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Jonathan Pollack @jonathanpollack.bsky.social · 14h

How does that define "unhealthy" vs. healthy? #NephJC

Jonathan Pollack @jonathanpollack.bsky.social · 14h

Would have been better to not go through that, though. It's hard enough maintaining a good plant-based diet, adding protein restriction was brutal. #NephJC

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Jonathan Pollack @jonathanpollack.bsky.social · 14h

At my next appointment, I shared my challenges and my nephrologist admitted protein restriction was stupid, especially on a plant-based diet, and that ended daily protein restriction. #NephJC

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Jonathan Pollack @jonathanpollack.bsky.social · 14h

I said I was lurking but I'll chime in here. I switched to a plant-based diet and was told to restrict protein (<0.6g/kg/day) after diagnosis and I'm very compliant when my health is on the line. I lost weight very rapidly and was constantly starving. I opted out of social opportunities. #NephJC

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Jonathan Pollack @jonathanpollack.bsky.social · 14h

Here I am! I switched to a plant-based diet immediately upon diagnosis in Jan 2025. Happy to chime in upon request.

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Jonathan Pollack @jonathanpollack.bsky.social · 14h

Jonathan Pollack from St. Louis, MO. IgAN patient with my own thoughts about intermittent protein restriction, but lurking tonight. No COI. #NephJC

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Jonathan Pollack @jonathanpollack.bsky.social · 1d

Showing my work:

Ye et al., Mol Cell, 2015; Wolfson et al., Science 2016; Saxton et al., Nat Struct Mol Biol 2016; Kogot-Levin et al., KI Reports 2020; Chen et al., PLoS One 2012; Kim et al., Int J Mol Sci. 2024; Wang & Mitch 2011; Cooke et al., FASEB J 2018

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Jonathan Pollack @jonathanpollack.bsky.social · 1d

For those following along, my theory on intermittent protein restriction is:

intermittent protein restriction → AA-scarcity → ↓mTORC1 → ↓TGF-β/SMAD → ↓collagen → ↓fibrosis

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Jonathan Pollack @jonathanpollack.bsky.social · 1d

Hope this covers protein restriction at various stages of CKD as well! Should be interesting regardless. (I'm pro investigating intermittent protein restriction → possible mTORC1 suppression.)

Nephrology Journal Club @nephjc.bsky.social · 2d

🗓️Join us 10/14/25 as we discuss:
Are you team PRO protein 💪 or team RESTRICT protein 🥗
The strategies seem to shift somewhat as CKD progresses to ESRD. What's the evidence say 🤔?
🕰️9pm EST only on Bluesky. #NephSky #MedSky
www.nephjc.com/news/proteins-eskd

The Protein Pendulum in CKD: supplement or restrict? — NephJC

This week, we will discuss an old dilemma in nephrology. To restrict or supplement the proteins? Premise: advanced CKD and dialysis.

www.nephjc.com

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Jonathan Pollack @jonathanpollack.bsky.social · 1d

So you would advocate saying it a dozen times in a short conversation even if you've established that's the topic? Surely "EYE-gan" is a useful abbreviation? Or "the disease" if you hate that abbreviation?

Jonathan Pollack @jonathanpollack.bsky.social · 2d

Not a hill I'm willing to die on, but it's a mouthful and (as I said in response to this) I generally switch to "EYE-gan" after I've used the full clinical term when talking to people, lay or professional. I see it as a win if somebody can remember my condition enough to go look it up after we talk.

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Jonathan Pollack @jonathanpollack.bsky.social · 3d

As a patient with the disease, I tend to call it "Eye-GAN" as an abbreviation after I've called it "I-G-A nephropathy" in a conversation. Abbreviations are a good thing. But in truth, I don't care what anyone calls it as long as work is done to modify it and/or repair/regenerate my kidneys.

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Jonathan Pollack @jonathanpollack.bsky.social · 5d

Best line IMO: "In a testament to The Goopies’ charisma, the audience howled like stray dogs until they left the stage, no questions asked."

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Jonathan Pollack @jonathanpollack.bsky.social · 5d

There's so much technological waste everywhere, mostly in my basement. I have stacks upon stacks of old hard drives dating back to 1990.

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Jonathan Pollack @jonathanpollack.bsky.social · 6d

Licensing becomes an issue.

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Jonathan Pollack @jonathanpollack.bsky.social · 6d

I wrote myself up as a case report and did just that per your recommendation. Here's hoping Detective Nephron will see it.

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Jonathan Pollack @jonathanpollack.bsky.social · 6d

How can I get in touch with Detective Nephron? Is there a searchlight? A secret handshake? A code word?

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Jonathan Pollack @jonathanpollack.bsky.social · 6d

KDIGO IgAN suggests flozination with eGFR 20-45 even with low UACR. What's the current opinion on -flozins, and what kind of real-world eGFR dips do nephrologists see with them, if any?

Jonathan Pollack @jonathanpollack.bsky.social · 8d

Guess I'll stick with my AAR and you can keep the retatrutide. I wish there were more non-pharmacological trials to see about modifying established fibrosis instead of new injury. There's a lot of evidence pointing different places, but nothing solid.

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Jonathan Pollack @jonathanpollack.bsky.social · 8d

LLM says membranous nephropathy. How'd it do?

Jonathan Pollack @jonathanpollack.bsky.social · 8d

It's still in CKD trials, right? Do we know the effect on normotensive people with normal BMI, no T2D, etc.?

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Jonathan Pollack @jonathanpollack.bsky.social · 8d

Sounds like a great miracle drug to add on as part of an untrialed multi-target therapy that could potentially kill me! Not sure if my UPCR (I don't have UACR tested) can get much lower or even if eGFR can improve, but I am doing all I can to avoid dialysis & transplantation.

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Jonathan Pollack @jonathanpollack.bsky.social · 8d

I'm a patient doing a fully plant-based diet with intermittent amino acid restriction (i.e. low-protein days) to try to modulate mTOR activity and autophagy signaling - aiming to reduce renal fibrosis and support tubular repair. Phew. And I do love my protein days, especially peanut butter days.

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Jonathan Pollack @jonathanpollack.bsky.social · 8d

Great that KDIGO recommends it, then! I mean, it's working for me, so...

Jonathan Pollack @jonathanpollack.bsky.social · 8d

Is there a list of multi-target therapies that have been trialed?

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