Dr. Isreb- The Integrative Nephrologist

Dr. Isreb- The Integrative Nephrologist Specializing in integrative kidney therapies, Nephrology, Hypertension, Dialysis and Transplant

🥤🍞 Hidden phosphorus additives are everywhere, from sodas to processed breads. But reducing them could have a major imp...
09/22/2025

🥤🍞 Hidden phosphorus additives are everywhere, from sodas to processed breads. But reducing them could have a major impact on kidney health.

In a recent feeding study, adults with CKD who cut phosphorus additives for just 6 weeks saw:

🔻 FGF23 levels drop by 25%
🔻 Parathyroid hormone (PTH) levels drop by 20%
🔻 Urine phosphorus drops by ~30% (in all participants)

📉 These are not just numbers; they reflect real improvements in mineral balance, which plays a critical role in slowing CKD progression and reducing cardiovascular risk.

💡 Why it matters:

✔ Phosphorus additives are absorbed more readily than natural sources
✔ They worsen calcium-phosphorus balance and elevate FGF23 and PTH
✔ Lowering them is a simple dietary step with measurable benefits

👀 Look out for ingredients like “phosphoric acid,” “sodium phosphate,” or “pyrophosphate,” and aim for more whole, unprocessed foods.

📣 A kidney-friendly diet isn’t just low in sodium, it’s also low in hidden phosphorus.

Read the study:

https://journals.lww.com/cjasn/fulltext/9900/effects_of_lowering_dietary_phosphorus_additive.614.aspx

🔍 The latest KDIGO CKD Guidelines (2024) recommend using both creatinine and cystatin C together to estimate kidney func...
09/21/2025

🔍 The latest KDIGO CKD Guidelines (2024) recommend using both creatinine and cystatin C together to estimate kidney function (eGFR).

What is cystatin C?

Cystatin C is a small protein produced at a constant rate by nearly all nucleated cells in the body.

Its primary role is to inhibit cysteine proteases (enzymes that break down proteins).

Importantly, cystatin C is:

➡️ Freely filtered by the kidney’s glomeruli
➡️ Not secreted by the renal tubules, unlike creatinine
➡️Almost completely reabsorbed and broken down in the proximal tubules
➡️ Less affected by muscle mass compared to creatinine, making it more accurate in older adults, malnourished patients, or those with reduced muscle mass.
➡️ Not influenced by diet (e.g., high meat intake) the way creatinine can be.
When combined with creatinine in the CKD-EPIcr-cys equation, it provides better precision in estimating GFR.

KDIGO 2024 now recommends cystatin C (along with creatinine) in situations where an accurate GFR is critical — such as:

✅ Confirming CKD diagnosis when creatinine-based eGFR is uncertain
✅ Drug dosing for medications cleared by the kidneys
✅ Evaluating kidney function in frail, elderly, or malnourished patients

Why does this matter?

✅ Using both markers in a combined equation (2021 CKD-EPIcr-cys) gives a more accurate and reliable picture of kidney health compared to creatinine or cystatin C alone.

✅ This helps doctors detect chronic kidney disease (CKD) earlier, adjust medications safely, and better plan care for patients.

This shift highlights the importance of precision and personalization in kidney care. At the Integrative Kidney Institute, we believe that combining modern science with a whole-person approach is the key to better outcomes.

🚨 New Blog Post Published!When should we start screening for chronic kidney disease?A new cost-effectiveness study sugge...
09/20/2025

🚨 New Blog Post Published!

When should we start screening for chronic kidney disease?

A new cost-effectiveness study suggests age 55 may be the sweet spot—where prevention benefits and healthcare costs align.

But we also highlight how lifestyle and integrative interventions play a critical role in slowing CKD progression when caught early.

👉 Read the full blog here: [https://f.mtr.cool/jcwjysprhr

09/20/2025

Think high-protein diets are always safe? Not for your kidneys.
Protein forces the kidneys into hyperfiltration - like running an engine redlined all day.
It also raises dietary acid load, fueling inflammation and speeding up kidney decline.
Animal protein hits harder.
• Plant protein is less acidic and easier on the kidneys.
That's why even conventional nephrology recommends cutting back on animal protein.
Full conversation with Dr. Dr. Yousef Elyaman & I now on the FMP
Essentials Show.

🎉📢 The Glomerulonephritis Protocol is still available! 🌐📚Unlock the ultimate guide to understanding and managing autoimm...
09/19/2025

🎉📢 The Glomerulonephritis Protocol is still available! 🌐📚

Unlock the ultimate guide to understanding and managing autoimmune kidney diseases! From IgA nephropathy to Membranous nephropathy and more, this 40-page treasure trove is your first step towards empowered care. 🧠💡

👩‍⚕️ Perfect for healthcare professionals aiming for top-notch patient care.
👤 Essential for patients seeking clarity and actionable insights on glomerulonephritis.

Plus, it's packed with tools to navigate the world of autoimmune kidney diseases like a pro! 🛠️

🚀 Dive in NOW and enrich your knowledge!
🔗 Download here:
https://inkidney.com/product/the-glomerulonephritis-protocol/


Did you know that primary hyperparathyroidism often leads to kidney stones—especially calcium phosphate stones?Here’s wh...
09/18/2025

Did you know that primary hyperparathyroidism often leads to kidney stones—especially calcium phosphate stones?

Here’s why:

😱 Excessive PTH leads to elevated calcium levels in the blood and urine.
😩 PTH also makes the kidneys waste phosphate and reabsorb less acid.
😒 This shifts the urine to a more alkaline pH.
😞 Alkaline urine + high calcium = perfect conditions for calcium phosphate stones to form.

🟦 In short: Hyperparathyroidism not only raises calcium in the blood but also tips urine chemistry toward stone formation.

🏠 Mold isn’t just an allergy trigger—it may be a hidden factor in kidney disease, especially for those with pre-existing...
09/17/2025

🏠 Mold isn’t just an allergy trigger—it may be a hidden factor in kidney disease, especially for those with pre-existing CKD, immune compromise, or poor indoor air quality.

🔬 This blog breaks down:

✔ Which mycotoxins are most nephrotoxic (Ochratoxin A, Citrinin)
✔ Foods and environments where they're found
✔ How they damage kidney tubules and glomeruli
✔ Early signs, biomarkers, and testing methods
✔ Prevention strategies and detoxification tips

🛑 Kidney protection starts at home. Don’t ignore water damage, humidity, or food quality.

📖 Read the full article → [https://f.mtr.cool/rxvbfqmvwj

🧬 New genetic evidence confirms it:Elevated TSH (thyroid-stimulating hormone) may directly impair kidney function.In a l...
09/15/2025

🧬 New genetic evidence confirms it:

Elevated TSH (thyroid-stimulating hormone) may directly impair kidney function.

In a large Mendelian randomization study using data from the Taiwan Biobank and European cohorts:

🔻 Higher TSH levels and hypothyroidism were causally linked to lower eGFR

🔗 Free T4 and TPO antibodies did not show the same effect

📣 Why it matters:

➡️ Thyroid dysfunction may play an active role in chronic kidney disease (CKD)
➡️ Managing thyroid health could be a key strategy in slowing CKD progression
➡️ Routine screening for thyroid function might be more important than we thought

👩‍⚕️ Integrating thyroid screening into CKD care may help uncover hidden contributors to kidney decline.

Read the study:

https://journals.lww.com/cjasn/fulltext/9900/unveiling_the_causal_relationship_between_thyroid.605.aspx

🔍 Depression affects up to 30% of people with CKD, and anxiety is even more common—yet mental health often goes unaddres...
09/14/2025

🔍 Depression affects up to 30% of people with CKD, and anxiety is even more common—yet mental health often goes unaddressed in routine care.

📉 Without emotional support, patients face higher rates of:

– Isolation
– Faster kidney function decline
– Poor treatment adherence

💡This blog explores:

✔ The mental toll of CKD
✔ Why therapy and peer support matter
✔ How mindfulness and integrative care can help
✔ The importance of routine mental health screening

🫂 A healthier kidney journey starts with compassion for the whole person.

📖 Read the full article → [https://f.mtr.cool/rfvsqxkegb

🚨 Chronic kidney disease (CKD) is on the rise—and most people don’t even know they have it. A new article in the Nationa...
09/13/2025

🚨 Chronic kidney disease (CKD) is on the rise—and most people don’t even know they have it. A new article in the National Geographic is highlighted.

Nine out of 10 people with CKD are unaware until it reaches advanced stages. That’s what happened to Alex Simmons, a healthy 37-year-old who landed in the ER with dangerously high blood pressure—only to learn his kidneys were failing.

🌍 An estimated 700 million people worldwide are living with CKD, including 35.5 million in the U.S.

The good news? Advances in diagnosis and new therapies are giving hope for earlier detection and more effective treatments.

🩺 Know the risk factors, protect your kidneys, and don’t ignore the signs because early detection is a key to reversing the disease.

Read the article here:
https://f.mtr.cool/xttsrawcer

Navigating polycystic kidney disease?: Check out our comprehensive guidePolycystic kidney disease is the most common inh...
09/12/2025

Navigating polycystic kidney disease?: Check out our comprehensive guide

Polycystic kidney disease is the most common inherited kidney ailment, affecting 1 in 800! Those fluid-filled cysts aren't just ominous; they compress the kidneys, leading to their gradual failure. 😰

But, you're not in the dark. 🌟

Our PKD Protocol is a treasure trove, guiding you through:

Evaluating PKD patients 🧐
Risk assessments 📊
Lifestyle changes 💪
Medication options 💊
In essence, it's your PKD bible! 📖

Why wait? Dive deep, enlighten yourself. Download NOW [link in bio]! 🔗

https://f.mtr.cool/pjvzwnynmh

Today, we are sharing our dietary approach to kidney stone prevention.➡️ Kidney stone formation (also called urolithiasi...
09/11/2025

Today, we are sharing our dietary approach to kidney stone prevention.

➡️ Kidney stone formation (also called urolithiasis or nephrolithiasis) is a complex disease 😷 influenced by multiple factors, including diet, genetics 🧬, and environment.

Conventionally, the approach to treatment is a multi-pronged approach and may include medication, dietary and lifestyle interventions, surgical removal, and using ultrasonic waves to break up stone.

However, dietary guidelines tend to focus on stone composition instead of on the underlying pathology.

In this blog series, we’ve been discussing the combination of upstream risk factors that impact the risk of stone formation. Details are at the Link in profile.
https://inkidney.com/dietary-approach-to-kidney-stone-prevention/


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