Posted on 07/11/2023 9:52:52 PM PDT by ConservativeMind
Chronic kidney disease is a growing problem. Now, a study reveals that a protein known for treating cardiovascular diseases also counteracts a mechanism in the kidney that reabsorbs proteins. This could potentially lead to new treatment options.
A study suggests that the cardiovascular system may open up a treatment strategy. Kathrin Weyer, explains:
"We have found that a protein called PCSK9, which influences the cholesterol level in the blood and increases the risk of cardiovascular diseases, has completely new and unexpected effects in the kidneys. In the study, we can see that PCSK9 regulates a receptor in the kidneys that controls the amount of protein excreted in the urine. This knowledge can potentially be used to treat patients whose kidneys are overloaded and therefore have an accumulation of protein in their urine," she says.
In the kidneys, the so-called megalin receptor is central to the reabsorption of filtered proteins, and thus to the amount of protein excreted in the urine. In patients where the receptor no longer functions optimally, the system becomes overloaded, leading to a condition called proteinuria, where there is an abnormally high level of protein in the patient's urine.
Proteinuria is an important indicator of kidney disease and a critical risk factor for developing chronic kidney disease. In the study, it is precisely the megalin receptor and thus the kidneys' efficiency in reabsorbing filtered proteins that PCSK9 appears to negatively regulate.
The fact that PCSK9 is a therapeutic target is not new in the medical field. Today, cardiovascular patients worldwide are treated with PCSK9 inhibitors used to lower elevated cholesterol levels. Says Kathrin Weyer:
"If it turns out that it actually enhances treatment, then within a relatively short period, a completely new form of therapy can be offered to kidney patients."
(Excerpt) Read more at medicalxpress.com ...
Maybe this would be helpful with nephrotic syndrome.
I can’t help but wonder how many of the chronic kidney problems are being caused by a lot of the drugs they sell us to ease other symptoms...
In 2015 my GFR was about 60 (Level 5, healthy kidney) and age was 77. In 2017 my GFR was around 40 where it has stayed ever since (Level 3, less healthy kidney). There was NO significant change in my supplements, and only drug has been levothyroxin (75 mg.). In 2016 I spent a week in bed with Salmonella (lab confirmed) and lost over 5 lbs. Could that have affected my kidneys permanently?
I have avoided my doctor’s suggestion that I take anti-cholesterol meds as my mother and all but one of 5 siblings lived to around 90, and my father, and his father with 5 siblings also, all but one. lived into their 90s and 2 of those great aunts died at 103 and 104. So since my health is usually good, no heart symptoms, and I eat carefully, don’t smoke or drink have decided to avoid the cholesterol meds. Does that make good medical sense?
I have just decided to do a serious bout of dieting to drop from near 150 to 135 lbs. (5’3”) using an Atkins approach—minimal carbs, moderate fats, plenty of low carb veggies, and more protein than usual. I am a little concerned about overloading my kidney’s since this post mentioned protein in the urine issues. I am currently eating about 45 grams protein a day and thinking about increasing to 60 grams daily. Would that be a safe increase? My doctor has been tracking my annual blood levels for ten years, but never suggested I meet with a kidney specialist in my HMO, he has mentioned blood levels related to kidney health, but not made any specific recommendations. Should he or I be doing more? I am able to read my blood work after my annual physicals including GFR levels. As a result of the Covid years I have increased my Vitamin D3, Zinc, and Quercetin/Vitamin C intake.
The formula for eGFR is made to use age as a forcing factor on making our eGFR look worse, as we grow older.
It is concerning you dropped 20 on the eGFR numbers, but it is great you have stayed “steady.” That isn’t normal, and shows you are actively doing something to increase your eGFR/kidney function.
As for whether a bacterial infection could hurt your kidneys, I’d say that seems reasonable, but it likely can’t be proven.
I would encourage getting a Cystatin C test done with the normal creatinine and using both numbers, with your height and weight, in the following eGFR calculator:
https://freerepublic.com/focus/f-chat/4099007/posts
My doctor saw one high cholesterol reading and had her nurse tell me she wanted me to take statins. It’s actually inappropriate for a doctor to rule you have high cholesterol worthy of statins off of just one reading. It could be a suggestion without good information, however. That is not how it was presented, though. I told the nurse the doctor was wrong to make such a diagnosis from just one blood test and that I would not take a statin—especially since the doctor knew I had recently changed my diet to low carb, and higher fat diets can cause elevated LDL for some months. By the way, a diagnosis of diabetes comes from two HbA1c readings over 6.5, as I recall, as an example of that two test expectation.
You can handle cholesterol on your own by loosing weight and changing foods and supplements. With fats, I would encourage minimizing saturated fats with low carb. It’s fine to get some, for sure.
With chronic kidney disease, a recent observational study showed substituting protein in place of current carb intake is helpful for them:
https://freerepublic.com/focus/f-chat/4159153/posts
If you know you have proteinuria, then I’d say it is not likely wise to eat more protein.
Of course, a kidney specialist would know more and help you get the two substances tested for a better eGFR value. You can also order these tests from places like Direct Labs, which uses Quest Diagnostics for testing.
Nephrotic syndrome is what I’m most familiar with but it has some overlap with other types of CKD.
Hypertension should be more of a concern than high cholesterol. High blood pressure damages kidneys. You don’t mention a blood pressure med so perhaps yours is in range. Mine runs 130s over 80 with medication. 120/80 is optimum but it varies with the individual.
I would definitely advise against a high protein diet, particular if the protein is from meat. Meat causes hyperfiltration, which isn’t an issue for those with healthy kidneys. But when you have CKD you’re making sick kidneys work harder and that’s not a good idea. When I’m dealing with a relapse my nephrologist wants me to limit my daily protein to 70 grams, and that’s for a body mass of 185 lbs. She’d be unconcerned if I’m getting extra protein from plant sources because plant protein doesn’t make the kidneys work as hard.
A good diet for you would be some variant of the DASH diet and the Mediterranean diet. That’s lots of fresh vegetables and fruit and moderate animal protein. You should also pay close attention your sodium intake. Read labels. Salt can be a big problem with CKD.
Vitamin D3, Zinc, and Quercetin/Vitamin C are all fine. My neph prescribed high doses of D3. You didn’t mention herbal supplements, but those can be risky with CKD.
Can’t answer most of your questions but I also refused to take the statins they wanted me to take for cholesterol.
A doctor told me that men over 55 were recommended to take the junk “just because they’re men and over 55” even though my cholesterol was in the “good range”. 71 now and my cholesterol is still in the “good” range with no problems.
Recently diagnosed with esophageal cancer from decades of acid reflux and they did all sorts of tests so I know my kidney GFR is 54.
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