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HOW TO HANDLE KIDNEY DECLINE · Your Daily Dose

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  Speaker 1: Well, I've been out of town for the last four
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  Speaker 1: or five days, so I'm now back, and hopefully we'll
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  Speaker 1: get this word out to you. Today we're going to
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  Speaker 1: talk about how most skin aging can be significantly delayed.
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  Speaker 2: You know, as I went around, I was in.
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  Speaker 1: Boca Raton this past week, and in Fort Lauderdale, and
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  Speaker 1: went to a number of different clinics, and it seems
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  Speaker 1: like everybody has just hung up on skin aging.
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  Speaker 2: And what you can do to keep young looking. So
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  Speaker 2: we're going to take a look at that today.
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  Speaker 1: Stay tuned.
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  Speaker 2: Hi, and welcome to Health Talk with Dr. Len, your
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  Speaker 2: daily dose.
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  Speaker 1: The information you hear on this show is informational. It's
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  Speaker 1: not meant to diagnose or treat any disease. Any kind
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  Speaker 1: of complete health conditions must be checked out and discussed
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  Speaker 1: with your primary care physician.
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  Speaker 2: Get ready for the good news of the day. God
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  Speaker 2: bless you folks. And here is Dr.
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  Speaker 1: Len. And our daily devotional today comes from the book
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  Speaker 1: of Psalms, chapter 4.
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  Speaker 2: Grow strong in the light of my presence.
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  Speaker 1: As my face shines upon you, you receive nutrients that
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  Speaker 1: enhance your growth in grace. I designed you to commune
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  Speaker 1: with me face to face, and this interaction strengthens your soul.
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  Speaker 1: Such communion provides a tiny glimpse of what awaits you
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  Speaker 1: in heaven, where all barriers between you and my glory
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  Speaker 1: will be removed. This meditative time with me blesses you doubly,
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  Speaker 1: You experience my presence here and now, and you are
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  Speaker 1: refreshed by the hope of heaven, where you will know
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  Speaker 1: me in ecstatic joy.
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  Speaker 2: Stay tuned. Thank you.
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  Speaker 1: 727-916-4215 Margaret, age 66, couldn't explain the dread. It wasn't
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  Speaker 1: tied to anything specific, just the low.
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  Speaker 2: Hum of something bad is coming that followed her through
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  Speaker 2: her days.
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  Speaker 1: Her doctor explained the way her cold hands, her aching back,
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  Speaker 1: nighttime trips to the bathroom was just part of aging.
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  Speaker 2: No one had connected.
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  Speaker 1: What all of that, including the fear, might be coming
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  Speaker 1: from the same place.
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  Speaker 2: Her kidneys. In classic Chinese medicine, cold hands.
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  Speaker 1: backaches, broken sleep, frequent bathroom visits, and nameless fears are
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  Speaker 1: traditionally understood as connected, not five separate problems. They're rooted
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  Speaker 1: in a single organ system, the urinary tract. Why do
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  Speaker 1: these organs hide their trouble so well? The kidneys are
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  Speaker 1: among the quietest of your major organs. A person can
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  Speaker 1: lose literally half of their kidney function before a single
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  Speaker 1: clear symptom appears.
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  Speaker 2: By the time a standard lab value.
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  Speaker 1: Drifts out of range, Years of slow decline may have
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  Speaker 1: already happened. The bladder is louder, urgency, frequency, waking at night,
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  Speaker 1: but its signals are so easily filed under ordinary aging
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  Speaker 1: that they're rarely questioned. Together, these two organs govern how
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  Speaker 1: the body handles water, filters waste, and helps to regulate
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  Speaker 1: blood pressure. As Western medicine is beginning to appreciate, they
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  Speaker 1: are also closely tied to how the body holds and
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  Speaker 1: releases fear. To understand what's happening to Margaret, I examined
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  Speaker 1: her across the four dimensions I use for every aging system.
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  Speaker 1: I call this approach the ACE model, anatomy, chemistry, energy,
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  Speaker 1: and soul. The structure, the anatomy of the body houses
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  Speaker 1: our organs. The chemistry regulates them. The traditional Chinese medicine
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  Speaker 1: concept of vital energy sustained them. An unprocessed emotional fear,
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  Speaker 1: fear in the kidney case, may wear on them in
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  Speaker 1: a way no scan can see. Margaret needed to care
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  Speaker 1: across all four dimensions, as most patients in her situation do.
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  Speaker 1: Each kidney contains about a million tiny filtering units called nephrons,
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  Speaker 1: which are gradually lost over a lifetime and not replaced.
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  Speaker 2: Some loss is a normal part of aging.
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  Speaker 1: What is not normal, though, although it's common, is the
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  Speaker 1: accelerated loss driven by decades of high blood pressure, elevated
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  Speaker 1: blood sugar, chronic dehydration, and certain medications, including any long-term medications,
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  Speaker 1: painkiller or acid reducer use. It can stress the kidneys
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  Speaker 1: over time. Ibuprofen, Tylenol, Prilosec. Because the kidneys are built
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  Speaker 1: with substantial reserve capacity, damage can stay hidden for a
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  Speaker 1: long time. A person can lose 40-50% of their filtering
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  Speaker 1: units and still produce a creatinine result that the lab
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  Speaker 1: reads as normal. A rise in creatinine may be a
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  Speaker 1: sign that the kidneys aren't working as they should. Typical
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  Speaker 1: range for serum creatinine is 0.74 to 1.35 milligrams per
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  Speaker 1: deciliter for adult men. The very surplus the kidney was
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  Speaker 1: born with is what masks its decline.
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  Speaker 2: The bladder ages along a different track.
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  Speaker 1: It is essentially a muscular sac, and aging affects both
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  Speaker 1: the muscles and the nerves that control it.
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  Speaker 2: Over time, the bladder wall grows stiffer and less elastic.
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  Speaker 1: Its capacity shrinks dramatically. and the signaling between the bladder
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  Speaker 1: and the brain becomes less coordinated. Hence, the urge to
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  Speaker 1: urinate arrives more suddenly and less predictably. In men, an
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  Speaker 1: enlarged prostate can press on the outflow to block the stream.
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  Speaker 1: In women, the pelvic floor, the sling of muscles that
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  Speaker 1: support the bladder and urethra, can weaken, often after childbirth
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  Speaker 1: and around menopause.
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  Speaker 2: The result is a familiar cluster.
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  Speaker 1: Nighttime waking, sudden urgency, and a growing sense that the
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  Speaker 1: bladder can no longer be trusted to wake. In Margaret's case,
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  Speaker 1: imaging showed that her kidneys were at the lower end
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  Speaker 1: of normal and that her bladder did not fully empty.
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  Speaker 1: Findings that taken individually did not seem urgent. One test
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  Speaker 1: that wasn't ordered was a urine albumin test, which could
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  Speaker 1: detect kidney stress years before creatinine testing alone. If you
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  Speaker 1: suspect your kidney function is declining, there's a few concrete
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  Speaker 1: things you can ask your doctor. Request an EGFR test.
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  Speaker 1: Estimated glomerular filtration rate. And your urine albumin to creatinine
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  Speaker 1: ratios is the second can reveal strain that the EGFR
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  Speaker 1: test misses. Also, ask your physician to review any long-term
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  Speaker 1: medication and supplements for any burden it may place on
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  Speaker 1: the kidneys. Anatomy, though, is just the first of the
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  Speaker 1: four windows. The kidney does far more than filter blood.
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  Speaker 1: Controls how much sodium and water to hold, which helps
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  Speaker 1: to set blood pressure. It converts vitamin D into its
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  Speaker 1: active form, which the body needs to absorb calcium. It
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  Speaker 1: signals bone marrow to produce red blood cells, which is
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  Speaker 1: why kidney decline often first shows up as unexplained fatigue.
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  Speaker 1: It helps maintain the body's acid-base balance. When this regulation
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  Speaker 1: begins to slip, the early signs are often misread. Fatigue
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  Speaker 1: is often blamed on age, and rising blood pressure may
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  Speaker 1: prompt another prescription rather than a broader workup. Bone loss
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  Speaker 1: is often attributed solely to menopause. Because each symptom is
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  Speaker 1: handed to a different specialist, connections between them will be missed.
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  Speaker 2: Read together rather than one line at a time.
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  Speaker 1: Margaret's labs revealed a coherent story. Several lab values, sodium
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  Speaker 1: in the upper range, apparently expanded blood volume, low vitamin D,
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  Speaker 1: and hemoglobin at the low end of normal, together suggest
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  Speaker 1: her kidneys were under strain. In the absence of another
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  Speaker 1: clear explanation for her rising blood pressure, Sodium retention is
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  Speaker 1: one of several possible contributors to hypertension, alongside arterial stiffness.
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  Speaker 2: Weight, hormones, and genetic.
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  Speaker 1: Mild anemia is often one of the first hints that
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  Speaker 1: the kidneys are under strain. They tell the marrow to
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  Speaker 1: make red blood cells and make less than the signal
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  Speaker 1: when the system is weakened.
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  Speaker 2: Two of the most significant.
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  Speaker 1: Drivers of kidney damage over time are chronically elevated blood
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  Speaker 1: sugar and blood pressure levels, both of which injure the
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  Speaker 1: small blood vessels that make up the kidneys.
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  Speaker 2: Filtering units.
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  Speaker 1: For your physician, the useful questions are about the direction
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  Speaker 1: of these lab values, not just today's snapshot. Ask not
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  Speaker 1: only whether your A1c and blood pressure are normal, but
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  Speaker 1: also where they've been heading over the years. And ask
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  Speaker 1: for your vitamin D, calcium, phosphorus, and a full blood count,
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  Speaker 1: rather than just single numbers in isolation. For your own part,
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  Speaker 1: the most useful habit is steady hydration. Drink with intentions
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  Speaker 1: throughout the day rather than large volumes late at night,
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  Speaker 1: which mainly strains an aging bladder and disrupts sleep. In
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  Speaker 1: traditional Chinese medicine, the kidney is understood as the storehouse
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  Speaker 1: of what is called jing, or essence, a foundational reserve
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  Speaker 1: a person is born.
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  Speaker 2: With and draws from over a lifetime.
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  Speaker 1: The essence stored in the kidneys governs growth in childhood,
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  Speaker 1: fertility in adulthood, and timing and pace of aging itself.
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  Speaker 1: When traditional Chinese medicine said the kidneys govern the bones,
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  Speaker 1: opens into the ears, and rules the gate of water,
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  Speaker 1: it's describing much of what Western medicine now knows. that
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  Speaker 1: the kidney activates vitamin D for bone, shares developmental pathways
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  Speaker 1: with the inner ear, regulates the body's water through urine.
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  Speaker 1: Language is different, but the organ described is the same.
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  Speaker 1: Essence is thought to be rapidly depleted by chronic excessive work,
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  Speaker 1: too little sleep, untreated illnesses, prolonged fear, and unrelenting stress.
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  Speaker 1: When the essence runs low, Traditional Chinese medicine associates the
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  Speaker 1: loss with a cluster of symptoms the aging kidneys produce
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  Speaker 1: a weak, sore lower back and knees, ringing in the ears,
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  Speaker 1: thinning bones, graying, declined fertility, frequent waking to urinate, and
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  Speaker 1: a pervasive sense of cold, especially in the hands and feet.
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  Speaker 1: Margaret's cluster of symptoms mapped onto much of this traditional picture.
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  Speaker 1: Practical measures to address these root causes of kidney decline
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  Speaker 1: include protecting sleep, which is often when the essence is restored,
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  Speaker 1: keeping the lower back and feet warm, and working with
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  Speaker 1: a trained practitioner on acupuncture and classically prescribed herbs. The
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  Speaker 1: fourth dimension is one no lab can measure, and Margaret's
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  Speaker 1: case matters most of all. Traditional Chinese medicine pairs each
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  Speaker 1: organ with an associated emotion. The idea is not that
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  Speaker 1: the organ feels that emotion, it's that the two are
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  Speaker 1: so closely linked that a lasting excess of emotion wears
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  Speaker 1: on the organ, and weakened organs make the emotions easier
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  Speaker 1: to fall in on. The emotion associated with kidneys is fear.
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  Speaker 1: Not the sharp fear of immediate danger, but deep, chronic,
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  Speaker 1: low-grade fear. The tradition holds that sustained fear depletes the
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  Speaker 1: kidney essence over time.
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  Speaker 2: What we coached Margaret to do is concrete.
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  Speaker 1: We name the fear out loud because the fear that
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  Speaker 1: is named tend to lose part of the grip on
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  Speaker 1: the body. We treat the bloke in sleep, and chronic
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  Speaker 1: fear is a single problem since each need each other.
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  Speaker 2: And both erode the kidneys.
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  Speaker 1: In working with patients in this situation, I often combine approaches,
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  Speaker 1: including psychodynamic and cognitive behavioral therapy, along with acupuncture aimed
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  Speaker 1: at reducing chronic stress. For Margaret, the change was not abstract.
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  Speaker 1: Her blood pressure eased, she stopped waking in the middle
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  Speaker 1: of the night, and the unknown dread began to lift.
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  Speaker 1: Margaret's physician was not wrong about any of the individual findings.
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  Speaker 1: Her kidneys were mildly reduced. Her imaging and labs showed
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  Speaker 1: up as much. Her blood pressure did need attention. Her
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  Speaker 1: nighttime waking was in part due to an aging bladder.
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  Speaker 1: The gap was in the fragmentation. Each finding reviewed is isolation,
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  Speaker 1: without asking how they might connect. The ACES model exists
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  Speaker 1: to ask the question. The anatomy showed a filter and
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  Speaker 1: reservoir wearing down, The chemistry showed the master regulator losing
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  Speaker 1: its grip. The energy revealed the depleted essence beneath the
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  Speaker 1: previous two dimensions. The soul uncovered the chronic fear that
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  Speaker 1: was actively accelerating it all. Treating any one dimension alone
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  Speaker 1: would have left the others free to keep doing their damage.
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  Speaker 1: Working on all four at once, protecting the nephrons, steadying
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  Speaker 1: the chemistry, restoring the reserve, and quieting the fear is
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  Speaker 1: what allowed Margaret's body to settle into a way that
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  Speaker 1: added years of that medication could not have done. The
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  Speaker 1: kidneys tend to fail without initial symptoms. Catching the pattern
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  Speaker 1: early across all four dimensions makes the decline visibly early
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  Speaker 1: enough to change, and the fear that accelerates it becomes
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  Speaker 1: something a patient.
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  Speaker 2: Can finally put away. Now, I told you it was
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  Speaker 2: about aging. We're going to talk about aging on the
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  Speaker 2: next one.
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  Speaker 1: This one dealt with the kidneys first, and the first
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  Speaker 1: line for aging is proper hydration. So we'll be talking
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  Speaker 1: about that More in depth on the next podcast.