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Live Longer. Live Better.
Evidence-based strategies for metabolic health, kidney protection, and longevity.
SLEEP IS
MEDICINE
EXERCISE IS
MEDICINE
LOVE IS
MEDICINE
FOOD IS
MEDICINE
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About
Sean Hashmi, MD, MS, FASN, is a board-certified nephrologist and obesity medicine specialist on a mission to make evidence-based health accessible to everyone.
Through his YouTube channel (@SeanHashmiMD)—with over 100,000 subscribers—Dr. Hashmi translates complex medical research into clear, actionable strategies for metabolic health, kidney protection, and longevity.
His approach is built on the SELF Principle: Sleep, Exercise, Love, and Food—the four pillars of lasting health.
Dr. Hashmi founded SELFPrinciple.org as a 501(c)(3) nonprofit to ensure this life-changing information remains free and accessible to all. His mission: help you take control of your health and live longer, healthier, and better.
![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-sea1-1.cdninstagram.com/v/t51.82787-15/570280491_18370520548153103_5803235134891308339_n.jpg?stp=dst-jpg_e35_tt6&_nc_cat=100&ccb=7-5&_nc_sid=18de74&efg=eyJlZmdfdGFnIjoiQ0xJUFMuYmVzdF9pbWFnZV91cmxnZW4uQzMifQ%3D%3D&_nc_ohc=yJhf9IFGCLIQ7kNvwGK4fIC&_nc_oc=AdloJKkpwp0Ol4JJj1RMVVls8DOYBw19ZLj8FmfcOJ8qbK162awlk4ME-MfIoyIArBM&_nc_zt=23&_nc_ht=scontent-sea1-1.cdninstagram.com&edm=ANo9K5cEAAAA&_nc_gid=CSnanr4DGIf9do311DD-oA&_nc_tpa=Q5bMBQH60MgxswOHJJFsGods3p9hMznWKnra84btX2Obl0J-mzAU2GDU2bnUfmPY-sztdBlOE12_jcjn&oh=00_Afvv8LPzafE7QvKVYKfMRZr10gpuopS6yQsAUp6Bgh7lUg&oe=69A6715C)
![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-sea5-1.cdninstagram.com/v/t51.82787-15/525216182_18358496413153103_6475994893361665277_n.jpg?stp=dst-jpg_e35_tt6&_nc_cat=111&ccb=7-5&_nc_sid=18de74&efg=eyJlZmdfdGFnIjoiQ0xJUFMuYmVzdF9pbWFnZV91cmxnZW4uQzMifQ%3D%3D&_nc_ohc=lzmePO5XnAgQ7kNvwGA5BXS&_nc_oc=AdmYWsiv4CHVszkuBPwDYi980VR4c1I9OauEMZQcGA1fnqbD9nMkdkxqrjTeyh3-JOQ&_nc_zt=23&_nc_ht=scontent-sea5-1.cdninstagram.com&edm=ANo9K5cEAAAA&_nc_gid=CSnanr4DGIf9do311DD-oA&_nc_tpa=Q5bMBQFSUgD5RV6mNTQDpCIJ3Tsu74JHgYUhOOkfB-OvJBNk7P-mJOn4Nv5ppoWfdFxJx05EWblyZ-uW&oh=00_AftJDSzhHIa4MH3LNh9eAzkbhHNUJsSKakMtrMBP-j33dA&oe=69A65E83)
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