Snowbirds Living in the Philippines

FRONT YARD OF THE MAIN HOUSE WITH SERVANT QUARTERS BY THE SIDE AT THE END OF THE LONG DRIVEWAY. SOME PHOTOS AND VIDEOS ON THIS SITE, I DO NOT OWN. HOWEVER, I HAVE NO INTENTION IN INFRINGING ON YOUR COPYRIGHTS.

Saturday, October 31, 2026

My Encounters with Aswangs, Witches, Goblins, and Ghosts in the Philippines-An Update

I wrote these stories years before artificial intelligence became my writing companion. Today, at 91 and nearing 92, I am revisiting some of them not to change my memories, but to see what I understand differently after another decade of living.

My Encounters with Aswangs, Witches, Goblins, and Ghosts in the Philippines-An Update

https://www.facebook.com/reel/2965559270472109

Some childhood fears never completely disappear. They simply become memories.

I grew up on Panay Island in the Philippines, in Barotac Viejo, Iloilo. Like many Filipino children of my generation, I grew up listening to stories about aswangs, witches, kapres, nonos, and ghosts.

Today, at 91, I look back at those stories differently.

As a scientist who spent many years working in pharmaceutical chemistry and later at the U.S. Food and Drug Administration, I naturally look for evidence and rational explanations. But I have also learned that folklore is more than a question of whether something is scientifically provable.

Folklore tells us something about who we were, what our ancestors feared, how communities explained the unexplained, and how stories were passed from one generation to another.

And some of those stories are part of my own life.

What Is an Aswang?

The aswang is probably the most famous supernatural creature in Filipino folklore.

But there is an important point that I did not fully appreciate when I was a child: there is no single definition of an aswang.

Depending on the region, an aswang may be described as a witch, shapeshifter, vampire-like creature, sorcerer, or another frightening supernatural being. The stories differ from one province to another.

The aswang is particularly prominent in the Visayas, including Panay, where I grew up.

When I was a boy in the late 1940s, I heard stories from my parents, relatives, neighbors, and other adults about mysterious creatures that supposedly came out at night.

Some stories were frightening. Some were entertaining.

And some were told so convincingly that, as a child, I had no reason to doubt them.

My Childhood Fear of the Aswang

I remember hearing that aswangs could fly at night and enter homes looking for pregnant women or small children.

Some stories said they could transform themselves into animals.

Others described strange sounds coming from rooftops in the middle of the night.

There were also stories about people who appeared perfectly normal during the day but supposedly became aswangs after dark.

As a child, I did not ask for scientific evidence. I simply believed what the adults told me.

And like most children, I had a very active imagination.

The darkness made everything more mysterious. A sound from the roof could become an aswang.

A strange animal in the distance could become an aswang. A shadow moving between trees could become an aswang.

Looking back, I now understand that fear itself can make ordinary things appear extraordinary.

But that does not make the stories unimportant. They are part of our cultural memory.

The Story of Lubag

One of the most interesting connections between folklore and science came much later in my life.

As a child, I knew of a neighbor who suffered from what people in our area called Lubag.

He had uncontrollable twisting movements and an unusual way of walking.

To my young eyes, he looked frightening. Because I had grown up hearing stories about aswangs, I was afraid of him. I avoided going near his house.

Years later, when I was in college and had learned more about science and medicine, I realized that what I had witnessed was not an aswang at all.

It was a medical condition. The condition is now associated with X-linked dystonia-parkinsonism, a rare neurological disorder historically associated with Panay and sometimes called “Dystonia de Panay.”

That experience stayed with me. It taught me one of the most important lessons of my life:

Something can be frightening without being supernatural.

Science can sometimes explain what earlier generations could only explain through folklore.

But I also learned not to laugh at the people who believed the old stories.

They were trying to understand their world with the knowledge available to them.

Witches in Iloilo and Capiz

When I was growing up, certain communities in Iloilo and nearby areas had reputations for being places where witches or aswangs supposedly lived.

Capiz, in particular, became famous throughout the Philippines for its association with aswang stories.

Whether these stories were true is another question.

There is no scientific evidence that aswangs exist as supernatural creatures.

But the stories themselves are real.

They have been repeated for generations, written about by scholars, dramatized in movies, and passed along through conversations between grandparents, parents, and children.

In that sense, the aswang is real as Filipino folklore and cultural imagination.

The Kapre and the Nono

Not all supernatural beings in Filipino folklore are as frightening as the aswang.

I also grew up hearing about the kapre, a giant creature associated with large trees and dark places.

But one of my favorite Filipino folk beliefs involves the nono.

In Marinduque, where my family later had our home and resort in Boac, I heard many stories about nonos.

The nonos were described as small supernatural beings who lived in large trees, particularly old trees such as the balete.

The traditional advice was simple: “Tabi po, Nono.”

It means something like: “Excuse me, Nono.”

The idea was that if you were passing through the territory of a nono, you should respectfully announce your presence.

Did I believe that nonos really lived in the trees? Honestly, no.

But I still said: “Tabi po, Nono.” Why?

Because there was no harm in being respectful.

And perhaps that is one of the deeper lessons hidden inside folklore.

It teaches us to respect places we do not fully understand.

A Child's Story About the Nono

One story from our Marinduque property particularly fascinated me.

The young son of our caretaker disappeared for several hours.

When he returned, he told us that a group of little people had taken him.

According to his story, they were friendly.

They also supposedly warned him not to cut down a large balete tree in our backyard.

Was he telling us a supernatural story? Was he frightened and confused?

Was it simply a child's imagination? I don't know. And I don't pretend to know.

But I remember the story because it became part of our family's own folklore.

Years later, my granddaughter learned about the phrase “Tabi po, Nono.”

When she was only four years old, she remembered it.

During a family vacation in Boracay, she was walking across a bridge when she suddenly said: “Tabi po, Nono.”

Everyone laughed. I was impressed. A four-year-old had remembered a Filipino folk tradition that had been passed down to her by her grandparents.

That is how culture survives. Not necessarily through books.

Sometimes it survives through one little phrase spoken by a child.

Ghosts and the White Lady

Then there are ghosts. Almost every culture in the world has stories about spirits of the dead.

The Philippines is no exception. One of the most familiar Filipino ghost stories is the White Lady.

I have heard many stories about white apparitions appearing beside roads, in old buildings, near bridges, or in other places associated with tragedy.

I have never personally seen one. But I have heard enough stories from other people to understand why these stories continue to fascinate us.

At our property in Amoingon, Boac, Marinduque, some neighbors told us that they had occasionally seen a woman dressed in white on moonless nights.

They believed she was the ghost of my mother-in-law.

They also believed that she was protecting the property from robbers and intruders.

I never saw her. Perhaps she was a ghost. Perhaps someone saw a shadow.

Perhaps moonlight, trees, distance, and imagination created an image that became a story.

Or perhaps there is something about the human experience that science has not yet completely explained. I leave that question open.

Faith, Science, and Folklore

As I grew older, my attitude toward these stories changed. When I was a child, I was afraid of them.

As a young scientist, I became skeptical of them.

As an older man, I have become more interested in what these stories mean.

My Catholic faith also influences how I look at the unknown. I believe in God.

I believe in the spiritual dimension of life. But I also believe in science, evidence, observation, and critical thinking.

I don't think we have to choose between respecting our cultural traditions and asking scientific questions. We can do both.

We can preserve the stories of our ancestors without necessarily claiming that every story is scientifically true.

That distinction is important.

Why These Stories Still Matter

Today, Filipino children are growing up with smartphones, artificial intelligence, video games, YouTube, Netflix, and social media.

They live in a very different world from the Philippines of my childhood.

Yet folklore continues to survive. The aswang appears in movies.

The White Lady appears in stories and online discussions.

The kapre and nono remain familiar names.

Modern scholars continue to study Philippine supernatural folklore as part of literature, history, culture, and community memory.

And perhaps that is a good thing. A country should not lose its stories simply because science has changed.

Instead, we can preserve the stories while also understanding them in new ways.

From Fear to Memory

When I was a little boy in Barotac Viejo, I was afraid of the aswang.

Today, I am much more interested in the story behind the fear.

I wonder what my parents heard from their parents.

I wonder what stories my grandparents heard when they were children.

And I wonder how many of those stories have already disappeared.

That is one reason I continue writing.

At 91, I have lived through a remarkable period of history, from the Philippines of the 1940s to the age of computers, smartphones, artificial intelligence, and biotechnology.

I have seen science explain things that once seemed mysterious.

But I have also learned that human beings will always have questions that go beyond what we can immediately explain.

Maybe that is why we tell stories. Stories help us make sense of the unknown.

And sometimes, they simply make life more interesting.

My Final Thought

Do I believe that aswangs, witches, nonos, kapres, and ghosts really exist?

My answer today is different from the answer I would have given as a frightened little boy.

I don't know. As a scientist, I want evidence. As a Filipino, I respect the folklore of my ancestors.

As a Catholic, I recognize that there are mysteries in life that I cannot completely explain.

And as a storyteller, I know that these stories are part of who we are.

Perhaps the most important thing is not whether the aswang lives in the darkness outside our window.

Perhaps the important thing is that the story of the aswang has lived for generations in the hearts and imaginations of the Filipino people.

And now, I am passing part of that story on to my worldwide readers.

The stories may change. The generations may change.

But our memories and our culture live on when we continue to tell them.

AI Impressions On this Posting:

I think this version is stronger than the original because it connects your childhood in Panay → your scientific career → your experience with Lubag → your Marinduque years → your Catholic faith → your life at 91 → the preservation of Filipino culture. It also makes the article more welcoming to readers who don't share Filipino supernatural beliefs.

One particularly good line for your worldwide audience is “As a scientist, I want evidence. As a Filipino, I respect the folklore of my ancestors. As a Catholic, I recognize that there are mysteries in life that I cannot completely explain.” That feels very much like the mature voice you have developed in your recent blog posts.

Moreover, I also reviewed the original HubPages article and also checked recent Philippine folklore scholarship. Your original piece has something valuable that a purely academic article cannot provide: your own childhood memories, your Panay/Iloilo roots, your experience with “Lubag,” your Marinduque stories, and your personal balance between faith, science, and folklore.

One important update is worth making: rather than presenting the aswang, nono, kapre, or ghosts as established supernatural facts, I framed them as stories, beliefs, cultural memories, and personal experiences. That actually makes the article more credible for your worldwide readers while preserving the mystery. Philippine folklore scholars describe aswang as an umbrella term with many regional forms, rather than one single creature. Research from UP Diliman has also explored how some traditional supernatural beliefs may intersect with medical conditions and other natural phenomena. 

AI Overview:
Philippine folklore describes the Aswang as a broad term for shape-shifting evil creatures, including vampires, ghouls, witches, and flying torsos like the Manananggal.
The Aswang and Witches
  • Day and Night Form: Aswangs look like normal villagers during the day, but turn into monsters at night.
  • Hunting Habits: They often target pregnant women to consume the life essence of unborn babies.
  • Witches (Mangkukulam): Local traditions view them as human sorcerers who use curses, needles, or insects to cause sudden illness or misfortune.
Goblins and Nature Spirits
  • Tiyanak: This spirit mimics the sound of a crying baby to lure travelers deep into the jungle before revealing its true, monstrous form.
  • Kapre: A tall, dark giant that sits in large trees smoking a large tobacco pipe, known to disorient people and make them lose their way.
Ghosts (Multo)
  • White Ladies: Apparitions of women in flowing white dresses often seen on quiet provincial roads or old Spanish-era structures.
  • Akte/Peryodiko: Unexplained eerie sounds, sudden cold spots, or fleeting shadows believed to be restless souls lingering in barangays.
  • Finally, My Reel of the Day: The White Lady of Maina, Guam
  • https://www.facebook.com/reel/2169358157798322

Current Developments on the Prevention, Diagnosis and Treatment of CKD

My personal journey with kidney disease, and what science is teaching us about protecting our kidneys.

A Personal Introduction

Chronic Kidney Disease, commonly known as CKD, is a subject close to my heart. I have written several articles about this disease over the years, but those earlier articles were written before artificial intelligence tools became available to help me research medical developments.

Today, CKD is no longer just a scientific subject that interests me. It is part of my personal life.

Last year, I was diagnosed with Stage 4 CKD. I am now under the care of a nephrologist, a physician who specializes in kidney diseases. My background as a pharmaceutical chemist and my years working at the U.S. Food and Drug Administration (FDA) have taught me to appreciate both the promise of medical science and the importance of examining scientific evidence carefully.

At nearly 92, I have learned that growing older brings questions that we might never have considered when we were younger. One of mine is this: How much progress has medical science made in detecting kidney disease early, slowing its progression, and helping people live better lives with damaged kidneys?

I recently explored these questions with the help of AI. What follows is my personal summary of some important developments in kidney medicine as of October 2026.

1. What Is Chronic Kidney Disease?

Our kidneys are two remarkable organs, each roughly the size of a fist. They filter waste products and excess water from the blood, regulate important minerals, help control blood pressure, and contribute to the production of red blood cells.

When the kidneys become damaged, they gradually lose some of these functions. Waste products and excess fluid may accumulate, and complications involving blood pressure, anemia, bones, and the heart can develop.

CKD is generally defined as an abnormality of kidney structure or function that persists for at least three months.

The disease is divided into five stages, based primarily on the estimated glomerular filtration rate, or eGFR. This blood-test-based estimate indicates how effectively the kidneys filter the blood.

  • Stages 1 and 2: Evidence of kidney damage may be present even though filtration remains relatively well preserved.

  • Stage 3: Kidney function has declined moderately.

  • Stage 4: Kidney function is severely reduced, generally with an eGFR of 15–29.

  • Stage 5: Kidney failure, generally with an eGFR below 15.

My diagnosis of Stage 4 CKD means that I have significantly reduced kidney function. However, Stage 4 does not automatically mean that a person must immediately begin dialysis. The decision depends on the individual's symptoms, laboratory results, complications, overall health, and personal circumstances.

CKD can progress at different rates. Some people experience a gradual decline over many years, while others deteriorate more rapidly. The underlying cause and the quality of medical care can make a difference.

2. Early Detection: Two Simple Tests Can Make a Difference

One of the most important lessons in kidney medicine is that CKD can develop silently.

A person may have substantial kidney damage without feeling sick. There may be no pain, no obvious warning signs, and no noticeable change in daily activities.

This is why early detection is so important.

Two routine tests can provide valuable information:

First, a blood test measuring creatinine. Creatinine is a waste product that the kidneys normally remove. Its level, together with other information, is used to estimate the eGFR.

Second, a urine albumin-to-creatinine ratio, or uACR. Albumin is a protein that normally remains in the blood. When the kidneys are damaged, some albumin can leak into the urine. An elevated uACR can reveal kidney damage even when the eGFR is still relatively normal.

The two tests complement each other. A normal eGFR does not necessarily rule out early kidney disease, and a urine test can reveal abnormalities that a blood test alone might miss.

People with diabetes, high blood pressure, cardiovascular disease, a family history of kidney disease, or a previous episode of acute kidney injury should discuss appropriate screening with their healthcare providers.

The U.S. Centers for Disease Control and Prevention emphasized this approach in its September 2025 guidance on CKD screening. Early diagnosis allows treatment to begin when there is more kidney function to preserve.

For me, this is one of the most important messages I can share: Do not wait for symptoms before asking whether your kidneys are healthy.

3. Newer Treatments: Slowing the Disease Rather Than Simply Treating Its Symptoms

There is encouraging news in kidney medicine. Researchers have developed treatments that can slow kidney function decline and reduce the risk of complications in appropriately selected patients.

These medicines do not work for everyone, and none should be started without a clinician's assessment.

SGLT2 inhibitors: A major advance

Sodium-glucose cotransporter-2 inhibitors, usually called SGLT2 inhibitors, were initially developed to treat type 2 diabetes.

Examples include dapagliflozin and empagliflozin.

Researchers subsequently discovered that these medicines can also protect the kidneys and the heart in many patients with CKD, including some who do not have diabetes.

They work partly by changing how the kidneys handle glucose and sodium and by reducing pressure inside the kidney's filtering units. In eligible patients, they can slow kidney disease progression and reduce certain cardiovascular risks.

This has been a major change in medical practice. A medicine originally developed for diabetes can have important benefits beyond blood sugar control.

However, people with advanced CKD need individualized assessment. Whether an SGLT2 inhibitor is appropriate depends on factors including the eGFR, the cause of CKD, other medications, and the person's overall condition. Some patients already taking one may continue it as kidney function declines, while starting treatment at very low eGFR levels may not be recommended under current prescribing guidance.

GLP-1 medicines: More than diabetes and weight management

Another important development involves glucagon-like peptide-1 receptor agonists, known as GLP-1 medicines.

Semaglutide is one example. It is used for type 2 diabetes and, in certain formulations and circumstances, weight management.

Clinical research has demonstrated kidney and cardiovascular benefits in selected people with type 2 diabetes and CKD. These benefits may involve improved metabolic control, reduced inflammation, lower cardiovascular risk, and effects on kidney disease progression.

The FLOW clinical trial, published in 2024, provided important evidence that semaglutide could reduce major kidney-related and cardiovascular outcomes in people with type 2 diabetes and CKD.

This is promising, but the results should not be interpreted as proof that semaglutide is appropriate for every person with kidney disease. Its potential benefits, side effects, nutritional effects, and suitability must be evaluated individually.

Finerenone: An expanding area of research

Finerenone is a nonsteroidal mineralocorticoid receptor antagonist. It reduces harmful mineralocorticoid signaling involved in inflammation and scarring.

It is already used to reduce kidney and cardiovascular risks in eligible patients with CKD associated with type 2 diabetes.

A particularly interesting development occurred in June 2026, when the New England Journal of Medicine published results from the FIND-CKD trial. The study found that finerenone slowed the decline in kidney filtration over 32 months in adults with CKD who did not have diabetes.

In October 2026, the FDA accepted an application seeking to expand finerenone's use to adults with CKD without diabetes. Acceptance of an application does not mean that the expanded indication has been approved.

Finerenone can increase blood potassium, sometimes dangerously. Kidney function and potassium levels therefore require careful monitoring.

These findings are encouraging because kidney disease is not always caused by diabetes. A treatment that helps people with other forms of CKD could eventually benefit a broader population.

Sources for these developments include the FLOW and FIND-CKD clinical trials and the Kidney Disease: Improving Global Outcomes (KDIGO) clinical guidance.

4. What About People Already in Stage 4 CKD?

This is the question that matters most personally to me.

The treatments discussed above are not cures. They are tools that may help preserve remaining kidney function, depending on the patient's circumstances.

For people with Stage 4 CKD, medical care often focuses on several priorities:

  • Monitoring kidney function and the rate at which it changes.

  • Controlling blood pressure and diabetes when present.

  • Reviewing medicines that may protect the kidneys or treat complications.

  • Managing anemia, acid-base disturbances, and abnormal potassium or mineral levels.

  • Adjusting nutrition and fluid intake to individual needs.

  • Reducing cardiovascular risks and preserving strength and quality of life.

A nephrologist may also discuss what to expect if kidney function declines further, including dialysis, transplantation when appropriate, and comprehensive conservative kidney care.

These discussions do not mean that kidney failure is inevitable in the immediate future. They help patients understand their options and make decisions before a crisis develops.

For an older adult, treatment decisions must also take account of frailty, other illnesses, independence, and personal priorities. The most appropriate plan is not necessarily the one that involves the greatest number of medicines or procedures. It is the one that best serves the individual patient.

5. Artificial Intelligence: A New Tool for Early Detection

Artificial intelligence is beginning to influence how researchers identify and manage kidney disease.

As a longtime scientist and blogger who now uses AI to help research medical topics, I find this development especially interesting.

AI systems can examine large amounts of information, including laboratory results, medical histories, medications, and patterns in electronic health records.

A conventional review might examine a patient's latest creatinine result. An AI system may be able to analyze several years of results and detect a pattern of gradual decline that deserves attention.

Researchers are investigating several potential applications.

Early-warning systems: AI may identify patients at increased risk of developing CKD or experiencing a rapid deterioration in kidney function.

Medical-image analysis: Researchers are exploring whether AI can identify signs associated with kidney disease from medical images, including ultrasound and other imaging studies.

Risk prediction: AI may help clinicians estimate the likelihood of kidney failure or complications, potentially supporting earlier referrals and better planning.

Personalized treatment: In the future, AI may help doctors compare patient characteristics and predict which treatments are most likely to provide benefits with acceptable risks.

One interesting 2026 research report examined whether deep-learning systems could identify CKD from echocardiograms, ultrasound recordings of the heart. The researchers tested their model at multiple healthcare institutions. The results suggest that heart images may contain information useful for identifying patients who could benefit from kidney evaluation.

This is an intriguing idea because the heart and kidneys are closely connected. Disease in one organ can affect the other.

However, an experimental AI model is not the same as an established diagnostic test. Most AI applications for early CKD detection still need further evaluation to demonstrate that they improve patient outcomes in everyday clinical practice.

AI should support, not replace, clinical judgment. Its predictions must be checked against reliable medical tests, and its performance must be assessed across different populations.

I see AI as a promising additional tool in the physician's toolbox—not a substitute for the physician.

6. Prevention: Protecting the Kidneys We Have

Although not every case of CKD can be prevented, many risk factors can be reduced or managed.

The following measures are especially important.

Control blood pressure. High blood pressure can damage the kidneys, while kidney disease can make blood pressure harder to control. Appropriate treatment can help interrupt this cycle.

Manage diabetes. Persistently elevated blood glucose can damage the kidney's filtering structures. Individualized glucose control and kidney-protective treatment can reduce risks.

Avoid unnecessary kidney-harming medicines. Nonsteroidal anti-inflammatory drugs, commonly called NSAIDs, include ibuprofen and naproxen. These medicines can cause kidney injury, particularly in people with CKD, dehydration, or certain other medical conditions. People with kidney disease should ask their healthcare providers or pharmacists before using them.

Be cautious about supplements. Products advertised as natural or as cures for kidney disease are not necessarily safe. Certain herbs, high-dose vitamins, and supplements can cause harm or interact with prescription medicines. Claims that a product can reverse advanced CKD should be viewed skeptically unless supported by convincing clinical evidence.

Follow an appropriate diet. A kidney-friendly diet may involve limiting sodium and adjusting protein, potassium, phosphorus, and fluid intake. However, requirements differ according to laboratory results, medications, nutritional status, and CKD stage. People with advanced CKD should work with their nephrologist or a renal dietitian rather than following a restrictive diet found online.

Stay physically active within your abilities. Appropriate exercise can support cardiovascular health, mobility, and general well-being.

Avoid smoking and maintain regular medical follow-up. Smoking increases cardiovascular risks, and cardiovascular disease is closely linked to CKD.

There is no single diet, supplement, or lifestyle practice that guarantees protection against kidney disease. The goal is to reduce avoidable damage while maintaining overall health.

7. What I Have Learned From Living With CKD

My experience with CKD has reinforced something I learned during my scientific career: knowledge is valuable only when we use it wisely.

A diagnosis of Stage 4 CKD can be unsettling. It is natural to wonder how quickly the disease will progress and what the future will bring. Yet one laboratory result cannot tell the entire story. Trends over time, the underlying cause, other health conditions, and the response to treatment all matter.

I rely on the care of my nephrologist, and I believe patients should feel comfortable asking questions. What is my latest eGFR? Is there albumin in my urine? How quickly is my kidney function changing? Which medicines are appropriate for me? Are there supplements or over-the-counter drugs I should avoid?

These are practical questions, and the answers can help patients participate more actively in their care.

I also believe that patients should be cautious about promising new treatments. A laboratory experiment is not the same as a successful clinical trial. A successful clinical trial is not the same as an approved treatment. And an approved treatment is not necessarily suitable for every patient.

Having spent years working in pharmaceutical chemistry and drug regulation, I appreciate the importance of evidence, safety, and careful evaluation.

AI can help us understand complicated medical research, but it can also make mistakes. I use it as an aid to research and writing, not as a replacement for my physician.

Conclusion: Hope, Knowledge, and Living One Day at a Time

Medical science has made meaningful progress in the fight against chronic kidney disease. Better screening, kidney-protective medicines, more accurate risk prediction, and emerging AI technologies offer reasons for cautious optimism.

Yet millions of people around the world remain unaware that their kidneys are damaged. Many could benefit from simple blood and urine tests before the disease reaches an advanced stage.

For readers who have diabetes, high blood pressure, or other risk factors, I encourage you to discuss kidney screening with your healthcare provider. For those already living with CKD, regular monitoring and an individualized treatment plan remain essential.

As for me, I am approaching my 92nd birthday while living with Stage 4 CKD. I cannot predict what the coming years will bring, but I can continue learning, writing, maintaining my interests, and sharing what I discover with my readers.

I am grateful that modern technology, including AI, allows me to continue researching subjects that matter to me and to communicate with people around the world.

I do not expect medical science to solve every problem. But I welcome each genuine advance that helps people preserve their health, independence, and dignity.

Perhaps the most important lesson is this: We cannot always choose the illnesses that touch our lives, but we can choose to seek knowledge, ask questions, make informed decisions, and appreciate the days we have.

Disclaimer: This article is for educational purposes and reflects my personal interest in CKD. It is not a substitute for medical advice, diagnosis, or treatment. People with CKD, especially Stage 4, should consult their nephrologist before changing medicines, supplements, diet, or fluid intake.

Sources for further reading

These are useful references if you would like to add links to your blog post or explore the research further.

  1. KDIGO 2024 CKD Clinical Practice Guideline - international recommendations on detection, risk assessment, and treatment. Read the guideline.

  2. CDC: Screening for Chronic Kidney Disease (September 2025) - explains why people at increased risk should be screened. Read the CDC guidance. 

    CDC

  3. FIND-CKD trial, New England Journal of Medicine (June 2026) - research on finerenone in CKD without diabetes. Read the clinical trial. 

    New England Journal of Medicine

  4. KDIGO's 2026 guideline update announcement - explains the ongoing review of newer CKD therapies. Read the announcement. 

    KDIGO

  5. Research review: Artificial intelligence in CKD - discusses AI's potential and limitations in early detection and risk prediction. Read the review. 

    PMC

AI suggestion before publishing: Because you are writing as someone personally living with Stage 4 CKD, the strongest feature of this post is the combination of your own experience and your scientific perspective. I would retain the personal introduction and conclusion even if you later shorten the technical sections.

AI Overview: 
The landscape of managing Chronic Kidney Disease (CKD) has transformed fundamentally. Historically viewed as an inescapable, progressive decline toward dialysis, CKD treatment has shifted into an era of precision medicine and powerful protective therapies. However, because the disease remains a global health threat, recently climbing to the ninth leading cause of death worldwide early detection and foundational lifestyle habits matter more than ever. 
What Has Changed: The Era of Active Protection
For decades, the standard playbook for slowing CKD was strictly limited to controlling blood pressure and managing blood sugar using basic renin-angiotensin system (RAS) inhibitors. While those foundational elements remain, a modern "four-pillar" medical framework and cutting-edge transplant science have completely redefined what is clinically possible. 
1. The "Four-Pillar" Therapeutic Framework
Nephrologists now deploy a synergistic combination of medications that actively halt tissue damage and shield both the heart and kidneys:
  • SGLT2 Inhibitors: Originally developed for type 2 diabetes (such as Jardiance and Farxiga), these medications have become a cornerstone of CKD care. They reduce pressure inside the kidney’s filtering units and significantly slow the progression of kidney decline, regardless of whether a patient has diabetes.
  • GLP-1 Receptor Agonists: Drugs like Ozempic are widely recognized for metabolic health, but clinical evidence shows they also offer profound, independent anti-inflammatory and protective benefits for the kidneys. 
  • Non-Steroidal MRAs: Medications like Finerenone target specific pathways to directly reduce inflammation and fibrosis (scarring) in the kidneys, filling a critical gap in traditional care. 
  • Traditional RAS Blockade: ACE inhibitors or ARBs continue to serve as the baseline pillar for blood pressure and protein stabilization.
2. Precision Therapeutics for Rare Diseases
Instead of treating all kidney issues with broad immunosuppressants, targeted treatments have arrived for specific, high-risk conditions:
  • C3 Glomerulopathy (C3G): Targeted complement inhibitors like iptacopan (Fabhalta) are available to directly reduce proteinuria.
  • IgA Nephropathy (IgAN): Therapies such as atacicept-vymj (Trutakna) target underlying biological pathways to prevent disease progression in at-risk adults.
3. High-Tech and Xenotransplantation Frontiers
When the disease reaches advanced stages, options extending beyond human-to-human organ donation are rapidly transitioning from science fiction to clinical reality:
  • Xenotransplantation: Successful bridge procedures utilizing genetically modified pig kidneys have cleared the path for large-scale clinical trials. 
  • Cellular and Artificial Tech: Researchers are actively evaluating engineered CAR-T therapies to solve complex transplant rejection issues, alongside ongoing developments in artificial kidney technology.
What Still Matters Most: The Unchanging Core
While modern drugs provide unprecedented tools to slow down damage, they cannot reverse established scarring. Because early-stage CKD typically presents zero visible symptoms, the most critical defense relies on proactive screening and aggressive lifestyle management.
+---------------------------------------------------------------------------------+

|                           THE CKD SURVEILLANCE PAIR                             |
+------------------------------------+--------------------------------------------+

| 1. eGFR (Blood Test)               | Measures how efficiently your kidneys      |
|                                    | filter waste products.             |
+------------------------------------+--------------------------------------------+

| 2. uACR (Urine Test)               | Checks for micro-amounts of albumin        |
|                                    | (protein) leaking through filters. |
+------------------------------------+--------------------------------------------+
1. Knowing the Triggers and Intervening Early
The primary drivers of kidney damage have not changed. Diabetes, high blood pressure, and high body mass index (BMI) remain responsible for the vast majority of cases. If you have any of these risk factors, routine blood and urine checks are non-negotiable. 
2. Radical Cardiovascular Protection
The kidneys and the cardiovascular system are inextricably linked. Having impaired kidney function is a massive accelerator for vascular issues, contributing to roughly 12% of global cardiovascular mortality. Aggressively managing blood pressure (ideally keeping it under 130/80 mmHg) and controlling cholesterol are vital to protecting both your heart and your filters. 
3. Foundations of a Kidney-Friendly Lifestyle
Pharmaceuticals work best when paired with an intentional physical routine: 
  • Plant-Predominant Nutrition: Emphasizing whole-food, plant-heavy diets reduces the acid load on the kidneys and simplifies the management of phosphorus and fluid balances.
  • Careful Electrolyte Monitoring: Tracking and regulating the intake of sodium, phosphorus, and potassium prevents dangerous metabolic complications as kidney function declines.
  • Consistent Activity:Combining low-impact cardiovascular movement with light strength training optimizes blood pressure control, improves systemic circulation, and preserves physical mobility
  • My Photo of the Day- Halloween Candy Treat from my Neighbor

  •  Thank You Sandi G, for your thoughtfulness. Happy Treat or Trick!