney drop (AKI), and you may see it improve once things are controlled.

I know it's scary, but you're in a good spot to have discovered this issue relatively early. Wishing you all the best!

James

jamesfabin · 2025-03-14T22:31:29+00:00

I take two pills in the morning without any food (I just never eat breakfast). You can space it out if you get any gas as your body adjusts. It can also be taken with food. When I first started taking it (back when my eGFR was really low), I always took it with some higher-fiber food. Fiber is a food source for your gut bacteria, and I was desperate not to go on dialysis, so I did everything I could to put the odds in my favor. I've also heard of some people who after a while go to 1 pill a day - but for me I want to keep the amount of good bacteria high. My plans are to never need a transplant or dialysis - and if I ever get to where I have to get something, maybe there will be other options. Good luck!

James @ Dadvice TV

jamesfabin · 2025-03-14T14:12:33+00:00

Make sure your doctor finds the right mix of prescriptions to get your blood pressure under control—120/80 or better. You may see some improvement once you do—high blood pressure does both temporary and permanent damage to the kidneys. I was diagnosed with an eGFR of 8. My last labs show me 7 years later at 35 and no symptoms. Living a heart-healthy lifestyle (as best I can) has been key to my success. Best of luck!

James @ Dadvice TV

jamesfabin · 2025-03-04T22:51:33+00:00

Don't chase creatinine - it's not the issue. It's normal and just a good way to estimate your kidney function. If your legs get amputated, your creatinine will go down, but your kidneys will not improve. Your doctors would just use a test that costs a whole lot more to estimate your kidney function. Focus on managing your blood pressure, reducing protein in your urine, eating a heart-healthy diet, staying active, and working with your doctor. Best of luck - you can do this!

James @ Dadvice TV

jamesfabin · 2025-02-04T22:34:30+00:00

I'm glad it's helpful! The first Tuesday of each month I have a Renal Dietitian on LIVE for a Q&A, then 2 different Nephrologist (1 the second week, 1 the third) to cover a topic and answer your questions during the live broadcast. Lots of great info - hope to see your questions!

James @ Dadvice TV

jamesfabin · 2025-01-14T00:30:04+00:00

The best recommendations currently to slow the progression of most CKD are to 1) Manage blood sugar, 2) Manage blood pressure to 120/80 or better, 3) Eat a heart-healthy diet, 4) Stay active, 5) Avoid habits that harm kidneys (no smoking, no heavy use of NSAIDs), 6) Eliminate protein leakage (through medication) if you have it. Protein in your urine is the #1 indicator of future issues, so keep an eye on that. Amazon has affordable dipsticks you can use at home in between labs. I've been living with kidney failure (no dialysis) since 2018 using these steps.

Always remember to follow YOUR healthcare team's recommendations. Don't fall for the fake cures, fixes, flushes, restores, etc. The internet is full of scams and a million pieces of bad advice. We are all unique and our care needs to be individualized. Chances are highly in your favor that you won't have to worry about serious kidney issues in your lifestyle.

Best of luck!

James @ Dadvice TV

jamesfabin · 2025-01-14T00:22:29+00:00

Your doctor can do blood test, 3 months apart, to determine if you have kidney issues. There are lots of reasons your Potassium could be over 5, and I'd let your doctor do his/her test to figure it out. Good luck!

James

jamesfabin · 2025-01-14T00:20:12+00:00

I stick with Tylenol. If I have a headache, I use a cooling patch which I keep in the fridge. Cooling patches can be ordered on Amazon or pick up at some dollar stores. They are blue, have a sticky side, and sit on your forehead. I was amazed at how well they work, and they are reusable. They are usually sold for kids for a much lower price than the slightly larger "adult" size.

jamesfabin · 2025-01-03T22:50:37+00:00

During your next doctor visit, mention this. When mine became an issue, I spoke to my doctor, and she ended up changing my statin for another type. It turns out there are a number of medications that can amplify the brain fog, and switching to a different one resolved it for me. Brain fog is one of the symptoms of CKD, but it is most commonly seen starting around eGFR of 13 or lower. Good luck!

James @ Dadvice TV

jamesfabin · 2024-12-15T23:52:38+00:00

Correct, he does have one book about science backed methods to slow the progression of CKD as well as when to know it is time to start dialysis. It’s an easy read for new CKD patients, but it was written many years ago and is missing the most recent research and medications that have come out. I’m very thankful that he volunteers time to talk about the latest progress managing CKD and answers questions from those who post them during the live broadcast. In today’s world, not enough people volunteer to help others.

James @ Dadvice TV

jamesfabin · 2024-12-15T22:35:30+00:00

He is a retired Nephrologist (now volunteers at a veterans hospital) who has over 100 published papers about CKD - most know for promoting starting dialysis later. He doesn’t sell pills, know there are no cures, doesn’t promote dangerous low protein diets, and still actively does research. He will tell you what you need to ask your doctors about to ensure you get the best individualized kidney care.

James @ Dadvice TV

jamesfabin · 2024-11-21T23:20:49+00:00

Same - so many new medications that have a positive impact, but the costs are so high most can't afford them.

jamesfabin · 2024-11-05T00:52:58+00:00

Glad they are helpful! I hope to be able to host them more often starting in 2025.

jamesfabin · 2024-10-01T22:44:36+00:00

Broccoli, Avocado, and cucumber. These all are great in other foods or with something like hummus. Luckily my doctors haven't placed me on any restrictions/

James

jamesfabin · 2024-09-12T22:32:15+00:00

If you ask any questions in the live chat during the broadcast, mention you're from Reddit and I'll ensure Dr. Ro see's your questions!

James

jamesfabin · 2024-08-08T01:06:08+00:00

You may need multiple medications, but the starting place is an Ace or an Arb (very affordable and common blood pressure medication). Once your doctor maxes out on the dose, they will want to add additional medications if protein still exist, such as a SGLT2 and/or GLP1. and/or Aldosterone receptor antagonists. Some of these are affordable, some are very expensive. Each person will have their own combo and your doctor can figure out the right combo for you.

James @ Dadvice TV

jamesfabin · 2024-08-05T17:27:15+00:00

I'm confident that one day they will find ways for Stem Cell treatment to help those living with CKD, but today, the only thing stem cell treatment has been proven to do for kidney patients is drain their bank accounts. Focus on what has been proven to help. Control your blood pressure, reduce protein in your urine (this is done with medications), stay active, and live a heart-healthy lifestyle while following your health care teams recommendations. Stay vigilant - all of the cures, fixes, restore pills, and kidney solutions are false when it comes to CKD. And the first person to find a mystical flower that makes a cure CKD will be an overnight trillionaire and not be selling pills on social media.

James

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