Jonathan Pollack

American Society of Nephrology ASN is working toward a world without kidney diseases by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest q...

That link doesn't work here - I think this is the right one? www.youtube.com/user/ASNKidn...

Novartis didn't share any eGFR slope data anywhere, did they?

How does that define "unhealthy" vs. healthy? #NephJC

Would have been better to not go through that, though. It's hard enough maintaining a good plant-based diet, adding protein restriction was brutal. #NephJC

At my next appointment, I shared my challenges and my nephrologist admitted protein restriction was stupid, especially on a plant-based diet, and that ended daily protein restriction. #NephJC

I said I was lurking but I'll chime in here. I switched to a plant-based diet and was told to restrict protein (<0.6g/kg/day) after diagnosis and I'm very compliant when my health is on the line. I lost weight very rapidly and was constantly starving. I opted out of social opportunities. #NephJC

Here I am! I switched to a plant-based diet immediately upon diagnosis in Jan 2025. Happy to chime in upon request.

Jonathan Pollack from St. Louis, MO. IgAN patient with my own thoughts about intermittent protein restriction, but lurking tonight. No COI. #NephJC

Showing my work:

Ye et al., Mol Cell, 2015; Wolfson et al., Science 2016; Saxton et al., Nat Struct Mol Biol 2016; Kogot-Levin et al., KI Reports 2020; Chen et al., PLoS One 2012; Kim et al., Int J Mol Sci. 2024; Wang & Mitch 2011; Cooke et al., FASEB J 2018

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For those following along, my theory on intermittent protein restriction is:

intermittent protein restriction → AA-scarcity → ↓mTORC1 → ↓TGF-β/SMAD → ↓collagen → ↓fibrosis

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Hope this covers protein restriction at various stages of CKD as well! Should be interesting regardless. (I'm pro investigating intermittent protein restriction → possible mTORC1 suppression.)

So you would advocate saying it a dozen times in a short conversation even if you've established that's the topic? Surely "EYE-gan" is a useful abbreviation? Or "the disease" if you hate that abbreviation?

Not a hill I'm willing to die on, but it's a mouthful and (as I said in response to this) I generally switch to "EYE-gan" after I've used the full clinical term when talking to people, lay or professional. I see it as a win if somebody can remember my condition enough to go look it up after we talk.

As a patient with the disease, I tend to call it "Eye-GAN" as an abbreviation after I've called it "I-G-A nephropathy" in a conversation. Abbreviations are a good thing. But in truth, I don't care what anyone calls it as long as work is done to modify it and/or repair/regenerate my kidneys.

Best line IMO: "In a testament to The Goopies’ charisma, the audience howled like stray dogs until they left the stage, no questions asked."

There's so much technological waste everywhere, mostly in my basement. I have stacks upon stacks of old hard drives dating back to 1990.

Licensing becomes an issue.

I wrote myself up as a case report and did just that per your recommendation. Here's hoping Detective Nephron will see it.

How can I get in touch with Detective Nephron? Is there a searchlight? A secret handshake? A code word?

KDIGO IgAN suggests flozination with eGFR 20-45 even with low UACR. What's the current opinion on -flozins, and what kind of real-world eGFR dips do nephrologists see with them, if any?

Guess I'll stick with my AAR and you can keep the retatrutide. I wish there were more non-pharmacological trials to see about modifying established fibrosis instead of new injury. There's a lot of evidence pointing different places, but nothing solid.

LLM says membranous nephropathy. How'd it do?

It's still in CKD trials, right? Do we know the effect on normotensive people with normal BMI, no T2D, etc.?

Sounds like a great miracle drug to add on as part of an untrialed multi-target therapy that could potentially kill me! Not sure if my UPCR (I don't have UACR tested) can get much lower or even if eGFR can improve, but I am doing all I can to avoid dialysis & transplantation.

I'm a patient doing a fully plant-based diet with intermittent amino acid restriction (i.e. low-protein days) to try to modulate mTOR activity and autophagy signaling - aiming to reduce renal fibrosis and support tubular repair. Phew. And I do love my protein days, especially peanut butter days.

Great that KDIGO recommends it, then! I mean, it's working for me, so...

Is there a list of multi-target therapies that have been trialed?

So no Comic Sans then?

I don't want a tonsilectomy based on a regional skew in trial participants...

I am prepared to be a case study.