Hematuria

[Clay Coker]

84 yo male afib, remote hx prostate ca,s/p  XRT, PSA<.1. Spinal stenosiswith laminectomy/fusion 1992. R foot drop for 15years.   DDD Progressive severe low back pain.  On xarelto 20.  Started Cjc/ipa 5ux 5days.  TB4 15u daily,  bpc 25u qd, kpv oral bid for 2 weeks.  At 2weeks, no pain.  Back seeing patients 3 days weekly. (Family Doctor Has begun to see some “rosy” urine but no gross hematuria. ( Avoided pentosan / selank/semax ) due to anticoagulant effect.   Should I taper/ stop any of  CJC/TB4/BPC/KPV?

[Kristelle Reyes]

Hello doctors @byurthgmail-com @drerikaeshealth-com @drhusaininterlinkedmd-com @drkriswyahoo-com @cpaigepaigemd-com , would love to have your inputs here. Thank you! ?

[Robin Rose]

Clay, my particular focus is early and moderate CKD , the ignored and neglected zone. With bold assumption, I suspect this man has CKD – age and inflammatory circumstances. The thing to realize is kidney is complex and filtration is one role: so very many more which negatively synergizes with other commodities and exacerbates them.  The fragility that’s enhanced in CKD cannot be ignored- the array of inflammatory and mitochondrial shifts is purely senescent with a remarkably small hormetic zone. And hematuria in light of all that fits – any data to support my suppose?

[Clay Coker]

Thanks.
Gfr is about 70.
crp is about 2 or so.
no dm.  3mos of semaglutide for neuroprotection and senolytic effect.

just thinking about potential contra indications if his regimen   Bpc can upregulate Vegf, but with his remote prostate ca, shouldn’t be a problem
, will only do cycles of 3 mos on  TB4 .
Kpv really seems to be a big part of his pain relief   .   He has had basal cell ca , but I don’t believe it is contraindicated despite stimulating the a MeSH pathway

 

 

[Bruce Sloane]

Urologist here: Remember the basics-work up his hematuria as he is at increased risk of secondary malignancy having had XRT.

 

[Clay Coker]

Thanks.  Recent ct due to renal stones and clean cystoscope with stone extraction.

[Robin Rose]

Clay in my work a GFR70 is not normal – the enhancement of comorbids by this degree of kidney deficit (it is only 58% function after all) is a profound portal with then uniquely corrupted signals transports and in an elder a relentless production of inflams. Gut and nutrient assess. With a Renology eye. I’m all ears learning the fine tuning with peptides for this inordinately neglected facet of the bigger picture. Thanks for your thoughts.

[Kristelle Reyes]

Hello, @clay_cokeryahoo-com !

Here’s another response from Dr. Seeds’ SSRP Office Hours 7/13/21 at 41:02, please watch below:

Thank you! 🙂

[Kristelle Reyes]

Claim your CME here: https://earnc.me/OVyBHN

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