Dr. Isreb- The Integrative Nephrologist

Dr. Isreb- The Integrative Nephrologist Specializing in integrative kidney therapies, Nephrology, Hypertension, Dialysis and Transplant

Most kidney disease patients never get a genetic workup.Yet up to 1 in 4 diagnoses can be reclassified with broad-panel ...
02/24/2026

Most kidney disease patients never get a genetic workup.

Yet up to 1 in 4 diagnoses can be reclassified with broad-panel genetic testing.

That means tens of thousands may be on the wrong treatment path… or worse, told their condition is “unknown.”

🧪 New genetic tools like Renasight can reveal:

✅ The true cause of kidney disease when everything else comes back negative
✅ Whether a biopsy or immunosuppression is necessary
✅ How to match transplant patients with the right donor
✅ And which medications are safest based on your genes

We’re entering a new era of precision nephrology.

But it starts with asking the right question:

🧠 “What if my kidney disease isn’t what I think it is?”
💬 Have you ever wondered if your kidney disease has a genetic cause?
Do you think genetic testing should be routine in nephrology?

Drop your thoughts or questions below 👇

Read the blog [link in bio]

https://inkidney.com/genetic-testing-in-kidney-disease/

What if something as simple as lemon water could help lower uric acid and support kidney function? 🍋💧A small but intrigu...
02/23/2026

What if something as simple as lemon water could help lower uric acid and support kidney function? 🍋💧

A small but intriguing study looked at patients with gout and asymptomatic hyperuricemia who drank the juice of two fresh lemons diluted in 2 liters of water every day for six weeks.

Here’s what they found 👇

• Significant reductions in serum urate levels in both gout and hyperuricemia patients ⬇️
• A modest but meaningful improvement in kidney function (eGFR) in gout patients 🧪🧠
• No changes in urate-lowering medications, suggesting an independent dietary effect
Why might this work? 🤔

Lemon juice is rich in citrate, a compound known to alkalinize urine, enhance renal urate excretion, and improve tubular acid handling. Even though urinary citrate wasn’t directly measured, the results align well with what we already know about citrate physiology ⚙️🧬

This doesn’t mean lemon water replaces medications ❌💊

But it raises an important question: can simple, low-risk nutritional strategies meaningfully complement gout and hyperuricemia treatment?

Should dietary citrate be discussed more often in kidney and metabolic care?

Would you try this approach, or have you seen it help patients in real life?

Drop your thoughts and questions below 👇💬

Read the study here: [https://f.mtr.cool/omejdzigup




🍋

Blog highlight 🪡🧠“The Benefits of Acupuncture in Kidney Disease”One of the most compelling findings in the acupuncture l...
02/22/2026

Blog highlight 🪡🧠

“The Benefits of Acupuncture in Kidney Disease”

One of the most compelling findings in the acupuncture literature is its anti-inflammatory effect.

Multiple reviews show that acupuncture modulates cytokine balance, activates neuroimmune pathways, and may engage the cholinergic anti-inflammatory reflex.

For patients with CKD, this matters because chronic low-grade inflammation contributes not only to kidney decline, but also to fatigue, anemia, sleep disturbance, itching, and cardiovascular risk.

This reframes acupuncture from being just a symptom-relief tool to a potential biologic modifier of disease burden when used alongside conventional care.

Have you seen inflammation-driven symptoms improve with acupuncture?

Would you consider it earlier in CKD care rather than as a last resort?

Share your thoughts or questions below 👇🩺

Read the blog here: [https://f.mtr.cool/klkcumwsuc


New blog out today 🚨🧠🫀🩺Ni****ne Pouches and Kidney Health: What We Know About Metabolic, Vascular, and Renal EffectsNi**...
02/21/2026

New blog out today 🚨🧠🫀🩺

Ni****ne Pouches and Kidney Health: What We Know About Metabolic, Vascular, and Renal Effects

Ni****ne pouches are often marketed as “smoke-free” and “tobacco-free” — but that does not mean they are biologically neutral.

This new blog breaks down what current science tells us about how ni****ne itself affects insulin resistance, blood pressure, renal blood flow, and inflammatory pathways inside the kidney.

Even without combustion, ni****ne can:

• Increase insulin resistance and metabolic stress ⚠️
• Raise blood pressure and activate the sympathetic nervous system 📈
• Disrupt renal blood flow and glomerular regulation 🧬
• Promote oxidative stress and fibrotic signaling in kidney tissue

For patients with CKD, diabetes, hypertension, or elevated cardiovascular risk, these effects matter. Harm reduction is not the same as harmlessness — and understanding that distinction is key for protecting long-term kidney health.

Are ni****ne pouches part of your smoking cessation journey?
Have you noticed effects on blood pressure or glucose control?

Questions or thoughts — drop them below 👇💬

Read the blog here: [https://f.mtr.cool/cnfttuvhma

****nepouches

Navigating the paths of cognitive decline & CKD? Many prevention strategies intersect, urging us to prioritize total wel...
02/20/2026

Navigating the paths of cognitive decline & CKD? Many prevention strategies intersect, urging us to prioritize total well-being. Here's your blueprint:

🥗 Diet: Boost cognition with foods high in fiber, antioxidants, & omega-3s! 🌿 Did you know? The Mediterranean diet is linked to reduced dementia risks & slower CKD progression. But remember, in CKD, also monitor sodium, phosphate, & protein!

🏋️‍♀️ Physical Activity: More than just a fitness routine! Aerobic activities increase brain blood flow & enhance cognitive functions, while also benefiting BP control & kidney health.

🧘‍♀️ Stress Management: Say no to chronic stress! Whether you prefer meditation, hobbies, or deep breathing, keep stress in check to safeguard both mind & kidney.

🚭 Avoid Toxins: A double win for cognition & kidneys - limit alcohol, say goodbye to smoking, and be wary of over-the-counter meds like NSAIDs.

💓 Blood Pressure Control: Diet, exercise, & sometimes meds, are pivotal for maintaining BP—vital for both vascular health & your kidneys.

🍞 Insulin Resistance: Beyond diet & exercise, focus on carb reduction, quality sleep & weight management. Reverse insulin resistance for holistic well-being.

🧩 Mental Stimulation: Keep that mind razor-sharp! Dive into puzzles, books, or new hobbies—it's a cognitive booster!

Join us in championing a holistic approach to health—because a sound mind in a sound body is true wellness. 🌟

For more info read the blog (link in bio)

https://inkidney.com/dementia-and-chronic-kidney-disease/

🧠💬 What does a kidney-friendly plate actually look like?We get this question all the time—and the answers might surprise...
02/20/2026

🧠💬 What does a kidney-friendly plate actually look like?

We get this question all the time—and the answers might surprise you.

🥦🍎🥩 Curious whether all fruits and veggies are safe for your kidneys?

Wondering if meat still has a place in your diet? Or how gut health ties into kidney health? Let’s talk about it.

We released our e-book, Fundamentals of a Plant-Based Diet for Kidney Health, packed with practical guidance—and we’d love to hear what YOU think.👇

📘 Inside you’ll find:

🔹 Evidence-based food recs tailored to kidney health
🔹 The truth about meat on a kidney-friendly diet
🔹 Gut health strategies to support kidney function

👥 Let’s start a conversation:

What’s been the most confusing part of managing your kidney diet?

Have you tried a plant-based approach—what worked (or didn’t)?

What questions do you still have about food and kidney function?

👇 Drop your thoughts, experiences, or questions in the comments—we’re here to learn together.

🛍️ Grab the full guide here:

https://inkidney.com/product/fundamentals-of-a-plant-based-diet-for-kidney-health/

02/19/2026

Blog highlight 📘🧬

“The Woven Threads of Klotho: Unraveling the Role of Klotho in Kidney Health and Vascular Calcifications”

Klotho, produced primarily by the kidneys, works hand-in-hand with FGF23 to regulate phosphate excretion. When Klotho levels fall, as they often do in chronic kidney disease, phosphate retention increases, setting the stage for vascular calcification and accelerated cardiovascular risk.

This helps explain why CKD behaves like a state of premature aging, where mineral imbalance, inflammation, and vascular stiffness intersect.

What makes Klotho especially compelling is that it is modifiable. Exercise, vitamin D optimization, phosphate reduction from ultra-processed foods, and specific nutraceuticals have all been shown to influence Klotho expression.

Supporting Klotho may be one of the most overlooked strategies in integrative kidney and cardiovascular care.

Are you thinking about phosphate and Klotho when managing CKD?

Have you seen vascular calcifications progress despite “normal” labs?

Let’s discuss 👇🧠🩺

Read the blog here: [https://f.mtr.cool/mgmbudlwjq


Blog highlight 📘“Demystifying Oxalate: The Antinutrient Unveiled”Vitamin B6 plays a critical role in oxalate metabolism....
02/18/2026

Blog highlight 📘

“Demystifying Oxalate: The Antinutrient Unveiled”

Vitamin B6 plays a critical role in oxalate metabolism. When B6 levels are low, the body diverts glyoxylate toward oxalate production instead of safely converting it into glycine.

The result is higher endogenous oxalate production, even if dietary oxalate intake is modest.

This helps explain why some patients continue to form calcium oxalate stones despite strict dietary restriction. In these cases, the driver may be a functional vitamin B6 deficiency rather than food alone.

Addressing B6 status can reduce oxalate generation at its source and may lower stone risk without extreme dietary limitations.

Have you ever checked vitamin B6 levels in patients with recurrent stones?
Have you seen stone risk persist despite “doing everything right” nutritionally?

Let’s talk 👇🧠🧪

Read the blog here: [https://f.mtr.cool/zeckmcxftq


Today, we are sharing our dietary approach to kidney stone prevention.➡️ Kidney stone formation (also called urolithiasi...
02/17/2026

Today, we are sharing our dietary approach to kidney stone prevention.

➡️ Kidney stone formation (also called urolithiasis or nephrolithiasis) is a complex disease 😷 influenced by multiple factors, including diet, genetics 🧬, and environment.

Conventionally, the approach to treatment is a multi-pronged approach and may include medication, dietary and lifestyle interventions, surgical removal, and using ultrasonic waves to break up stone.

However, dietary guidelines tend to focus on stone composition instead of on the underlying pathology.

In this blog series, we’ve been discussing the combination of upstream risk factors that impact the risk of stone formation. Details are at the Link in profile.
https://inkidney.com/dietary-approach-to-kidney-stone-prevention/


🧪 New Research Insight: Inflammation May Be the Missing Prognostic Signal in CKDWhat if kidney disease progression isn’t...
02/16/2026

🧪 New Research Insight: Inflammation May Be the Missing Prognostic Signal in CKD

What if kidney disease progression isn’t just about eGFR… but about inflammatory identity?

A large prospective study in stage 3 CKD followed patients for up to 10 years and found that specific inflammatory cytokines strongly predicted:

📌 Faster worsening of albuminuria
📌 Progression to kidney failure
📌 Cardiovascular events
📌 All-cause mortality

The strongest signals came from TNF-α, GDF-15, and IL-22.

Researchers identified six distinct inflammatory “profiles.”
Patients with the highest inflammatory burden had the worst renal and cardiovascular outcomes, while those with low cytokine activity had the slowest CKD progression and best survival.

Even more concerning:

➡️ Many patients shifted into more inflammatory profiles over time, suggesting that inflammation accelerates as CKD advances.

This raises an uncomfortable but necessary question:

Are we underestimating inflammation as a primary driver of kidney decline?
And if so, why aren’t we measuring it more intentionally?

These findings support a future where CKD care moves beyond one-size-fits-all staging and toward:

✔️ Early identification of high-risk inflammatory phenotypes
✔️ More personalized, anti-inflammatory strategies
✔️ Better prediction of who will progress — and who may not

We’d love your thoughts:

📌Should inflammatory biomarkers play a larger role in CKD risk stratification?
📌 How might this change how we monitor or treat earlier-stage CKD?
📌 What anti-inflammatory strategies have you found most impactful in practice?

Read the study here: [https://f.mtr.cool/fzeiduzjtl

Let’s discuss below 👇
















Blog highlight 📘“Demystifying Oxalate: The Antinutrient Unveiled”The gut microbiome plays a critical role in oxalate han...
02/15/2026

Blog highlight 📘

“Demystifying Oxalate: The Antinutrient Unveiled”

The gut microbiome plays a critical role in oxalate handling. Certain bacteria, including Oxalobacter formigenes, can actively degrade oxalate in the intestine, reducing how much is absorbed and ultimately excreted in the urine.

When these microbes are depleted — due to antibiotics, gut dysbiosis, or chronic inflammation — oxalate absorption increases, even if dietary intake stays the same.

This helps explain why two people can eat identical diets and have very different oxalate stone risk. It also shifts the conversation from restriction to restoration: supporting gut health may be just as important as modifying food choices.

Have you ever noticed stone risk increase after antibiotics or GI issues?

Curious how probiotics or diet diversity fit into oxalate management?

Let’s discuss 👇🧬🦠

Read the blog here: [https://f.mtr.cool/ywlumsetgo

Blog highlight 📘“Demystifying Oxalate: The Antinutrient Unveiled”This is one of the most misunderstood concepts in kidne...
02/14/2026

Blog highlight 📘

“Demystifying Oxalate: The Antinutrient Unveiled”

This is one of the most misunderstood concepts in kidney stone prevention.

A significant portion of urinary oxalate is generated by the liver from amino acids and collagen, not just from high-oxalate foods.

This explains why aggressive food restriction alone often fails and why metabolic health, protein balance, gut function, and micronutrients matter just as much as what’s on the plate.

How often do you see patients blamed for diet alone when the issue is metabolic?

What questions do you have about oxalate handling?

Let’s talk 👇🧠🧬

Read the blog here: [https://f.mtr.cool/msericjdsn


Address

Vancouver, WA
98662

Opening Hours

Monday 8am - 5pm
Tuesday 8am - 5pm
Thursday 8am - 5pm
Friday 8am - 5pm

Telephone

(360) 200-5155

Website

Alerts

Be the first to know and let us send you an email when Dr. Isreb- The Integrative Nephrologist posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to Dr. Isreb- The Integrative Nephrologist:

Shortcuts

Share

Share on Facebook Share on Twitter Share on LinkedIn
Share on Pinterest Share on Reddit Share via Email
Share on WhatsApp Share on Instagram Share on Telegram

Category