Ep 130 - Dr Torres | Fix The Kidneys: The WORST Possible Foods For The Human Body

I'm getting kidney stones. Has I got anything to do with a carnivore diet or eating more protein on meat or anything? Well, I think that it happens is because of the. Dr. Jacob Torres, one of the world's leading voices of kidney health. He's exposing the lies and showing you how to regain control of your kidneys. If things aren't going well in the kidney, then nothing else really works. I'll see him oxalate. These things, they form these little crystals and they jam up the kidney tubules and the inflammatory pathway gets turned on, the kidney's going to be injured. Do you know what is a safe daily oxalate intake for somebody that doesn't have kidney problems? Gram to gram in a half, somewhere in that range. It depends on. There's a high fat diet help with polycystic kidney disease. The experiments I did, yes, there was an improvement in kidney function in the three months that they were on the diets. And then that also was interesting that it correlated with the BHB level. So those who had a deeper ketosis, some better improvements, ketogenic diets are also anti-inflammatory. So anytime you have a anti-inflammatory mechanism, kidneys are going to be much better off. How many people have kidney damage but don't even know it? High blood sugar and insulin resistance protein does high protein destroy the kidneys? This is similar to the cholesterol argument. When we think about health, most of us worry about heart attacks, stroke or even fatty liver disease. But one vital organ that is often overlooked is our kidneys. And shockingly over 35 million Americans have some sort of kidney failure and most don't even know it because the symptoms are silent until it's too late. My guest today is Dr. Jacob Torres. He's a metabolic scientist who has spent decades researching kidney disease and he will share how many so-called healthy foods that we're eating every single day is actually harming not just our kidneys but our entire body and will also dive into groundbreaking new research showing how a high fat diet, yes, high fat can actually protect kidney function and even help reverse kidney damage. So Dr. Torres, my first question. What are the worst so-called healthy foods that we're eating every single day that is damaging our kidneys and also our health? Well, I think that there's a few that come to mind for me immediately and one of the my study at undergrad school was calcium oxalate crystals. Those are these little micro crystals that are formed from compounds of oxalate with some other ion circunemagnesium or calcium. Usually it's calcium though in the body. But these things, they form these little crystals and they jam up the kidney tubules and they kind of occlude the kidney and there's a mechanism that the kidney to remove them. And this is what I was studying in grad school is that it looks like the kidney tubule actually expands in order to let these things through. And in order to do that, they have to activate these pathways that are involved in inflammation. So the inflammatory pathway gets turned on. They kind of dilates the tubule and then the crystal is cleared. But that dilation process, during that time period, the kidney is going to be injured. So the tubule no longer is going to be doing its normal function which is making pulling up water and keeping track of solutes in the blood. And so the function is going to go down during that period of time that there's a crystal there. And so this can be really damaging and these are found commonly in lots of foods. So I'm sure people might be familiar with the almonds, spinach, lots of green vegetables. They're everywhere. They're all over the place and we make them as well. So there is an endogenous production of oxalate. So we can handle some amount of it. We've evolved to handle it. It's not like we have to avoid them at all costs. But excessive oxalate is really the issue there. The other one would be uric acid. I think uric acid is a big issue as well. Some people are familiar with gout as the uric acid crystals that can form in the joints. These also form in the kidneys and they are similarly damaging. But for a different reason and we have another member of my lab who's working on this. And he's been carrying on the work of crystal injury in our lab in the kidneys with PKD. And we find that these are also very damaging. So uric acid comes from things like fructose, for instance, so high sugary drinks or a big source of it. You can also have phosphate crystals, which are things like phosphoric acid. So Coca-Cola is going to say it because it's the main thing. Phosphoric acid and a lot of fructose, which contributes to these crystal formation in the kidney. So those are the big ones. The other big ones are advanced glycation in products. So things that are coming out of heavily fried food. Those are really bad for kidneys. So things like the like the like breaded and fried. Those things can those cause immediate damage like after they make it into the blood because there's receptors that respond to the advanced glycation in product and they cause a similar inflammatory pathway. So anything that triggers inflammation that's going to cause kidney problems, at least transiently or if it's happened over the long term, then you know, but the chronic issue that will definitely do kidney problems. Okay. I do what I mentioned. I've got a list of foods here. So the initial foods that you mentioned foods, high in oxalates that cause oxalic acid, they crystals that go into the tubular of the kidneys. But I think people don't realize how much oxalates are actually in some healthy foods. Spinach. Per, like this is very surprising. Spinach, per 100 grams, it's got 970 milligrams of oxalates. Okay. Armin. So you mentioned almonds, 450 milligrams. And I'm going to mention how much people need to be having as well. Banana butter and peanuts, who doesn't have peanut butter and peanuts? 180 milligrams of oxalates, dark chocolate, many people, 75 to 85% dark chocolate, 120 milligrams of oxalates. So do you know what is the safe daily oxalate intake for somebody that doesn't have kidney problems? It's not that much. If I remember right, it's somewhere around the, like a less than a gram, gram to gram and a half, somewhere in that range, it depends on, you know, how it's the salt. So this is a, there's another consideration of caveat. So there's soluble versus insoluble oxalate. So the, the insoluble stuff is the free oxalate. And that's this thing. It's not bound to anything. So sometimes you might be consuming oxalate in a form that is not, it's going to be excreted rather than absorb. So that can make a difference. The problem is that there's no real way, good way to report that on a, like a, you know, getting a hold of this information is going to be really tricky, like which is the soluble versus the insoluble. And you're going to probably go crazy trying to figure out like how much insoluble oxalate you're consuming versus soluble. So avoidance is easier because it's just total oxalates a way to think about it. But I remember off top of my head, it's, it's somewhere between a, a little bit less than a gram to two grams is the most per day. I remember I did as experiment not that long ago and I was using spinach. Spinach is the way to best way to get a hold of a lot of oxalate. And it is, it, it's about a serving of spinach was about the, you know, the most oxalate you're supposed to get in a day if I remember off top of my head. But that's, that's kind of like a good, you know, it's 100 grams of spinach is a very, like a small little, like a little dish of, of spinach is not that, not that many leaves overall. And if people are familiar with any eat spinach, you know, you kind of get that gritty sensation on the teeth, that's the oxalate binding to the, to the, to the teeth there. So you kind of can already feel that it's a, you know, it's a fact we're just from chewing it. So it's also interesting tea as well. So black tea is also high in oxalates. So it says here 50 to 80 milligrams or in one cup. My mom has five to six cups a day. I have to tell her mom, like that's high in oxalates, don't have it. So as you mentioned, there's a safe daily oxalate intake. So if somebody does have existing kidney problems, should they just be staying away from all of these, these foods? Yeah. I think, you know, avoidance is a good idea, just to lower the burden, the total burden that's possible. As an aside, just if you are consuming like tea, putting milk in your tea is probably a good idea because it binds the calcium will bind to oxalate. And it's significantly a fax of two. If your mom does milk in her tea, I don't know if she does that, that might be one of the reasons people do it. It's interesting that people do these things. First of all, it might not make a lot of sense. But when you think about it, it does bind up a lot of the oxalates. Maybe we'll figure that out a long time ago. Interesting. Okay. So getting back to the oxalates, when somebody ingest these foods and then you have these crystals that form over time. So they go into the kidney, but how are they damaging other parts of the body? What is the pathway that you mentioned earlier? When the concentration is significant, they can precipitate in other parts of the body as well. So the oxalate itself is a mitochondrial poison, so it can affect just energy production in general throughout the body. They also, these crystals can just form in the connective tissue. They can form in different organs. So it's just everybody can have similar exposure. It's just that the kidney has the highest exposure because it concentrates the blood into these tubules. So they precipitate there because the pH and the water and the solute concentration is sufficient to precipitate them. So they're much easier to precipitate. But if you have a high concentration of oxalate in the blood, they could precipitate anywhere. I have a question. group and people say to me, I'm doing carnival and I feel like I'm oxalate dumping and I feel I'm getting crystals coming out of my eyes and crystals all these different things. It could just be that they're moving on to a carnival diet getting fat adapted and then maybe they're excreting toxins from doing their previous diets, not just the oxalates, but it's all these different things that people talk about oxalates. So it's very interesting and the impact on the kidneys. And later on, I want to talk about some easy swaps that people cannot have those foods and other healthy foods when we talk about what to eat. I do want to understand about the kidneys because I think people might not think about their kidneys and their kidney health and are their kidneys failing. Why do you think people should care about their kidneys, not just their heart, brain and their liver? I always find this question funny. It's this because the kidneys are, I do notice that people do not think about kidneys the same way they do other organs. I would argue that all organs are valuable in their own way and probably equally so. I don't know if I'd want to go without any of them at any point. But the kidneys are, I think, they're very well studied, but the way that they're thought about is that, you know, what many, this says a very kind of a concept across science is that we oversimplify the function of the organ and so we kind of just neglect like what it does. And so we kind of tear rank certain organs as being more valuable over others because of their functionality and their, you know, their rated importance are perceived importance. And kidneys are kind of just think about as filtering water. I think they're, you know, they're kind of like the water organ. They kind of don't really, what are they doing really? They're just kind of like sitting there and pumping water or filtering the water. But they're, you know, they're an endocrine organ, you know, that's where the adrenal glands are located. So they are, you know, intimately tied to all of the other processes that are going on the body. You know, there's the, I also study the gut as well. And so the gut and the kidney are intimately related as well. There's a lot of signaling going back and forth between them. So what's happening in the gut and the kidney are constantly talking to one another based on like what's being produced in the, in the gut is affecting the kidney function and vice versa. So it's, I think that the kidney is, is very important. You know, you know, you know, that's why you have two of them. It's so important. You need to have a backup. That in case the other one fails, you have the ability to keep, keep filtering. And it's, it's just a, you know, I think it's a very important organ for just overall health because if things aren't going well in the kidney, then nothing else really works. So I think that's the, that's the other problem. It's, it's, it's also the, a very highly ketogenic organ. I think that people don't know that as well. It is, besides the liver, the, the, the kidney is the other organ that's producing ketones, but it's not producing them in a way that is affecting the systemic circulation. It's kind of, they produce them internally and, and, and kind of keep them there and consume and recycle them. So there are some effects of ketogenic diets that alter the kidney function as well, pretty, pretty drastically. It also can control the serum fatty acid concentration. I think people don't know that about the kidneys because they are a very oxidative organ. And they, if serum concentration of fatty acids goes up, it actually will store a lot of those in lipid droplets to kind of release them back into circulation. So it kind of is a buffer from high serum fatty acids. And it's also one of the reasons why what, you know, you get these diseases like from diabetic kidney disease. It's just when, you know, fatty acids go too high. You start to actually over accumulate these lipid droplets and they can cause a lot of damage. So there's a lot of things that are kind of like go unnoticed. I think that's the thing that is just kind of just tirelessly working away. Well, as I said, I didn't understand the importance of the kidneys and, you know, my stepmom, she actually has PKD, which is polycystic kidney disease. You know, and that's where you have cysts that hang on around the organs. And it's just, you know, terrible if somebody has that, and no doctor would say that you can actually reverse or slow down PKD or any chronic kidney disease with a high fat diet. And that's what we're going to talk about. The evidence around that because that's going to give people hope that no matter what problem they have, even pretending to their kidneys, that there is hope. You mentioned serum fatty acids in the kidneys. What does that mean? So you have fatty acids in, so the serum is the component of the blood that everything else besides the red blood cells and the other blood cells are located in. So it's just kind of the extra stuff has the water and the ions and everything else in it and all the other extra proteins. And the fatty acids are carried in the blood on certain proteins that transport them around. And so they're released during fasting or during, you know, like if you have a high fat diet, that will be also increased. And the kidney kind of can buffer the amount that's in the blood. And so if you're fasting, these lipid droplets will form inside of the kidney because the serum fatty acids go up really quickly. And then the kidney will then hold on to some of them so they can kind of slowly release them and also use them for energy itself. So it has like a dual function. Now as Dr. Torres mentions, our kidneys are incredible at using fat full energy. And we really need to pay attention to all of these toxins, including oxalates that not only destroy our kidneys, but also our entire body. And this conversation extends to other aspects of our health, including the toxins that we put on our skin. Because whatever you put on your skin, penetrate what's called the blood brain barrier. That means it can get into your cells, causing disease. And when I find out about this, that changed everything for me. Because as you know, I have followed a high fat kind of a lifestyle for the past five years. But I still didn't realize I was still exposing my skin to chemicals through my everyday skincare. And I used to use 10 different skincare products. But now I only use one. It's 100% natural chemical-free telebarm. And you might be thinking, "Rena, why would you put talo on your skin?" Well, this has helped my skin so much. It's helped it to stay hydrated. It's improved the skin texture. So I generally have very sensitive acne-prone skin. And this has helped me so much. And that is why I created the primal telebarms as a chemical-free solution for your skin, but also for my skin. Primal telebarms are made from 100% grass-fed grass-finished talo that naturally contains vitamins A, D, E, and K2. So what does that mean for you? Well, you could experience better skin moisturization, hydration, and better skin texture. And the best thing is, there's no nasties, there is no preservatives. It is just pure talo. And I like to use this unscented balm every single day. Just one dollop last meet 24 hours. So if you want to be chemical-free from the inside out, pick up a telebarm. Just head to shop.thepramble.com and get 10% off. Your next order is also a link in the description. I want to ask a big question that people have in the ketogenic carnivore realm, which is about protein. Do high protein, does high protein destroy the kidneys? I don't think so. We did a review on this not that long ago just to kind of get this question, kind of settled in this review article we wrote. We specifically for PKD and triggers for damaging. So a co-author, the first author has paper, Molina Messing. She's a postdoc in our labs. If you're looking for this paper, it's out there. It's called Trigger Warning. So it's on our lab website. But we looked at this topic specifically because it comes up a lot that there's protein is damaged in the kidney. I think the issue is that you get this thing when you have high protein intake on a short duration. It's called transient hyper filtration. So it's a constriction of the arterial lead to the kidney. So the kidney has these filtering mechanism. So it has a glomerulus. And the glomerulus is being fed by the blood supply. And then the glomerulus is the kind of the beginning of the tubule. So we call it the nephron. So it's like the glomerulus. Anyway, it's coming in and you have a certain flow right up from the blood that's coming in to do the pressure that's being pushed on it. And when an advanced kidney disease occurs, you have this hyper filtration that starts to happen where the constriction of the blood vessel forces more blood pressure into the glomerulus. And it causes it to be damaged. So the cells there are sensitive to the pressure and they can become detached from their actual foot process that's holding them in place. And then that is a that's bad. That's a bad that's bad because now the things can now flow through from the blood freely into the nephron. There's no longer being filtered. And so you can kind of start x peeing out like proteins and other things. So they get proton areas, a common symptom of advanced kidney disease because the those foot process that those cells that are holding the glomerulus in place are no longer attached. And so things are coming through and then you can measure that in the urine. And then that's it. That's how they would signal kidney disease. So that call that hyper filtration is the start of that process. So the kidney function looks like it goes up because they're actually pushing stuff like harder through that glomerulus. And when you approach a protein, there is a similar mechanism transiently that occurs where filtration goes up because there's a certain amino acids are responsible for the constriction of the blood vessel. And so they will cause the filtration to go up. That that is why the that observation. This was back in the late 70s, early 80s. This observation was made. And I think even in the paper that it's mentioned and says that this is probably not an issue with kidney function decline. And somehow it became that that would accelerate kidney disease because it looks like the hyper filtration that occurs during advanced kidney disease. So there's no evidence at the time to say that that was going to cause damage. The protein itself was damaging, but because it looks like the hyperfiltration that occurs from the kidney disease, people just made the conclusion that this is similar to the cholesterol argument. Like it's very similar type of story. And so studies since then have looked at moderate to high protein intake and have found that maybe there are examples of long-term high protein that kidney functions maintains the same, but then decline is similar to people who had moderate protein intake. So they were saying it looks like it might be normal function, then it just kind of looks the same later on, but it kind of goes up and it drops down similar to the way it did in normal moderate intake. And this is in longer observational studies. Not like I don't think anybody's actually done the experiment, you know, like a controlled experiment, just that they've observed it. And they're in short-term experiments, it does not look like protein is accelerating kidney disease. Like they'll look at like low protein diets versus moderate or higher protein, and they do not look like they accelerate kidney disease or say spare kidney function with lower protein diet compared to moderate to high protein diets. And so that's kind of, and this is in the, I think they're calling high protein like 1.2 grams per kilogram. I think that's there, to 1.4. I think that's where they're calling high protein. Just be aware that it does not look like it does accelerate kidney disease in that range. Okay, that's very moderate. 1.2 grams per kilo. I mean, I eat like 120 grams of protein a day. And I'm like, yeah, 41 years old, normal, perfect kidney function. So, okay, so basically the protein has no correlation with damaging the kidneys. And then it's that extra filtration that happens, especially on the end stage kidney disease, if somebody has that, they might say, oh, the protein is causing it, but there is no evidence that higher protein in that realm that you were talking about 1.2 kilo, 1.2 grams per kilogram is causing any problem. Is that correct? Yeah, that's what it seems like. You do get, like I said, you do get this hyper filtration that occurs immediately following a high protein intake because of these amino acids, specific amino acids that are associated with the constriction of the arterial, but that's it. Okay, and that's just a normal process. That's a normal, yeah, that's a normal thing, yeah. Okay, so a question for you, if someone's doing a carnival diet or a ketogenic diet, how much protein is safe for them? Because I think people are worried, oh, if I have too much protein, it's going to damage my kidneys, even though you said it doesn't damage them. But how much is the upper limit that they could eat, like, in grams? That I don't know. I don't know what the upper limit is. Humans seem pretty good at assimilating protein. I don't know, it just from, you make a lot of sense evolutionarily that we would consume quite a bit of protein. So we must have mechanisms to deal with large protein intake. I don't know if consistently day after day, if that's the way we're evolved to do it because it seems like we might have large, ballast of protein in a single sitting or a day or two and then maybe don't have food for a few days, like kind of going back and forth. So it kind of plays into the fasting part of the pathways. Maybe you need to rest the kidneys for some period of time or maybe you need to rest the digested track for some period of time in between and then you're going to have ketosis in the mean times, kind of having another effect in there. So I don't know exactly what the day in and day out upper limit is. You can look at bodybuilders. They seem to eat a lot of protein day in and day out and they are alive. I don't know how long I got to look at the longevity studies and then we don't have all that data yet. So that would be one way to think about it. And also without all this, you know, anabolic steroid use, I think that's going to be a confounding factor. I was thinking about the ketogenic and the carnival diets and I think because they have fatty protein and it's the fat that kind of modulates that protein. So it's not the lean protein and as you said that the kidneys itself, if we're talking about protein and the damage on the kidneys, the kidneys really love fat and they behave very well with ketones as they feel as opposed to glucose. So maybe it's the fatty protein which carnivores tend to eat and people want to ketogenic diet tend to eat which is quite good for your health and therefore your kidneys. Would that be plausible? Yeah, there might be some other mechanisms there with the eating the fat at the same time as the protein. I imagine that that's a much different scenario than just consuming a protein shake that just only amino acids or only peptides. I think that's going to be a different effect entirely versus something that has to be digested, broken down into constituents and then assimilated along with fat because fat also is serving as like the co-factors that help it digest as well. So I think that's definitely would play a different role and I think that's one of the problems with all studies is they rarely study whole food or the composition of foods because it's just very difficult to tease apart the like what what is actually going on when you start putting constituents together just increasing your variables. So studies are generally done with only protein shakes. There are a few examples of protein meals where they do like where you know they do a plant protein versus an animal protein. I think there is like one experiment I can think of that was done that way to look at the hyper filtration effect but that's the only time I've ever seen things like that done so I don't know. I don't think that people are having much protein powder. Although is protein powder okay for the kidneys if people are just having one or two of those a day? I don't see why not protein powder would be bad. I like I use way protein because it's just you know bi-available, easily digestible and it's just seems fine. All the studies I've seen doesn't seem like it's going to be a problem. Okay good all right. I don't think people would use protein powder a lot but just a question if it impacts the kidneys doesn't seem that it does. Okay question about kidney stones. Now when people do a carnival diet or ketogenic diet I do see this sometimes in my carnival community where they say I'm getting kidney stones. Has that got anything to do with a carnival diet or eating more protein or meat or anything? Well I think that it happens is because of the the acid load. So the acid base balance is a thing that would be affected by high protein or high fat diets and since they're excluding a lot of animal or you know all the plant products you know you're not getting as much of the alkali. So alkalinity is the is the one of the effects of um so you have always I should say there are different types of stones so just make sure that's clear is that they're depending on the pH so you have high pH you're more likely to form one type of stone versus if the pH is low and the pH I'm talking about is in the nephron itself not the pH of the blood. So the blood pH you know is very tightly regulated so you're not going to affect that by you could eat a lot of protein and or you know a lot of fat doesn't matter what you're doing in the the blood pH will stay very consistent because of the way that it's regulated but in the nephron that's when you have the re-uptake of the you know there's ions that are being reuptate they're they're being kept in the nephron to kind of maintain the acid base balance and then you also have the things like a bicarbonate and citrate that are very important for maintaining the the balance there and so if you are not consuming any alkali that means you're you know you're like your potassium is potassium is a big part of this process so if potassium is not as high then you're going to have a little more acidic pH in the urine that's being produced and then that can cause like oxalate crystals to form so that's the that's what those are generally the main crystal that people run into when they're on ketogenic diet it's oxalate and so it's because of this increase or the decrease in the the nephron pH so the way that people can overcome that is like potassium citrate supplementation you know we we form to accompany a samberber nutrients that makes a we may make a product that's specifically for this reason for PKD because this is one of the issues with PKD so it's called keto citra and we have it's BHB and citrate put together and one of the effects of it is that it helps with alkalinity in the urine to prevent like the formation of these kidney stones and also it has you know BHB which helps the kidneys and that was you know a lot of my research is based off of that I'm sure you're familiar so that's that's the that's kind of the the other way we get around this so even though people are following you know are following ketogenic diet you know we have that I shall also mention we have a ketogenic diet diet intervention called Rennew and so that's also part of our company that we we kind of restarted this program and we we have people supplementing with keto citra on top of the ketogenic intervention to prevent the for the formation of these crystals as well so that's kind of the way that we get around it and we you know we've talked with other our other collaborators in Germany so that they you know we did a ketogenic diet to diet intervention and so we have them you know taking potassium citrate to prevent any negative effects of the when we did study on on PKD and ketogenic diets as well interesting is there any other types of kidney stones so you mentioned the oxalate kidney stones potentially coming from doing a ketogenic diet but any other types of you mentioned is due to the pH type of pH would determine what type of stone it is what's the other types of stones well your acid was the one that I mentioned before that's those are and count and there's also potassium phosphate so phosphate requires a higher pH like a little bit higher than the, I think it's, I was at forget these pH values, but I think it's a little over seven. And then uric acid, I think also requires that more acidic as well. So they're just they, these are, these are kind of the, that's kind of the one of the issues with when you're, you know, taking a lot of these like fruit toast or, you know, a lot phosphoric acid in is that it's going to also lower the pH of the urine. And that's going to help precipitate these stones. Now, as Dr Torres mentions protein does not damage the kidneys. And if you really want to lower inflammation and fix insulin resistance while also protecting your kidneys, you need two things. You need enough protein and you also need enough fat, but you also need to drop the carbohydrates. And some people need to even go zero carb. And with a zero carb diet or what's called a carnipod diet, I've seen hundreds of people reverse chronic health conditions, things like heart failure, diabetes, thyroid issues, and also losing so much weight. And I've got the same results when I went carnivore five years ago. And what I found kept me and my community on track was medical support through carnivore doctors, because I had the same questions as you, well, what about my cholesterol, especially my L. T. O cholesterol, how much protein and fat should I be eating? That's why I created go carnivore. It's an online private community where you can ask any of your questions to your favorite carnivore doctors, including the ones that you see on this podcast. One of the best things about our community are our monthly challenges. We have challenges like our high fat challenge, our dairy free challenge, and our protein challenge. And this is where our members get the best results. So if you want to try carnivore with the medical support, just head to go carnivore.com and try your free 14 day challenge and also get a free meal plan. There's a link in the description. I do want to ask about your work with the high fat diet. So question for you. This is very obvious question, but there's a high fat diet help with polycystic kidney disease. Well, in the preclinical models, so when I the experiments I did, yes, does help. And so we use rat, rat models of the disease and they seem to help and actually reverse the disease, which is something that has been, not ever been, never been demonstrated with diet alone. So that was the, that was the first one. So it does look like it does and do something. We also did a collaboration with the University of Cologne in Germany. So Roman Mueller and it was one of the authors that we work with there. And he he had his group performed the study and they found that after three month intervention, so it was comparing water fast, ketogenic diet versus nothing, they actually saw improvements in kidney function. And when they, there was a further analysis that happened, they, they showed that it was correlated with the actual BHB level that was in the blood. So the greater the BHB level was, they saw better improvement. And they're even with some MRI, they did sell by MRI to look at the kidneys. And there were some examples of reversal of the size of cysts. And so that was not, not enough, there was not enough individuals in the study to make it, you know, convincing that this is like real, but it was, you know, we saw examples of it and it did show that improvements in kidney function over that time period with a biomarker cystetan C. So it did seem like it was doing something. But it's, it was a three month trial. And so we need to do another study and a long term study. And that's where we've been trying to kind of get this, that ball rolling is getting, it's, it's difficult to do these trials and we really want to do a long term study. But we do have some other interventions around the world that are underway as well in one of them in Japan. And that one also looks like it's, you know, the, after three months has similar effects as the, the trial in Germany. And that's using the renew program as the, the ketogenic diet interventions. Yeah. So we're actually just testing the, the program itself and in seeing how that is fair as that. And yeah, that, that seems to be working as well. Just, just by the preliminary data that's come out and that's, that trial is going to be a couple years to, to the finish. So it does look like yes, it does work. But currently there's no evidence according to them, the mainstream medicine. That's what, that's why here. Yeah. So that's what we were speaking about earlier about, is there actual evidence? I mean, you're talking about two studies here. So one in 2019 with animals. So it was rooted, I believe it was. Rodins, is that correct? Yeah. So there was mice and rats in there. The ketogenic diet was in the rats. We did fasting and mice. And we had also had done chloric restriction prior to that that was also effective in slowing the progression. And then that was kind of one of the things we thought maybe beta-adrexiburate was responsible for that because we could see that, you know, these mice, they like to, you give them the food for the calorie restriction, but they eat it all right away. So then they're just fasting for the rest of the time that they're there. So they're actually doing time restricted feeding in addition to their calorie restriction. And so not just calorie restriction, whether like eating it throughout the day. So that was kind of one of the observations we have that said that this is probably through another mechanism than just the chloric restriction. And the ketogenic diet also, there is no chloric restriction. They just are eating relative to their body weight the entire time. So we found that that wasn't the main mechanism. So if this is working at slowing down the progression of PKD polysistic kidney disease or even reversing it in some cases, is it possible that a high fat ketogenic diet can actually protect someone's healthy kidneys? Yeah, I think so. I think that there's a good evidence to suggest that this is, you know, a healthful type of diet that this would be, be kind of beneficial. I did some more more experimentation. So that's what I do. I just do a lot of experiments and I published a couple of papers in the last few years. And one of them found that just we could supplement with BHB alone and get a lot of the benefits that we saw from the time restricted feeding. So we, you know, kind of repeated the time restricted feeding experiments and adult animals before they were only in the young animals. We saw again, reversal of the disease and, you know, kind of the the the kidneys got smaller, the cysts got smaller, the kidney function improved. We saw all those good things and then we just gave them BHB and we saw the same, it's pretty much the same same same thing happened. A lot of the effects just from BHB alone was was sufficient. So it looks like, you know, increasing BHB is good for kidneys in general and even in wild type animals, you can see some kidney function improvement and with using these diets in the BHB alone. So I would say it's probably beneficial overall. Ketogenic diets are also anti-inflammatories. So anytime you have a anti-inflammatory mechanism, kidneys are going to be much better off than otherwise because that seems to be the main thing that takes them down is inflammation and if you need any way you can reduce that, that's going to be beneficial to kidneys. Okay. So we did mention the animal study in 2019, but you did mention there was a human small trial in 2022. So in case people are thinking, well, here you did it in animal studies, no humans as well and it showed the same thing. So I do want to center on this beta hydroxybutyrate. Can you explain what that is and how and how that's different from not different, but ketones ketosis beta hydroxybutyrate? BHB or beta hydroxybutyrate is produced in the liver during fasting normally. So if the carbohydrates are restricted or absent, then over time the insulin levels will drop down and then fatty acids are released from the fat cells. They make it their way to the liver and then the liver starts breaking them down into energy, acylocoe. And as that process continues, acylocoe will elevate to the point when it no longer can kind of keep up with the amount of acylocoe that's present. It'll start converting it into beta hydroxybutyrate. And since the liver cannot consume BHB for energy, it just leaks into the blood supply and then that's where the BHB comes from in the blood for the other organs. And primarily it's for the brain. The brain is the main recipient. Early on other organs can use BHB but as you if you're doing ketosis for a long time, those organs start to use fatty acids more than they do BHB. And so that's where the BHB is this kind of fat derived energy source. So it's an alternative pathway for storing energy or utilizing the energy from fat. I think that's the easiest way to think about it. So we call it a ketone, technically not a ketone because of its structure, but we call it a ketone still because it's comes from acy-- there's acetoacetate and acetone or the other things that are made during ketosis. And so BHB is the primary one we care about because it is the one that's kind of converted to energy and is a good store of it and for the other organs. So that's BHB because I think people have heard of beta hydroxybutyrate, but they automatically think that's ketones, I need to be in ketosis. People will put a lot of value in the blood BHB number, right? So people will measure their BHB and be like, oh, I'm not in ketosis because the BHB is not high in the blood. But that is not the relevant location for where BHB needs to be to do its signaling function. So if you're a person who's doing ketosis, you know, urine ketosis frequently, if you have small elevations in the blood or the serum BHB, that is probably mean-- that means urine ketosis. Like there's still ketogenesis occurring. So say most people are in the, you know, not red readable. So like average person on the street, zero, like they're like, the un-detectable levels of BHB. And then you have like an individual who exercise a lot is pretty healthy, but they're not in ketosis, like a ketogenic diet, they'll be at 0.2, 0.3 BHB. And that's a good sign. That means that the fat metabolism is functional and that you're producing. If you're producing any amount of BHB, that means that stuff's fats turning. Like it's actually, the liver is actually doing work to produce, it's consuming fatty acids. It's not just storing them or nothing's happening, right? You're not actually, you're not burning any fats. So that's a good sign. Then you're in ketosis, you might actually see like 0.6, 0.7. Like, you know, they're like, people will get dismayed because they're not in that one point to one point, like they get really hung up on the number. But then that's probably not the real story. The real story is that the, you know, BHB's getting sucked into tissues, like it's being used up in places. It's so it's actually doing stuff inside the cell, rather than in the blood. It's not doing anything for you in the blood. That's just a pool of BHB. And if it's high all the time, that means that you're not using it. It's just kind of being, it's just sitting in the blood. And so in the kidney, it actually might be very high because the kidney is pulling it in or maybe you're high in the brain because the brain's pulling it in. And so it's the serum concentration is not as high. So if people are getting, you know, the benefits of ketogenic diets and noticing differences, it's likely that you're probably just getting good at using the BHB, rather, you know, you're producing it probably and it's just getting sucked up in different places. That's one interpretation. But it would be hard to say just from the reading alone what the effect is. But if you are getting very, very high BHB because you're trying to like therapeutic intervention, that's gonna be, you know, then you are more concerned with the, getting that number up really high because you're trying to actually do like a therapeutic intervention and you want like saturation to be occurring. So that would be a different interpretation of why you would want that number to be high. - Makes sense, 'cause I always get this question because people think so when they do carnival or ketogenic, it's the main question. I test my ketones, why aren't they high? And therefore I'm not fat burning. That's not to do with the kidneys, but this is just a question that people always have. And as you mentioned, it's not even ketones or ketosis, it's beta hydroxybutyrate. That is the main thing that you're talking about. Okay, I follow up question. People talk about eating more fat like butter to increase their ketones and BHB. Do you think that works? - Probably. I mean, probably getting more fat is probably gonna help with getting the ketones to come up for transiently at least, I would think. If you eat too much, then it doesn't really make a difference. I don't think it's gonna make a difference if you eat too much. 'Cause you only have so much abilities to transport fat into the blood. Fasting is probably the biggest way to increase your BHB though, 'cause you're just, you know, that I think that's the one that is known to increase BHB the most. You know, all the studies I've seen in fasting, they could, you can get up to like five million or BHB after a couple days of fasting. So I think that's probably the most, eating more fat can help, but I don't know if it's gonna like accelerate things, it's just gonna get you substrate. - Okay, interesting. Okay, 'cause I have that question as well around, how high can your ketones or in this case BHB go before it's too high or what is too low? But is five too high of a number in that case for BHB? - I don't know. It's unclear if there's an issue with it because people that have been studied on long, long fasting durations. They, you know, they have this, you know, they have it kind of like escalate over a few days and then they kind of get to like five or six and then it starts to go back down. So it's kind of like that initial ramp up is, you know, you're just making a ton of BHB, but it doesn't seem to have any ill effects. I can, there's probably scenarios where you start to get like 10 million more or 12 million more, you probably start seeing some issues because of just the, there's probably like anything there's an acid-based balance thing that starts to occur. So that's like kind of the danceway, a lot of this associated with ketoacidosis is a big one, but that's in the context of diabetic ketoacidosis where you have just high fatty acids, high BHB, high glucose, like everything's just up 'cause nothing's working. You're just kind of dumping all these different substrates into the blood, trying to get something to work and nothing's working and that leads to a very dangerous acidotic state. So I think there might be some issues with super high levels, but other than that, I don't know how transiently five or six million molars an issue. 'Cause it will, yeah, if you're fasting, it's gonna go back down. I don't think it can maintain that for long periods of time. - Okay, well, Ireland's something new is not about ketosis and ketosis, it's actually about beta hydroxybutyrate. That's the most important thing. Okay, let's talk about other things that can destroy the kidneys as well. High blood sugar and insulin resistance. How does that damage the kidneys? - The insulin resistance part is, I think there's gonna be a lot of extra renal stuff that's affecting it. There are some things in the kidney, I think that have some insulin resistant effects, but the main thing is that you end up with a high glucose environment. And then that has all sorts of negative consequences, just having high glucose around. One of the main things that can happen is this glycation. So the glycation that we mentioned earlier, but the related to the AGE is important, but that's from dietary intake. This is the actual glycation of the cells themselves. So you have this around all cells, they have a thing called the glyco-calix. I don't know if you've ever talked to us before. So it's a kind of a forest of proteins that are on the extracellular side of cells. And then they have these modifications of sugar residues that are along these proteins. And they are very important for signaling from like they recognize self. So for one, like you might have them, a certain code that says this is me. So don't activate the immune system if you see this string of characters on this amino acid or sorry on this protein. And then that's one mechanism they also needed for just docking of certain proteins because they need to recognize the receptors that are there. They have specific glycations on them, or glycosylations, excuse me. The difference between a glycosylation is that is what the cell puts onto the protein as it's being made. But the glycation is the non-inzematic addition of a sugar molecule. So you have these glycosylated proteins, which have all these very specific residues. And then as glucose goes very high, you have just a non-inzematic addition onto these residues as well. And then that will change the code that's on the protein. And so now it no longer functions in the same way. And it actually can damage the cell because now these, it doesn't understand like the extracellular signal that's going on. So it can damage the glyco-K-lex. And then you can also damage the internal machinery of the cell similarly if the glucose cell was go too high. That's more regulated though, like the glucose intracilally is regulated due to the concentration of glucose that's extracellular to the intracellular side. So that is not as big a concern as just the high level of glucose that's being seen on the outside. And so the cells I mentioned earlier that are in the glomerulus. They are called potocytes. They have these little feet. They kind of, they call them the foot process. So they kind of like make the barrier between the blood and the naphron. When they are exposed to high glucose, they become detached. And then that all the causes of the damage from the high glucose in the blood. So those are kind of like the main mechanisms, I would say they're just high glucose persistent, high glucose for over a long period of time. That's probably the main one. - It's interesting with the heart as well in heart attacks. I was speaking to with Dr. Malcolm Kendrick about heart attacks. And he was saying it's the damage to the glyco-K-lex, which protects the arteries. So if you have damage to that, again, high glucose damages that. So I think it's the same across the whole body. High blood sugar, high glucose, eating sugarist off, process foods is gonna damage every organ including the kidneys. So next one, this is interesting. Medications, NSAIDs, which is like ibuprofen. - You know, I don't know the exact mechanism. That's one of the ones that I studied. I know that they do damage the kidneys. That, you know, that's, I don't know the mechanism exactly of how it's damaging, but I know that they do cause, they have metabolites that I think are associated with the injury. So we covered this in our paper as well, but this wasn't my section. So I didn't go deep into the insect. - That's okay. What about PPI's? So that's like next year, if somebody has acid reflux and they take PPI's, is that, like, do you know more about that, how that can damage the kidneys? - I don't know, but I do not know about proton pump inhibitors. I assume that they inhibit the ones in the stomach. They probably also inhibit the ones in the kidney, which I would think is not good. And anytime you have any of these non-selective inhibitors, if they just broadly inhibit any of these particular ion channels, they, you know, that's all the kidney does is, it's a lot of ion channels, spends a lot of energy controlling the sodium and potassium balance, you know, calcium magnesium. And yeah, if you mess with any of those pathways, require those transporters require that protons are part of the exchange. So if you inhibit that, you cannot pump ions across those, across the membrane. So I'd imagine that that would be the mechanism. If I just had to throw a gas at it. - Okay, next one you would know, chronic dehydration, why does that damage the kidneys? - That changes the solid concentration inside of the, the kid, inside of the nephron. So the more dehydrated, an individual is they might have to have more concentrated urine. And so the higher concentration can then allow precipitation of crystals for one. That's like a big one. But any other toxins that might be in there are going to be spent more time being more concentrated in the Neffron himself. So any other thing, it could be lots of other things that are they get filtered through. If the concentration goes up, then it could cause damage. So when we talk about dehydration, so how much water should someone drink per day so that their kidneys are good and their their health is good. You know, and with for PKD, it's higher because of there's a pathway that's relevant to this where it's a vasopressin seems to be a big driver of PKD. And so the kind of counteracting vasopressin is part of the, you know, drinking more water. So that people will consume quite a bit of water per day. I think they're up to like eight liters or something. It's a lot of, you know, they have to, they do drink a lot. Something crazy. It's like a crazy amount of people drink water, just add a little bit of, you know, and then uncomfortable amounts of water. I don't know. It seems like a lot. That's a lot. But the average person like should not drink eight liters of water. No, I think I might be over a saying that, but it's a lot of water that people I've heard people drinking on it. But I don't, there is a recommendation for increased water intake and for PKD. And I personally think that it's, our bodies are very smart. They, you know, they tell us when we're thirsty for a reason. And so it's consuming not just water, but minerals. I think that the minerals are the, are the real, the real thing for the kidneys that they need a lot. Because the, the water count, the water's pretty well controlled in the, in the, by the kidneys, but they need the, they need ions to do it. So the amount of sodium potassium is probably the more relevant factor when it comes to maintaining proper osmotic balance. And so if you drink water, that doesn't mean it's getting into your body. Like it just drink, you could just be drinking water for, you know, water sake. And now you're just going to pee out excess water, but also ions as well. So if you're not consuming sufficient ions, then I don't think it's that, you know, make a difference how much water you drink. It's so, it's really a combination of the two. I don't know what the actual recommendation is. I, I, question all recommendations at this point, like, what's good and what's bad? I don't know if we, there's good data to say, like, what the right amount of water is to drink, drinking to thirst. If people are really in tune with their, their bodies, that's probably the right way to go. And using salt as part of like, and, you know, when they're, when they're, whenever they drink water, if you're to, you know, with some salt, that's probably better than, than not. You know, I like the element that's the end of the, I like to drink those in the morning, have one of, you know, some of the little sachets of that in the morning, because I think, I used to just do sea salt, just put sea salt and lemon, I didn't water and drink that. I thought that was, felt like that was sufficient to get enough ions and, and water in a day. But yeah, depending on your activity, right? If you're, how much you're sweating, how much you're talking, you know, if you leave your mouth open all the time, then you're probably going to need more water. So there's a lot of considerations. Okay, so question for you. I love talking about salt because this full carnivores and people on a ketogenic diet, salt is so important. Do you have a recommendation of how much salt as a minimum, because I know it varies, but as a minimum, how much should they have along with their water? Oh, man. I don't know. The minimum is hard to say, because it's, it's so based off of your activity level. I think that the important part is the ratio, rather than the amount. So if you're consuming a lot of, you know, most of them are consuming way too much sodium. I think just an up processed diet. So highly processed foods are, they have a lot of preservatives that have sodium as the counter ion. And so the ratios get crazy. You were getting like 20 to 1 sodium to potassium or something. I think some absurd amount of of sodium. When they should be, I think, ancestral numbers, I think it's three to one, four to one, you know, sodium potassium. So potassium is, I think, a real, a real big, a big factor here, just that people don't get enough potassium in general. And it's just, especially if you're, you know, if you're eating a regular standard diet, people are just definitely not getting the right amount of potassium in their diet. And that's the, that's one of the main controllers of blood pressure is the potassium. So the kidneys are regulating the blood pressure. And that's why supplementing potassium is so valuable, because it can control the, the blood volume very well. So is the, you know, excess sodium leads to extra more water retention in the blood, because the, it has to dilute the sodium concentration, because you have to keep sodium and potassium at very specific concentrations for everything to work properly. So as sodium goes up, the, the kidney will have to control that by absorbing more water to keep the volume up. And as you drop sodium down, then now you can excrete excess water. And then that will, that will, can, that will bring the blood pressure down. So what you can do that is if you increase potassium, potassium will then cause sodium to be excreted. And then that will bring the, the level down as well. So in order to, to excrete potassium, or sodium, you have to excrete potassium with it. So that's part of the mechanism of like how the, just the pumps work. And so it's why it's just adding potassium to the diet for people that have high blood pressure, brings down their blood pressure, because they just pee out the excess sodium that brings the blood volume back down. So it's a long way of saying, I don't know what the right number is because it's based off of how much potassium you're getting. But you need about, I think four to six grams a day of potassium if I remember off top of my head. And so, you know, you think you can kind of extrapolate, you know, sodium potassium with that, that point, how much you actually need. Okay. Well, that goes into the next section. Before I want to talk about what to eat instead to protect the kidneys and also fix the kidneys is, especially if you have chronic kidney disease, I do want to ask because you have probably seen a lot of people following this ketogenic diet, who have had kidney disease. Have you got any success stories? Yeah. And anecdotally, there's a number of people that are that follow this and seem to be doing quite well. A lot of the PGD world, a stable kidney is good because, you know, it's purported to be, you know, indexed or bull that this is just going to continue to grow and grow and grow and at some point, your kidneys become non-functional and huge and they just have to take them out. So if you can have just a steady no change year after year, that's success. That would be a great treatment if that worked that way. Reverse all is unheard of in the in the field, so that would be also very unusual to see. So in the study for the, you know, the study in Germany, there was an improvement in kidney function in the three months that they were on the diet. So they did see that there was a, you know, people that were on the diet, PGD, they kind of saw a little bit of bump in kidney function. But then that also was interesting that it correlated on a further analysis. They correlated with the BHB level. So those who had a deeper ketosis saw better improvements. And on MRI, there were some examples of people that had a smaller, smaller cyst size after the three months. None of this was statistically, that was statistically significant because it's just the sample. The spread was too large. But it does seem like anecdotally, there's examples. We've had people that have done the renew program that have said that they had either just no change or, you know, decreased rate, which is also relevant as if the rate stops going up as rapidly, then you preserve your kidney function over time. And some people have reported even some cysts getting smaller. So there are a, there are people that have said it, you know, we have some documentation just anecdotally of some of these examples. And I think there's even a case report currently trying to write up on an individual who's had some success doing this protocol. So, you know, I know a few people that have this as well. So I think that it's, I think it's working anecdotally, which is, you know, evidence, but not the kind that needed to make it a widespread recommendation. Well, the conventional approach is what my stepman did that she has PKD. And she actually had to have one of her kidneys taken out because obviously it was overgrowing too much and it was actually failing. And so now she has one kidney and then she had a kidney transplant. But she was on these medications to, I don't know what the medications were, but it was really affecting her immune system. Yes, you have to be on immunosuppressants for the rest of your life. Yeah. So, you know, if somebody can do a kidney diet or your program, even if it can keep the kidney function stable and not progress, that is a big win because if people have ever been around this condition of PKD, it's terrible. It's just something that progresses. The kidney function declines slowly, slowly, slowly because these cysts it's like attaching over the kidney and just grows and it just stops the function. It's just a horrible disease. Yeah, it starts to, well, they start to push onto the other organs as well. So you kind of get a feeling of like just fullness and discomfort because it's just that it's just literally they become so large that they start to crowd out the other organs that are in the stomach. And that part feels uncomfortable. But I have had, also on that note, I have heard people saying that they prevented going on dialysis during the time they were waiting for a transplant. So they had like a two-year period. Like I talked to one person said that they had, you know, they're waiting for a transplant and they were going to have to go on dialysis. They heard about our research. They went on the ketogenic diet and they never had to go into dialysis and then they got their transplant. So even like that seems like a pretty beneficial effect as well, just not having to take that do on dialysis, which sounds, I mean dialysis seems really rough. I would not want to have to go through that. So if you can prevent people from just even that process, that's really good. Or extending the time until they get the transplant, that's a, that also is a beneficial part of it. - So if somebody wants to, not just for their kidneys, but also protect them the health and have good health, what should you eat on a ketogenic diet? - Oh, that's a good question, right? 'Cause it's a big question mark a lot of times I think it comes up like what to eat. I think that, I think you're probably familiar is that there's the, you know, people do keto genoc diets in a, they don't let dirty keto, they don't have to refer that term used before, where you're already technically getting the quantities or the, you know, the amounts of the fats and protein are then correct, but the composition of the diet is still very poor. And so you can always eat poorly. Like there's no endless, there's an endless way that you can do that. So if you know, you can be vegan and just eat Oreos and chips and stuff like that and never have to worry. You know, so ketogenic diets, no different. There's a lot of processed foods, a lot of, you know, not just the, just that you can eat peanut butter, right? You can see peanut butter and all sorts of other things that just are not that great. So I think the main thing is the fat composition should be, be kind of a focus. So the, you know, eating high polyunsaturated fat for keto is not great because it's just, you know, you're going to potentially push things into that pro and flammatory state of the, of the, a famitablism. So getting good amounts of monoinsaturated and good saturated fats as well. I think that's a big part of it. The saturated fats, I'm not really sure about like the amounts of saturated fats. I think it's going to be based off of kind of energy expenditure, like how much you actually are exercising and doing things like that's going to be relevant to how much fat you should be consuming from saturated fats. The monoinsaturated and the polyunsaturated are more relevant because they're like the structural fats. They're, they're going to be used more for the important signaling and, um, and structured function type things. So I would say kind of like prioritizing those over saturated is always, always a good idea. And, you know, eating whole foods, of course, I think is better than anything that's going to be, that's processed. So if you can get a hold of these fats in the forms of actual food, that's much better than having to do it. And I think even better processed, you know, better is minimally processed, but it's still a processed food. So you're kind of extracting the stuff out of the, out of the source was and putting into something that you can transport or keep. But I think that's, that's what I would be my main recommendation is just looking to whole food sources. I'm, you know, everybody, I love avocados. So I think everybody always likes from California. So we, they're quite abundant here. Um, but that's kind of like the go-to for a lot of people who's avocados. Um, but they don't know that like olives, olive oil, um, things like that that are fatty, you know, other fatty, um, fruits that are available. There's, there's a few, not a lot, but there are a few that are, that are available. It's interesting that avocado is a fruit. So like when you said fatty fruit, that's what it means. And then olives as well. Um, so just a point around the butter, because I think many people, they love butter, but as you mentioned, it is a processed fat, meaning that it's not coming in its whole food form. So that it is some processing involved. It's very easy to overeat. And one of our carnival experts, Dr. Sean Baker, does say that lean on the fatty, remnant meats, the whole meats, as you're probably saying, as opposed to just butter, because people, when they think about ketogenic diets, they think, I can just eat a whole lot of butter and light. It's not just that. That is like a accompaniment to the meat. So for example, things like remnant meats, like steak, uh, rib eye, beef, lamb, eggs, salmon. As you said, if you're doing more ketogenic, not just carnival, avocado, olives, even some cheese if people can tolerate, but you're emphasizing maybe mono unsaturated, as well as saturated, staying away from the poly unsaturated. How does that sound? Is that a good summary? Yeah. So there are certain polyenthes. Even there are required polyensaturated fats. I think it's just that people coming from any standard diet will have probably be very high in omega-6 polyensaturated fats. I mean, we have, there are other polyensaturateds that are relevant and very important. It's that the majority of them come in the poly-6 form. So that's the ones I am referencing when I say the poly unsaturated, just because those are, you know, people are usually overdominate in those in there. They're overrepresented in their bodies already. So if you're coming from a diet that was, you know, just eating standard food, you're probably going to argue overrepresented those. The longer you get into ketogenic diets, you'll have to have those. I mean, they'll come along with other things. They're very high in olive oil, for instance, that's a lot of poly-6 as well. So you're going to get them in the diet. So that's why you just have to prioritize them. That's why I say that. Yep. Polyensaturated, so it encompasses omega-3s and sixes. So as you're mentioning, a lot of people can go really high in omega-6s, especially if they have like pita butter. But you really want to prioritize omega-3s. So poly unsaturated, still good, but still, you want to focus on omega-3s. Last question for you. Early warning signs of declining kidney function. What are some warning signs that people can visibly see that could indicate bad kidneys? I think one of them is like edema. So just like on high blood pressure, those are kind of like the early signs of kidney function decline. I think that where high blood pressure, I think, is an obvious one. I think people will be able to tell. But it is a little bit difficult to tell externally that the kidneys aren't working well. Just not, you know, but lethargy is a sign that the kidneys are not functioning well. Just because there's going to be a lot of extra toxins or kind of metabolic waste products that are accumulating in the body. And then that can lead to things like brain fog and kind of lethargy overall. So those would be like symptoms that you might be able to detect before you start to see other symptoms of things going on. But that would be kind of a few of the early ones. Okay. Last question. So I didn't ask you this. Important lab markers that people can know that they have kidney damage. What should they look at on blood test? Okay. If they're doing a kidney function panel, the people are probably familiar with the creatinine is like a marker. I think it's a poor marker because if you consume a lot of protein or if you are very active, that number will be elevated. So it could affect the actual, you know, the true kidney function value. A good one is to stat and see. So if that's something that people are just want to know they're kidney function, so stat and see is the one that they should ask for. That gives you a very good marker for kidney function. In the urine, there is a protein. So protein area is the thing that we'll look for for kidney damage. And albumin. So albumin and neuro, Nuria, those are the two markers of kidney function that it's, you know, actual damage that you'd be looking for. So if you don't see protein, that's good. If you don't see excess albumin, that's good. And then, um, system see is the one for function. Okay. Is there any ranges that people need to know for those like, is it the standard ranges on a blood test? Because it's not like cholesterol, where it's all over the place. The place. These are pretty well defined. These kidney function numbers. So EGFR is the estimated glomerular filtration rate. That's the thing that they use to calculate. That's, that's based off of the, um, the creatinine. That's the number that they usually use. Um, you could just, you can get a similar value from the system. See, and I think if people are above 60, that's, you know, normal to good kidney function. Some people will be in 90 to 100, you know, that just, they can be really high. Um, the, the chronic kidney disease is, um, is measured by the EGFR, like how, what, how high it is. So once you start getting down below 40, then they start to become in the early stages. And then, you know, as you start to get 30, the, the, the stages progress. So, you know, based off of what the kidney function value is on the EGFR. So if you're instilling the normal range, then that's fine. That's probably is, you know, that's all you need to stay at. And that number will kind of fluctuate over time. So you get it as long as you're staying trending in the same range. That's good. Kidney function declines with age. Just be aware that, you know, I don't know how you're going to keep it high forever. It's probably just going to have some level of trail off over time. Um, but preserving it is, is good. I mean, that's the kind of the goal is just to kind of keep that rate of decline from accelerating. Okay. And how many people have kidney damage, but don't even know it? Probably all of us. I all, I imagine that all of us have kidney damage that we could not detect. I would think so. It's such a, it's, it's seeing so much of the environment all day. You know, you might have an exposure to a toxin that you would never know as a, and it makes the kidney be injured. The thing is is that you have a lot of reserve capacity in the kidney. So it, you wouldn't recognize damage right off the bat. Like if something, if you had an insult to the kidney that caused a portion of it to be damaged, it could recover for one. One other option is it might make a scar. So it gets fibiotic kind of closes off that nephron and just becomes fibiotic. And you might not notice it because you have so much reserve capacity built in. Because there's so many redundant nephrons. So, you know, over time, you know, as you go through your life, you're going to have, I don't know how you get away from it. You're just going to be out in the environment. And so things are going to be, you're going to be exposed to toxins. And so it would be hard to say you're not going to have damage. I would, I would find that any adult would, it's going to, if you looked at it like an MRI, you'd probably find some spots, you might find a few cysts, even, even normal people, they get a few cysts, just because that's a function of preserving like the, the, the, it's a, it's a mechanism to preserve the function of the kidney. So the cyst seems like a normal thing that can happen to individuals, if there's an injury, but they, they'll be small. They won't be many of them and they won't get super big. They'll just kind of like, there, it's something that the kidney couldn't get rid of. So it just makes a little cyst around it, keeps it walled off. So if like a bacteria made its way into the kidney, you might have an infection and the, you know, the kidney needs to deal with it. So just, you know, it doesn't have any way to get rid of it. So it walls it off and makes it a cyst around it. That's something that can happen to, from, from kidney injury. Wow. I learned so much from you today about BHB and also about cysts that even healthy kidneys have cysts. Dr. Torres, if somebody wants to find out more from you, where can they find you? Well, they can find me, Dr. Jacob Torres, dot com. That's the, I have all my, all my references and everything. Are there, at least my papers are on there. Also, I mean, the University of California, Santa Barbara in the Wimes lab. So they can always come to our lab page. So that just Wimes lab. It's pretty easy to find. And there's, we have all of, like, a lot more papers from our lab there. And they're also just confined to Santa Barbara nutrients.com. That's our, our company website. And that's where we have keto citra and the renew program and everything else that related to that. So those are all, yeah, all the places you can find me find our research. Perfect. Thank you so much. I'm, I'm really hoping that people can get a lot of information here about kidney health and, you know, the role of a ketodonecti in PKD and your work is incredible. So Dr. Torres, thank you so much. Thank you for having me. Thank you for joining me today. This episode with Dr. Jacob Torres. Now, if you're learning from it and doing these free episodes, please feel free to hit the subscribe button. You can also find me on other social media accounts. I'm on Instagram and on X under the name of the primal podcast. Now, if you love this episode, watch this one next with Dr. Ken Berry. It is all about how to reverse fat-elevated disease and the three tests that every single person needs to know. Finally, thank you for your interest in root cause healing. And I'll see you next week.