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A new diagnosis of end stage renal disease can feel like a conveyor belt: a rushed consult, a default clinic, a procedure you didn’t choose. We hit pause and hand you back the controls with three moves that change your trajectory: how to pick a transplant doctor with real outcomes, why cutting meat before your nutritionist visit lightens the load on your kidneys, and when to seek a second opinion without igniting referral turf wars.

We get candid about the forces you don’t see. Hospital call schedules quietly “assign” you a nephrologist. Clinic incentives can delay diet support until you’re already in the chair. Payment changes suddenly boost peritoneal dialysis offerings, even when PD could have fit your life months earlier. That’s why independent research matters: srtr.org for transplant program performance, hospital and university center data for physician experience, and clear questions that test how a doctor will coordinate your path to transplant, not just maintenance.

On the floor, details decide outcomes. Creatinine reflects meat metabolism and strain on failing kidneys. Needle spacing and angle influence clearance more than most patients realize. A skilled technician can recover precious effectiveness that a rushed stick erases. We talk through the art behind “good numbers,” how to ask for transparency in treatment notes, and why educated techs and curious patients make a powerful team. When you understand how incentives, staffing, and technique shape your care, you can spot shortcuts, request alternatives, and push for modality options like peritoneal dialysis that align with your goals and lifestyle.

If you or someone you love is facing dialysis, this conversation is your field guide to smarter choices: compare transplant centers, trim meat while protecting protein intake, and schedule second opinions on your own terms. Subscribe for more unfiltered, practical kidney care insights, share this with someone who needs it, and leave a review to tell us what you want covered next.

With hosts Maurice Carlisle and Ira McAliley

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When facing kidney failure, the difference between feeling powerless and taking control often comes down to knowledge. That's exactly what we're providing in this eye-opening episode where we unveil our new free ebook: "10 Critical Steps to Take After an End-Stage Renal Disease Diagnosis."

The medical system often rushes patients onto dialysis without exploring all options. Maurice shares a shocking revelation: three recent patients he referred for second opinions discovered they didn't actually need immediate dialysis despite being told otherwise. This pattern highlights why seeking a second opinion should be your first move after receiving an ESRD diagnosis—and why you shouldn't ask your current nephrologist for that referral.

We dive deep into the stages of kidney disease and reveal a crucial insight: at Stage 3A (a GFR of around 61%), patients have approximately a 70% chance of avoiding dialysis altogether with proper nutritional intervention. Yet most medical professionals don't intervene until you reach Stage 4 or 5, missing valuable prevention opportunities. This disconnect explains our strong recommendation to consult a nutritionist immediately upon learning of kidney issues.

The conversation takes a concerning turn as we expose troubling practices around dialysis access surgeries. The "Fistula First" mandate often leads to multiple painful surgeries for patients who aren't suitable candidates, particularly elderly individuals or those with diabetes. Even more disturbing, many of these surgeries fail during first-time use, creating traumatic experiences for new dialysis patients.

Whether you're facing kidney disease yourself or supporting a loved one, this episode provides the knowledge needed to navigate the system effectively. Join our Facebook community to download the free ebook and connect with others who understand what you're going through. Remember: you have more control over your dialysis journey than the medical system might lead you to believe.

With hosts Maurice Carlisle and Ira McAliley

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What happens when dedicated dialysis professionals step outside the system they've worked in for decades? A powerful shift in perspective that could change everything about kidney health treatment.

After 35+ years working inside dialysis centers, hosts Maurice Carlisle, Ira McAliley, and special guest Paul Terry have emerged with a revolutionary mission: to help people avoid dialysis altogether rather than simply treat end-stage kidney disease. Their journey has led them to challenging industry standards and advocating for patients in ways they couldn't while employed within the system.

This reunion episode marks a turning point as the trio reveals troubling insights about the profit-driven dialysis industry. From outdated nutritional guidance that may actually harm patients to the resistance they faced when suggesting alternatives, their candid conversation exposes gaps between emerging research and standard clinical practices. Maurice shares how connecting patients with physicians willing to provide second opinions has revealed many people being rushed toward dialysis prematurely.

The most surprising revelation? Simple, accessible remedies that can significantly impact kidney health are rarely discussed with patients. "Baking soda is one of the cheapest medications you can purchase," explains Paul, describing how this common household item can help alkalize blood and potentially improve kidney function - information many nephrologists don't routinely share.

Beyond clinical insights, the episode carries a spiritual undercurrent about divine purpose. These advocates believe their decades inside the system prepared them for their current mission: empowering patients, educating dialysis technicians about their true potential to help, and creating community networks that can be replicated nationwide.

Join us as we explore holistic approaches to kidney disease, challenge conventional wisdom, and work toward a future where fewer patients need dialysis. Connect with the hosts at an upcoming Cincinnati patient symposium in September, and stay tuned for future episodes featuring nutritionists, social workers, and patients sharing alternative perspectives on kidney health.

With hosts Maurice Carlisle and Ira McAliley