Does Rapamycin lower eGFR?

CKD is generally diagnosed when eGFR falls below 60 for more than three months. And a doctor will usually have a uACR test done if eGFR falls below 60. Sometimes imaging. Occasionally CKD is diagnosed in persons with an eGFR between 60 and 90 if protein is found in urine.

You can order Cystatin C and a uACR test yourself online, too. The reason these two tests might be a good idea is because of the variability in your creatinine-based eGFR.

Well, did you have a urine test, too? When eGFR goes out of range it usually triggers the doctor to check for protein in the urine, preferably an ACR.

Creatinine is a test which is affected by
a) Kidney Clearance
b) Muscle Mass
c) Creatine input.
d) Delays in testing after blood draw

d) Is a serious problem generally ignored. I did two blood tests on a sample taken by the same needle which gave a difference of about 50% of the lower value.

However, by driving the sample to the lab I have now got a creatinine level (and hence eGFR) on the lower range.

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If you do weight training you may want to look at the egfr calculation that includes cystatin c. Break down of muscle tissue from weight training throws off original egfr calc due to high creatinine levels. The calc with cystatin c corrects for that.

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I did three blood tests last Thursday, I have the results from two creatinine at 83 (eGFR 87) and 73.43 (eGFR 94). My best creatinine result this year was 61.82 (eGFR 101). I think the main variation in the creatinine comes from the time between blood draw and the actual test starting. My third blood test from Thursday flags up on the labs website as ā€œtesting in progressā€.

I do quite a bit of walking and some resistance training (upper body strength exercises, chin ups etc), but I donā€™t go to the gym. I generally donā€™t fast for blood tests. (sometimes I do, but rarely)

Those are very good egfr levels.

In micromolar values the bottom end of the range (from that lab) is 62. My strategy is to concentrate on biomarkers. I think the basic issue for kidney health is senescence. If the senescent load can be reduced (and my approach is to get cells to function rather than kill them) then the kidneys should function well.

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Could be that they overload kidneys by drinking too much.

Same thing happened to me

@desertshores Yes, 6 weeks on Rapa my eGFR went from 86 to 73

Iā€™ve had CKD for five years, with a GFR of 16 at its lowest point. I was advised to prepare for dialysis, which I refused to even consider. I went vegetarian and avoided alcohol, and my GFR jumped to 24 and then to 29. Since then, Iā€™ve taken Rapa, AKG, and Spermidine, and my GFR is now 43. With a study of n=1, I canā€™t prove cause and effect, but the regimen certainly isnā€™t hurting. The key is to take low doses of Rapa, not immunosuppressant levels.

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Iā€™ve posted this before on here, but canā€™t find it:

http://www.orthomolecular.org/resources/omns/v17n22.shtml

Great solution for very low cost and it does raise my egfr by quite a bit. Iā€™m already taking niacin, so that makes it even easier.

I think this could really help, welcome to the site!

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One more thing, if you have not had niacin IR before, do not take 500 right off the bat. It will burn like crazy. Start with 50ā€™s or 100ā€™s with a meal. Keep taking small doses all day for awhile until you can finally take the 500ā€™s without the pain.

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I know that niacin causes severe flushing, which makes my face look radioactive.

That was an interesting paper, and the author cites many sources on PubMed and elsewhere. Some of those studies say that niacin and its analogs seem to be effective, but that safety is uncertain. Iā€™m doing well without it, but I wouldnā€™t mind if my GFR jumped from 3b to 3a or 4.

They are effective and the IR version is safe. Several versions which try to reduce flushing by making it slow release are unsafe because they donā€™t give your liver a break. This comes from my doctor. You can take as much IR as you can stand.

In the beginning I would flush with 100, after a month or so I could take the 500ā€™s. Now I take a gram and a half every morning. I also have a gram every time I have a big meal. Usually just once more per day for me, But if I did have another gram twice during the day there would be no flush the next morning. Avoiding the flush is accomplished by continuing to swallow pills.

Good luck, it is the hardest supp to get used to that I have ever used. And I used DMSO for a long time.

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Thank you for your insights, sir.

I read the paper again and decided to try the IR niacin, starting low and tapering up slowly. The author said that even low doses are effective, so I may not go over 500.

I and the author differ on the amount of sodium bicarbonate needed to retard or reverse kidney failure. He advises no more than two grams per day while I take eight. Eight grams is the amount recommended by a large, multi-center, Italian study in a 2019 paper in PubMed.

I take eight grams, and sometimes more, because I have acid refulx and acidosis, which feed on each other. As you probably know, acidosis is associated with mortality and morbidity. So far, itā€™s working and my CO2 remains in the normal range. No side effects.

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Glomerular filtration rate (GFR) decline is causally associated with kidney failure and is a candidate surrogate endpoint for clinical trials of chronic kidney disease (CKD) progression. Analyses across a diverse spectrum of interventions and populations is required for acceptance of GFR decline as an endpoint. In an analysis of individual participant data, for each of 66 studies (total of 186,312 participants), we estimated treatment effects on the total GFR slope, computed from baseline to 3 years, and chronic slope, starting at 3 months after randomization, and on the clinical endpoint (doubling of serum creatinine, GFR < 15 ml mināˆ’1 per 1.73 m2 or kidney failure with replacement therapy). We used a Bayesian mixed-effects meta-regression model to relate treatment effects on GFR slope with those on the clinical endpoint across all studies and by disease groups (diabetes, glomerular diseases, CKD or cardiovascular diseases). Treatment effects on the clinical endpoint were strongly associated with treatment effects on total slope (median coefficient of determination (R2) = 0.97 (95% Bayesian credible interval (BCI) 0.82ā€“1.00)) and moderately associated with those on chronic slope (R2 = 0.55 (95% BCI 0.25ā€“0.77)). There was no evidence of heterogeneity across disease. Our results support the use of total slope as a primary endpoint for clinical trials of CKD progression.

Paywalled Paper:

https://www.nature.com/articles/s41591-023-02418-0

Related Issue, Different Paper:

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eGFR is more a senomorphic target.