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Better Kidneys.
Better Health.
Backed by Science.
SLEEP IS
MEDICINE
EXERCISE IS
MEDICINE
LOVE IS
MEDICINE
FOOD IS
MEDICINE
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About
Sean Hashmi, MD, is a board-certified nephrologist and obesity medicine specialist committed to helping you achieve better kidneys and better health, backed by science. As the creator of the “Sean Hashmi, MD” YouTube channel, he simplifies complex medical topics and shares practical, evidence-based strategies for kidney health, nutrition, and longevity. Dr. Hashmi is also the founder of SELF Principle, a nonprofit that makes science-based health information accessible to all. His mission: empower you to take control of your health and live your best life.
![Stage 5 kidney disease is a medical emergency. Let me explain why as your nephrologist. 🩺
When kidney function (eGFR) drops below 15, you enter what I call the uremic catastrophe. Your kidneys can no longer filter toxins from your blood.
Here's what happens inside the body:
💀 Urea accumulation
→ Nausea, confusion, seizures
⚡ Potassium rises
→ Can cause fatal heart arrhythmias
🦴 Phosphorus buildup
→ Calcifies blood vessels, increases heart attack risk
🔬 Acid accumulation (metabolic acidosis)
→ Destroys bones and muscles
💧 Fluid overload
→ Builds up in lungs, causes breathing crisis
This is uremia. Think of it this way: urine trapped in your blood. All the waste products and fluid that should leave your body through urine are now poisoning your bloodstream.
The timeline: Without dialysis or transplant, this can be fatal in days to weeks. This is NOT something you can manage at home.
🚨 Warning signs requiring immediate ER visit:
- Severe confusion or altered mental status
- Difficulty breathing or chest tightness
- Irregular or racing heartbeat
- Severe nausea/vomiting that won't stop
- Dramatically decreased urination
- Extreme fatigue or weakness.
Treatment options:
- Hemodialysis (at dialysis center, 3x/week)
- Peritoneal dialysis (can be done at home daily)
- Kidney transplant (best long-term option)
Early intervention saves lives. If you're at Stage 3 or 4 kidney disease, work closely with your nephrologist NOW to prepare for Stage 5. Planning ahead makes all the difference.
📚Referrences:
Rout P, Foris L, Katta S, Bashir K. “Uremia.” StatPearls [Internet]. 2024 Mar 29. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441859/
AlSahow A, et al. “Prevalence and management of hyperkalemia in chronic kidney disease or heart failure.” PMC (2023). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9994174/
Costa D, et al. “Hyperkalemia in CKD: narrative review of pathogenesis and prognosis.” Frontiers in Medicine (2023). Available from: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1178140/full](https://scontent-iad3-2.cdninstagram.com/v/t51.82787-15/570280491_18370520548153103_5803235134891308339_n.jpg?stp=dst-jpg_e35_tt6&_nc_cat=100&ccb=1-7&_nc_sid=18de74&efg=eyJlZmdfdGFnIjoiQ0xJUFMuYmVzdF9pbWFnZV91cmxnZW4uQzMifQ%3D%3D&_nc_ohc=D_R2b8vWKwAQ7kNvwGFq4se&_nc_oc=AdmCqb_GcTpe1uqrsA4NBarhZmpt-tKefbVopw3ZhYimPEKxD9ZVZzRRU3yiJM32Mr0&_nc_zt=23&_nc_ht=scontent-iad3-2.cdninstagram.com&edm=ANo9K5cEAAAA&_nc_gid=vNLHa0NBsOtr-NAPaym1eg&oh=00_Afit1ajWVWKhIEVUFTxrEnb_xfNuX8csdp16Ej7qos6PaQ&oe=691FF85C)
![Creatine for Dialysis Patients
WHAT MOST PEOPLE DON'T KNOW:
For years, doctors avoided creatine due to kidney concerns. But new research shows it may actually benefit dialysis patients with muscle wasting and cramps.
THE 2024 BREAKTHROUGH STUDY:
Long-term creatine (5g daily for one year) delivered compelling results:
✅ Increased fat-free mass: 60% vs. 36.8% placebo
✅ Increased muscle mass index: 65% vs. 15.8% placebo
THE PROTOCOL THAT WORKS:
Creatine loading: 20g daily for 5 days, then 5g daily maintenance:
Reduced malnutrition and inflammation scores
Better preserved lean body mass
Improved overall nutritional status
MUSCLE CRAMP RELIEF:
Creatine reduced hemodialysis-associated cramps by 60%—significant since 50% of dialysis patients suffer from these painful cramps.
IMPORTANT: This research applies specifically to dialysis patients under medical supervision.
📚 References:
Muscle Mass and Sarcopenia:
de Looijer, J., et al. (2024). Creatine supplementation increases fat-free mass and muscle strength in hemodialysis patients: a randomized controlled trial. J Cachexia Sarcopenia Muscle, 15(1), 134–142. https://doi.org/10.1002/jcsm.13485
van der Sande, F. M., et al. (2023). Creatine as a therapeutic option in dialysis patients: rationale and pilot studies. Kidney Int Rep, 8(2), 328–336. https://doi.org/10.1016/j.ekir.2022.11.001
Inflammation and Nutritional Status:
Johansen, K. L., & Painter, P. (2011). Exercise in individuals with CKD. Am J Kidney Dis, 59(1), 126–134. https://doi.org/10.1053/j.ajkd.2011.09.021
van Buren, P. N., et al. (2022). Effect of creatine supplementation on inflammation and protein-energy wasting in dialysis patients: a pilot trial. Nephrol Dial Transplant. [In Press]
Muscle Cramp Reduction:
Robinson-Cohen, C., et al. (2021). Creatine supplementation for muscle cramps in hemodialysis patients:
Medical Disclaimer: This content is for educational purposes only. Always consult your nephrology team before starting any supplements, especially on dialysis.
#Dialysis #Creatine #DialysisNutrition #MuscleWasting #KidneyHealth #EvidenceBasedMedicine #Nephrology #DialysisLife #MusclePreservation #DialysisCramps](https://scontent-iad3-2.cdninstagram.com/v/t51.82787-15/525216182_18358496413153103_6475994893361665277_n.jpg?stp=dst-jpg_e35_tt6&_nc_cat=111&ccb=1-7&_nc_sid=18de74&efg=eyJlZmdfdGFnIjoiQ0xJUFMuYmVzdF9pbWFnZV91cmxnZW4uQzMifQ%3D%3D&_nc_ohc=fFudWYBWxW0Q7kNvwHoZG9O&_nc_oc=AdkGyIjRDzJji_p_92qmsisjlsCh2U3M7P7-te1rQqr98pZsdHE0yulQVZ8O0Z6PwxE&_nc_zt=23&_nc_ht=scontent-iad3-2.cdninstagram.com&edm=ANo9K5cEAAAA&_nc_gid=vNLHa0NBsOtr-NAPaym1eg&oh=00_AfgbCPfr08j2MLkqWgJ8sUit-40Y7agwq8uwBolNy75a8A&oe=69201DC3)
![Test Your Kidney Health IQ!
Did you know diabetes is a leading cause of kidney disease? Take this quick quiz to learn how diabetes impacts your kidneys and share your answers in the comments!
Quiz Questions:
1️⃣ What percentage of people with diabetes develop chronic kidney disease (CKD)?
a) 10%
b) 33%
c) 50%
d) 75%
Hint: A 2023 study in Diabetes Care reveals this key stat [1].
2️⃣ Which diabetes-related factor most directly damages kidneys over time?
a) High blood sugar
b) Low insulin levels
c) Weight gain
d) High cholesterol
Hint: It’s what stresses your kidneys’ filters.
References:
Afkarian, M., et al. (2023). "Diabetic Kidney Disease: Prevalence and Progression." Diabetes Care, 46(5), 987–995. “About one-third of individuals with diabetes develop diabetic kidney disease (DKD).”
Ibid. “Persistent hyperglycemia is the primary driver of glomerular injury in diabetic kidney disease.”
#KidneyHealth #DiabetesAwareness #EvidenceBasedMedicine #SeanHashmimd #Nephrology #HealthyKidneys #DiabetesManagement #KidneyDisease #HealthEducation #ScienceBacked #WellnessTips #ChronicKidneyDisease #LiveHealthier](https://scontent-iad3-1.cdninstagram.com/v/t51.75761-15/505445969_18352968046153103_278646673752304901_n.jpg?stp=dst-jpg_e35_tt6&_nc_cat=107&ccb=1-7&_nc_sid=18de74&efg=eyJlZmdfdGFnIjoiQ0FST1VTRUxfSVRFTS5iZXN0X2ltYWdlX3VybGdlbi5DMyJ9&_nc_ohc=TIOfzwub9j8Q7kNvwFhb9jy&_nc_oc=AdkRhxrCou44C5aH4qwrWZXf8c61DIsIrLDJa72Elddub87dMialeS4JJE3IuRrZBQg&_nc_zt=23&_nc_ht=scontent-iad3-1.cdninstagram.com&edm=ANo9K5cEAAAA&_nc_gid=vNLHa0NBsOtr-NAPaym1eg&oh=00_AfjU6lc6ZNnYVY1fN3Di0LNLyzjJwyumuaaZmJf1d-RS3A&oe=69201E9B)
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