A whole year had passed since my last lab tests so I've subjected myself to another round of needles and blood and urine collection.

The good news is that nothing much has changed. My current blood creatinine level, the most common marker of kidney function, is 2.1mg/dL. The lowest reading I've had was 1.8mg/dL while the highest reading was 2.4mg/dL. The doctors say that a significant change is 1mg/dL, so probably my kidney function is about the same as when I was first diagnosed four years ago. This is pretty good because I've seen some progression graphs that show people going from my level to failure in around seven years!

Creatinine clearance is a supposedly more accurate measure of kidney function, as it directly measures how much creatinine gets filtered out of your blood and into your urine, but my results have been quite variable. My best result as been 52ml/min (which corresponds to around 50% of normal kidney function) and my worst has been 33ml/min (about 30% of normal). My current result was 37ml/min.

The amount of protein in the urine is also around the same as previous readings: 815mg in 24 hours. 300mg is the upper "normal" limit. The lowest I've had is around 335mg and the highest 1485mg.

One interesting change was an increase hemoglobin to 14g/dL, which takes me out of the anaemic range (less than 13g) for pretty much the first time. Not sure what caused that. Possibly increased cacao, bean and cabbage consumption (I've been experimenting with homemade fermented cabbage) which contain iron.

My current thinking on surviving chronic kidney disease
Current medical opinion is that damaged kidneys can't be repaired and their function worsens over time. I haven't, unfortunately, found any evidence to contradict the essence of this opinion but there does seem to be evidence that the decline in kidney function can be slowed (or even stopped) by adopting healthy lifestyle habits, which to me mean:

• Avoid all refined sugar and salt. Apart from being bad in themselves, I believe these ingredients trick your body into thinking what you're eating is more nutricious than it really is.
• Limit the amount of starchy foods you eat. Supposedly these turn into sugar pretty quickly in your body which may be a problem if you have excess body fat or at risk of diabetes.
• Eat mostly plants. Here is a very entertaining and informative presentation about the reduction in health risks that vegans apparently enjoy.
• Experiment with your diet to find out if any foods seem to have negative effects on your well-being, e.g. milk, wheat, coffee, etc.
• Do enough exercise to keep yourself in shape. High intensity training is in fashion right now and has the advantage that it doesn't take much time out of your day.
• Learn to be happy. Figure out what makes you happy and do more of that. If you really think about it, you'll probably find that nothing else matters too much. On the subject of happiness, I found The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom to be a very interesting analysis of ancient wisdom from the viewpoint of current psychology research.

I'm going to try and take even better care of myself for the next year and see what happens!