Kidney Coach

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If you could get a message back to yourself on the day you found out, what would it say?Ours would be something like thi...
16/09/2026

If you could get a message back to yourself on the day you found out, what would it say?

Ours would be something like this.

You are going to spend tonight reading things that will frighten you. Most of them are about people at a different stage, on a different trajectory, with a different cause.

Nobody is going to explain the difference between how much filtering is happening and how fast that is changing. The second one matters more.

The number will move around, and most of that movement will be noise.

You will feel, for a few weeks, like this is now your whole personality. It will not stay that way.

You will want it fixed by Christmas. It does not work like that. Six months is when you can start to fairly judge anything.

Someone will say there is nothing to be done. What they mean is that there is no drug that does it. Those are not the same sentence.

And you will get further than you think you will tonight.

What would yours say? There is someone in the comments on day one right now.

Stage 5. Three months. Four points.> "GFR raised from 14.2 to 18 in 3 months..... I'm EXCITED 😊 ... All my Labs have imp...
15/09/2026

Stage 5. Three months. Four points.

> "GFR raised from 14.2 to 18 in 3 months..... I'm EXCITED 😊 ... All my Labs have improved. Very happy 😊"

Claude S., May 2024.

Four points does not sound like much written down. At 14.2 it is not four points, it is nearly a third again on what he had.

And read the actual words. Two smiling faces and a capitalised EXCITED, from someone at the stage where people are usually told there is nothing left to try.

That is what the numbers look like from inside. Not a headline. Somebody genuinely pleased on a Tuesday because a lab result went the wrong way up.

Results are individual, and Claude's are his own.

This is the one that lets kidney disease run for years without anyone noticing.Creatinine is a waste product from muscle...
15/09/2026

This is the one that lets kidney disease run for years without anyone noticing.

Creatinine is a waste product from muscle. Your kidneys clear it. When they clear less of it, it rises in your blood. That is the whole logic, and it works.

The problem is when it starts rising.

Creatinine does not move meaningfully until a substantial amount of kidney function is already gone. It is a late signal. By the time it looks abnormal, you are not at the beginning of the story.

It has a second flaw. Creatinine comes from muscle, so how much you have changes the reading. A very muscular person can look worse than they are. Someone frail, or elderly, or who has lost weight can look considerably better than they are, because there is less muscle producing it in the first place.

The number that moves earlier is protein in the urine. **uACR.** It is a cheap test, it is not automatic, and in most cases you have to ask.

If someone tells you your kidneys are fine on the strength of a creatinine result alone, the honest reply is: fine, and what did the urine show?

One head of cabbage, three onions, two red peppers, and an hour that is mostly the oven doing the work. Feeds six.Per se...
14/09/2026

One head of cabbage, three onions, two red peppers, and an hour that is mostly the oven doing the work. Feeds six.

Per serve: sodium 41 mg, potassium 474 mg, and 6.4 g of fibre.

Forty-one milligrams of sodium for a full dinner portion. A single slice of supermarket bread often carries three times that.

The red pepper flakes and the bay are what stop this tasting like boiled cabbage. Do not skip them and do not be shy with the flakes.

Boil the cabbage five minutes first, sauté the onion, garlic and peppers, combine, then 45 minutes at 400°F until the top catches.

It reheats better than it has any right to.

In the beginning, it is there before you open your eyes.It is the first thing in the morning and the thing you are still...
14/09/2026

In the beginning, it is there before you open your eyes.

It is the first thing in the morning and the thing you are still turning over at midnight. Every twinge is evidence. Every meal is a decision you have to make consciously. You are, without having chosen to be, a full-time student of your own kidneys.

Nobody tells you that this part ends.

Not the condition. The constancy of it. At some point, and you will not notice the day, you get to lunchtime before you think about it. Then a whole afternoon. Then you are somewhere with friends and it does not come up in your own head at all.

That is not denial, and it is not carelessness. It is what happens when the routine stops needing your attention: the shopping, the cooking, the supplements, the tea, all of it running quietly in the background while you get on with your actual life.

If you are still in the loud part, that is where everyone starts. It does get quieter.

Food tastes metallic. You are not hungry at meal times, and then you are ravenous at nine at night. Things you have eate...
14/09/2026

Food tastes metallic. You are not hungry at meal times, and then you are ravenous at nine at night. Things you have eaten your whole life have gone slightly wrong.

Almost nobody mentions this at diagnosis, and people quietly assume it is them.

It is not. Here is what is actually happening.

As waste products build up, they change how things taste. Metallic and bitter are the two most commonly described. Meat is usually the first casualty, which is inconvenient timing given everything else you have been told about protein.

Uraemia also blunts appetite directly. The signal that says "eat" gets quieter.

Then there is the salt problem. When you cut sodium hard, everything tastes flat for a while, because your taste for salt is calibrated to what you have been eating. That resets. Genuinely. Most people find it takes a few weeks, and then food that used to taste bland tastes normal, and the food they used to eat tastes aggressively salty.

What helps in the meantime: acid and aroma instead of salt. Lemon, vinegar, herbs going in at the end rather than the start, garlic, roasting instead of boiling, and eating your bigger meal at whatever time of day your appetite actually shows up.

Has your taste changed since diagnosis? Say so. It is one of the least-discussed parts of this.

Ask someone with kidney disease what they are doing all this for and almost nobody says "my eGFR".They say a person.The ...
13/09/2026

Ask someone with kidney disease what they are doing all this for and almost nobody says "my eGFR".

They say a person.

The granddaughter who is four, and the wish to be recognisable to her at fourteen. The son's wedding, whenever he gets round to it. The trip that keeps being postponed. Being the one who picks up the phone rather than the one being checked on.

That is not a soft motivation. It is the most durable one there is.

Diet advice fails when it is about numbers. It survives when it is about a person you can picture.

So on Grandparents Day: who is yours?

Not the number you are chasing. The person you are staying well for.

Today is Grandparents Day, so here is a story about time.Lex Shirah was 68 and had lived with kidney disease for twenty ...
13/09/2026

Today is Grandparents Day, so here is a story about time.

Lex Shirah was 68 and had lived with kidney disease for twenty years. It started with malignant hypertension, diagnosed in 1990 and probably there long before that.

Over the previous four or five years, his creatinine had climbed steadily, from 2.0 to over 4.0. He had already had surgery to install a fistula, the access point used for dialysis. He had not started dialysis. The preparation was simply done, sitting there, waiting.

In his own words:

> "I'm Lex Shirah and have been on your kidney disease solution program for approximately three months. I visited the clinic yesterday, and my lab results were encouraging. Creatinine was 2.9, down from 4.2 on previous check in Dec. 2009."

Twenty years of decline. Three months the other way.

And this line, which is the one that belongs on today of all days:

> "I have not yet been on dialysis and hopefully will never be."

That is what most people are actually working towards. Not a perfect number. More ordinary years, with the people who want you in them.

Results are individual, and Lex's are his own.

You will find headlines arguing that a moderate amount is fine. Our answer is still no, and it is worth explaining why r...
12/09/2026

You will find headlines arguing that a moderate amount is fine. Our answer is still no, and it is worth explaining why rather than just saying it.

Alcohol is acid-forming. On an alkaline-leaning diet, where the entire point is taking acid load off kidneys that are already working hard to keep your blood in range, it works directly against you. That alone puts it on our list.

Then there is blood pressure, which alcohol raises. Blood pressure is one of the main things setting the pace of kidney damage, and that route exists well below the amount anyone would call heavy drinking.

It dehydrates you, which is the opposite of what your filtering needs.

It leans on your liver, and a struggling liver hands more work back to your kidneys.

And it interacts with a long list of medications that people with CKD are commonly on.

Heavy drinking is not a debate. Roughly four drinks a day for a man or three for a woman, and the risk of developing kidney disease approximately doubles.

But we do not think the interesting question is where the harm becomes obvious. It is what you are asking your kidneys to absorb for a glass of something.

Our position: this is one we suggest cutting out. Most people we work with do better without it, and the ones who miss it tell us they stopped missing it faster than they expected.

Six ingredients, one blender, twenty minutes in the oven. Makes twelve.Rice flakes, brown sugar, three apples, olive oil...
12/09/2026

Six ingredients, one blender, twenty minutes in the oven. Makes twelve.

Rice flakes, brown sugar, three apples, olive oil, rice flour, cinnamon. That is the entire list.

Look at what is not in it: no butter, no dairy, no salt, no baking powder, no eggs. For anyone who has read the back of a shop-bought muffin recently, that absence is the whole point.

Everything goes in the blender together. Fill the cases three quarters full. 425°F for twenty minutes.

They freeze, which matters more than it sounds. A muffin in the freezer on a Wednesday is the difference between a snack you chose and a snack the petrol station chose for you.

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