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PostPosted: Fri Dec 02, 2022 11:49 pm 
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By Stephen McConnell and W. Todd Penberthy Orthomolecular Medicine News Service

Approximately 786,000 people per year, in the US progress to ESRD (stage 5 CKD), which is generally considered an irreversible condition. Most of these become completely dependent on regular trips to dialysis. Estimation of the stages of CKD is based on (GFR) glomerular filtration rates starting with ≤60mL/1.7m2 for three months as definitive of initial CKD diagnosis.

Stages of CKD

Mild kidney damage, eGFR 90 or higher
Mild loss of kidney function, eGFR 60-89
Moderate loss of kidney function
a. eGFR 45-59
b. eGFR 30-44
Severe loss of kidney function, eGFR 15-29
Kidney failure or close to failure, eGFR less than 15

Supplementation with daily low-dose niacin reliably reverses a large amount of the functional loss. This simple treatment is effective and critically important. Mortality rates with CKD are striking, as the five-year survival rate for patients doing long-term dialysis is 35% compared to 25% in those with diabetes [T2DM] in the USA.

In over 25 documented individual cases of CKD stages 2 through 4, after initiation of a combination-therapy of supplements based on GFR, including 500 mg TID IR-niacin, over a three-month period, it was possible to improve their disease by at least one stage.

In basic and clinical research the evidence in favor of niacin for CKD is strong. Clinical research proves that the niacin is exceptionally well-suited to treatment and prevention of CKD, multimorbidity, and ultimately all-cause mortality.

Sampathkumar explained the current CKD treatment with niacin situation best:

Pharmaceutical industry driven large-scale studies are unlikely to be undertaken given the low-cost of niacin. David is up against the formidable Goliath of players promoting costly non-calcium containing phosphorus binders. It is time that international bodies like Kidney Disease, Improving Global Outcomes (KDIGO) take a call on usefulness of niacin as a low-cost, effective, and low pill burden agent for phosphorus reduction in CKD with multiple pleotropic benefits.

Recommended Doses to Address Chronic Kidney Disease

Low-dose immediate release-niacin, 100 mg – 500 mg, 1 to 3x/day. No-flush niacin or niacinamide will have equal efficacy on lowering phosphorus levels, but negligible cardio-vascular benefits compared with standard niacin.
Sodium Bicarbonate (baking soda) 1.8 g/d (1/3 at lunch and 2/3 at dinner).
Calcium carbonate antacid pills (400-1000 mg elemental calcium or 2-4 gms antacid tablets) with food to bind phosphorous in food.
Low-Dose-Thyroid Supplementation (25-50 µg T4/Levothyroxine or ½ grain of Desiccated Thyroid).
Methyl Folate (0.8 g to 2 mg L-MethylFolate).

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