The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
I do talk about with a subset of my patients especially these young patients in their forties fifties who buy cysts on C and Korea and maybe even a touch of microbe you man you know their GFR is eighty and I say if you're forty and your GFR is eighty there's a problem if you want to live to be a hundred cuz I don't know where you're gonna be at 80 yeah
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if you are in your 40s but you already have a glomerular filtration rate at 80 percent of what would be predicted you have to fast forward a little bit and say well what's that going to look like when you're 80
if we think that an average life expectancy should be 71 or something and we think that hey we're going to tolerate a person's gfr being in the low 40s when they're in their early 70s that's great but if we're trying to figure out a way to help people live and live well into their 90s or beyond that's that becomes a very unacceptable gfr you're going to run into trouble
so if i'm talking to a 40 year old patient and their gfr is 85 well most people would say that's normal but i want that 40 year old not to live to 80 i want her to live to a hundred which means i can't treat her like a 40 year old i have to treat her like a 20 year old i have to time shift her back to say i need her kidneys to survive another 60 years so based on epidemiologic data i can't treat her as a 40 year old and her gfr of 87 is not good enough i want her gfr to be 107 because i need to know that at a hundred her gfr is still 40.
so based on epidemiologic data i can't treat her as a 40 year old and her gfr of 87 is not good enough i want her gfr to be 107 because i need to know that at a hundred her gfr is still 40.