CKD, Diabetes, and Jardiance: Delay Kidney Failure!

There is controversy within the medical community about giving SGLT2 medications (especially Jardiance and Farxiga) to treat diabetic patients in CKD.

For example, my PCP framed it this way: “Cardiologists like it because it is so effective against heart failure. Nephrologists don’t like it because it is believed to be harmful to the kidneys.” (The latter is based on data from almost a decade ago.)

Here’s a very informed point of view based on recent data…

“Take a moment to look at this picture, alluding to the tortoise and the hare fable.

As far as the preservation of kidney function is concerned, the tortoise wins again! An average SGLT2-treated patient will delay dialysis by 15 years if put on an SGLT2 inhibitor with a RAAS inhibitor (for hypertension).”

So, if we begin treating diabetic patients with SGLT2s, we can postpone kidney failure (ESRD) by as much as 15-20 years! We must educate nephrologists and PCPs about the benefits of SGLT2 medications!

Considering that most CKD patients are hypertensive or diabetic and both and both of these conditions lead to kidney and heart disease, the opinions among physicians in their treatment should NOT be a controversy. Rather, it should be coordinated and based on current data, based on facts, not myths.

Here is the graph summarizing the latest research. Please take a look at recent studies of SGLT2 efficacy and make sure your physicians are informed. I still get pushback from my nephrologists about this. They aren’t up on the latest.

Posted in CKD, diabetes, dialysis, eGFR, eGFR, GFR, ESRD, Farxiga, GFR, Jardiance, kidney, Kidney failure, kidney research, Medications | Tagged , , , , , , , , | Leave a comment

Dialysis and Summer Weather Recipes

We’re coming into Summer when the extreme challenge of keeping hydrated while limiting fluids comes into play and a competition greater than March Madness!

Here are some low potassium recipes for your consideration from Davita. In this context, please consider the issue of fluid control while indulging in these summer treats. Low Potassium is only one side of the coin. You must watch the amount you are consuming. Pie? Not as much a fluid problem. YAY!

Low-Potassium Desserts and Drinks

Enjoy! Have a splendid Summer!

Also, for those (who isn’t included in this?) needing help with Fluid Control, check out the posting “Dialysis and Fluid Control“. If you are like me, fluid control was one of the top challenges as a dialysis patient. I hope you find it helpful.

Posted in Davita, dialysis, diet, dietary restictions, fluid control, kidney, Kidney Diet, Kidney-friendly, potassium, recipes | Tagged , , , , , , | 1 Comment

Dialysis and “Extra Help” with Meds

Most experienced Social Workers know this and will get you set up with this program as soon as you go on Medicare. However, many don’t which means you need to find this yourself. I hope I saved you some hunting time.

After three years on private pay or commercial insurance, you must transition to Medicare. You can do so prior to that but the dialysis facilities won’t encourage the move because commercial insurance pays much more than than Medicare. In your self-interest, you might want to consider it for the benefit of the Extra Help program which will help considerably to make your medications much more affordable (if you qualify).

When I was at “The Center from Hell”, I was asked to sign a form wherein I “opted out” from Medicare. The facility wanted me to stay on private pay insurance so they would get paid more for my dialysis. The problem was my insurance had huge deductibles and co-pays leaving me paying several hundred dollars a month for dialysis and medications. It was the cost for medications that was the larger share on my monthly cost. I was bleeding money. When I left that center, the first thing the new Social Worker did was get me on Medicare and Extra Help. Finally I was able to afford my medications!

It works like this: Medicare Part D and, in some cases, Part B will pay 80 percent of your medications leaving you responsible for the remaining 20%. In some cases, that can mean several hundred dollar per month for which you are responsible. If you have living on a low income, even an extra hundred a month is too much. Extra Help contributes to pay the twenty percent not paid by Medicare.

(Even after a kidney transplant, I still use Extra Help because I turned 65 while on dialysis for nearly ten years. That’s REALLY helpful because my meds would be about $3000/month!)

So, if you qualify, Extra Help can allow you to save a considerable amount on medications.

Check it out…

That website also has some valuable information about other Medicare and Social Security programs. Start clickin’ them links! Enjoy.

I hope this was helpful.

(c)2021 DevonTexas All Rights Reserved.

Posted in CMS, dialysis, Dialysis Center, Insurance, Medicare, Medications, New Patient, Social Work, Transplant | Tagged , , , , , , , , , | 2 Comments

Dialysis and Blood Pressure

Hey Y’all! Long time. no post. My fault entirely.

Since my transplant in late 2017, I spent my time recovering and absolutely enjoying my new-found life, free of the restraints of dialysis. That doesn’t mean I’m not constantly thinking about you and the world of dialysis. That’s why I want to post about this article, titled “Major Update’ of BP Guidance for Kidney Disease, Treat to 120 mm Hg”

Go ahead and skim over it… I’ll wait…

So, first point, it is meant for CKD patients who are not on dialysis and that might make it seem irrelevant to a dialysis patient. However, the reason I want you aware of this change in BP guidelines is so you understand the importance of blood pressure and its relationship to kidney disease. This decision supports the position that lower BP in kidney patients is extremely important. Keep this in mind every time your blood pressure is measured. Pay attention to the numbers. Watch for the Systolic (top) number and how high it might be above 120, if it is.

BTW, the way I remember which number is which: Like a fraction, where the bottom number is the “denominator”, the bottom number is a blood pressure measure is “diastolic”. They both begin with “D”? Therefore the upper number is “systolic”. Yes, it’s crazy. Yes, it is bordering on silly. But, it works and helps me translate from medical terminology to something I understand. I told one friend about my method and the response was, “I really don’t remember anything about math or fractions!” I guess they’ll have to find something else to help them. I am plumb out of ideas. Needless to say, “Systolic = top number” and “Diastolic – bottom number”

The fundamental reason I bring up this article is to encourage you to advocate for yourself when your blood pressure is being taken. The discussion subtitled, “Take Blood Pressure Well” is essential for dialysis patients, too. For kidney patients, getting a good number is important because it effects your medical treatment for hypertension which is a leading cause of kidney failure and most kidney patients have elevated blood pressure. Taking a poor measure will effect what medications and strengths you are given. Too much or too little can harm your kidney health. Read that section over again with this in mind. Also, keep this in mind when someone puts the blood pressure cuff on you. If you aren’t ready, say so and make sure you are seated for the recommended five minutes before they take a measurement.

The other important point is the new “120” level for systolic pressure. You need to know this because it often takes time for the message to filter down within the professional community. The physician may still be holding onto the 130 level. Likewise the tech or nurse may not be aware of the new number. Like a speed limit, people tend to add a couple miles per hour. Twenty-five becomes thirty or thirty-five. Similarly, 130 becomes 135 or 140. This new number should be held to as closely as possible to avoid the upward “creep” to greater than 120.

As an aside, the lower (diastolic) number used to be 80 and high was considered 90. The new number is 60 with 80 being high.

So, keep a close watch on your BP outside of dialysis. During dialysis, make sure it is being carefully watched and responded to appropriately. Also, keep in mind your BP during dialysis can swing widely (usually downward) which is why it is constantly monitored. Outside dialysis, it is your responsibility to monitor your BP. Measure a couple times a day or more; upon waking, mid-day and evening before bed are usually recommended times. If it is staying above 120/60, speak with your doc about adjustment to your meds. If is ranges above 130/70 or 140/80 in multiple measures, two things, 1) measure more often and 2) seek medical advice.

Keep that BP under control!

Thanks for reading and sorry for not writing more often. Stay healthy!

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Dialysis and pre-Transplant

Here is a great resource for getting on the Transplant List and preparing for the transplant process.

This from the Renal Support Network and Lori Hartwell, the RSN founder who has been a hardcore supporter and educator of the Kidney community.

If you’re in dialysis and looking into the transplant opportunity or just want to educate yourself about it, give a listen.


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Dialysis and Medications

Hey y’all…

I came across this article from the National Kidney Foundation (NKF) and thought it might be helpful to those wondering about the effect of medications on your kidneys. Some can be harmful to your kidneys.

Caution, however. If your doctor has prescribed a medication that you find in this article, don’t discontinue it without consulting with the doctor. Just make sure you bring it up at the next visit. You can also raise it with your nephrologist if that’s not who prescribed it.

Here’s the article. Let me know what you think.

DevonTexas, copyright 2019







Posted in CKD, dialysis, ESRD, kidney, Kidney Diet, Kidney-friendly, Medications, National Kidney Foundation. NKF, New Patient, Transplant, Uncategorized | Tagged , , , , , , | 1 Comment

Getting away: not always easy!

This gallery contains 6 photos.

Originally posted on Big D and Me:
Over the last six months, we have managed to get out of town occasionally, for one or two days around dialysis. By around dialysis, I mean that leave for our mini holiday accommodation…

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Ya’ll gotta see this…

Here are two photos.  One, taken in 2013 when I was in a wheelchair being pushed around the US Capitol, obese, ready to get off the exit on the Highway of Life. The other is 2016, lost 100lbs, able to walk with a cane, again at the Capitol, taking back my life from the terrible place I let it go to.

Can you see a difference?

So, although i haven’t posted in a while, I have been busy.  More later.  Exciting stuff.


Devon in DC 1Devon

Posted in dialysis, disability, ESRD, exercise, kidney, thankful, Transplant, weight loss, weight reduction | Tagged , , , | 6 Comments

Dialysis and Kidney-friendly Snacks

Still an important issue for those who want an ocassional snack without the worry of the chemicals they contain.


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1/15/16 Update – I saw a post on FaceBook that offered a free sample (just pay shipping) from Vida-Fuel.  I would highly recommend you try these snacks! Go to their WebSite to see the offer

Hey everyone!  Sorry for the lack of new material for a while but it’s been a tough year and I just can’t seem to get to my desktop as often.  Sorry for that.  I’ve been working very hard to get this old body in shape, reducing my weight, and earning a few extra bucks with Uber driving.  More about all that later (and I have much to say).  Now it’s about snacking.

If you snack then make it a kidney-friendly snack.  Frankly, I rarely eat any snack foods as they all contain the two dreaded ingredients, Phosphorus and Potassium!  Yuck!  However, here are a couple items that may fill the need and be kidney…

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Community Run Dialysis – Inspirational!

Reblogged. Something to seriously consider even here in the US. We have sonething close. It’s called Dialyspa. Their idea is that the patients come first. Patients over Profits? I wrote anout them in “Dialysis and Dialyspa” in my blog at

Big D and Me

Over the last week, I’ve been working on a new project that involved making a list of all the dialysis units in Australia (more on that soon). In the process, I discovered that all units are either public (free via Medicare) or private (fee charging), except one, which is owned and run by dialysis patients and their families.

Run by patients and families? What the…?

Of course, I had to know more, so I contacted them and discovered firstly that they’ve been around a while and I’m a bit late to this party. But that made finding them even more heartwarming and inspiring.

This community run dialysis service follows a very different model. It is focussed not just on dialysis, but also on the community, on keeping people together. Imagine a place where family and community, culture and country are integral to a happy and fulfilling life. Where people live…

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