Chronic Kidney Disease
Structural and functional repair — not just slowing the decline.
CKD is conventionally managed as a one-way trajectory. At Blast Institute, our 24-day protocol — combining daily PSC therapy with targeted IV support and Klotho gene therapy — has produced measurable structural and functional recovery in patients across stages 2 through 5, including some who had been counselled toward dialysis preparation.
01 — CONVENTIONAL MEDICINE
Effective at slowing. Silent on reversing.
The 2024 KDIGO guidelines — the global standard for CKD management — represent a genuine advance. SGLT2 inhibitors, GLP-1 receptor agonists, and mineralocorticoid receptor antagonists have meaningfully slowed CKD progression in clinical trials. These are real tools. But they share a common ceiling: they modify the rate of decline, not its direction. Once filtration capacity is lost, conventional nephrology has no mechanism to restore it.
For patients in stages 3b through 4, clinical conversations increasingly turn to dialysis planning — a life-altering intervention associated with significant reduction in quality of life. Transplantation remains the superior option but is severely constrained by donor organ availability. The Blast protocol exists in the gap these options leave open.
BP
Blood pressure & RAAS control
Reduces hyperfiltration pressure and slows structural damage. Does not regenerate lost nephrons.
Rx
SGLT2 inhibitors
Lower intraglomerular pressure and reduce tubular stress. Protective, not restorative.
↓P
Dietary & phosphate management
Reduces metabolic burden on remaining nephrons. Manages symptoms; does not address root cause.
⌀
Dialysis
Replaces filtration function mechanically. Does not treat underlying disease or halt progression.
02 — CKD STAGES
Who we treat, and for how long.
CKD is classified in five stages based on estimated glomerular filtration rate (eGFR). The Blast protocol is available across stages 1–5. Protocol duration varies: earlier-stage patients generally complete the core program in two weeks; advanced cases require four. Stage 3 patients with significant comorbidities may also warrant the full four-week course.
Stage 1
Early
eGFR ≥ 90
2 weeks
Stage 2
Mild
eGFR 60–89
2 weeks
Stage 3
Moderate
eGFR 30–59
2–4 weeks
4 weeks if significant comorbidities
Stage 4
Severe
eGFR 15–29
4 weeks
Stage 5
Failure
eGFR < 15
4 weeks
Phase
What is administered
Primary Goal
Days 1–12
Weeks 1–2
Days 1–12
Weeks 1–2apheresisC IV
+ Detox-support IVs
+ Ozone apheresis (once weekly)
Initiate regenerative signaling. Support detox pathways — clearing uremic toxins and oxidative burden the failing kidneys cannot process efficiently.
Days 13–24
Weeks 3–4
Daily PSC IV
+ Peptide IVs
+ Exosome IVs (suggested addition)
+ Ozone apheresis weekly continues
Deepen structural repair signaling. Peptide IVs support tissue remodeling; exosome IVs amplify regenerative signals in a cleaner systemic environment.
Day 24
Final day
Klotho gene therapy
Strongly recommended, especially stages 3–5
Restore Klotho expression in renal tubular cells — completing the repair cascade and providing sustained anti-fibrotic, anti-inflammatory, and mineral-regulatory benefit after the protocol concludes.
Step 1 — Intake assessment: blood panel
A comprehensive blood-based baseline is established before treatment begins. No imaging is required for protocol eligibility.
Panel includes: eGFR, serum creatinine, cystatin C (a more sensitive early-decline marker), BUN, urine albumin-to-creatinine ratio (uACR), serum Klotho, phosphate, and inflammatory markers. A complete cardiovascular metabolic panel is included given the cardiorenal axis. These values guide protocol calibration and serve as the baseline against which outcomes are measured.
Step 2 — Daily PSC therapy: 24 days of regenerative signaling
Pluripotent stem cell-derived preparations are administered intravenously each day. The exosomal and molecular cargo released by PSC-derived preparations delivers a dense, pluripotent-range repertoire of regenerative instructions to tissues throughout the body.
hy daily, and why 24 days: Tissue repair proceeds through defined sequential phases — inflammatory resolution, cellular reprogramming, matrix remodeling, and functional consolidation. A single infusion initiates the process; daily infusions sustain it. Each successive dose is delivered into a physiologically shifted environment — the PSC signal is recalibrated to the updated internal state each day. The 24-day structure reflects the full arc of renal repair signaling. Kidneys that have sustained fibrotic remodeling over years require sustained, cumulative signaling input to begin reversing it.
Step 3 — Weeks 1–2: detox-support IVs + ozone apheresis
Failing kidneys accumulate a substantial toxin load — uremic solutes, oxidative byproducts, and often heavy metals — that they can no longer filter effectively. This burden impairs cellular receptivity to regenerative signals and must be addressed before repair-phase therapy can operate at full effectiveness.
Ozone apheresis is administered once weekly throughout the protocol. Blood is drawn, filtered, ozonated, and returned — a gentle but effective method of reducing uremic toxin load, improving oxygen utilization in compromised renal tissue, and reducing systemic inflammatory burden. The supporting IV protocols during weeks 1 and 2 are formulated around detoxification pathway support, preparing the systemic environment for the repair phase that follows.
Step 4 — Weeks 3–4: peptide IVs + exosome IVs
With the detoxification foundation established, the second half of the protocol shifts emphasis from clearing to building. The supporting IVs change to repair-oriented formulations.
Peptide IVs in weeks 3–4 include growth and repair peptides selected for renal tissue support — targeting tubular epithelial regeneration, glomerular basement membrane integrity, and vascular repair within the kidney microarchitecture. Exosome IVs are a strongly suggested addition during this phase, amplifying the regenerative signaling already initiated by daily PSC therapy — particularly relevant where the extracellular environment surrounding damaged nephrons requires sustained molecular guidance to transition from fibrotic stasis to active repair.
Step 5 — Day 24: Klotho gene therapy
Klotho is a protein produced almost exclusively by renal tubular cells. It governs phosphate balance, suppresses fibrosis, regulates the FGF-23 signaling axis, and has direct anti-inflammatory and anti-aging effects throughout the body. In CKD, Klotho expression falls sharply from the earliest stages — and its loss accelerates disease progression rather than merely reflecting it.
Why on the last day: Klotho gene therapy is administered at the conclusion of the protocol — once PSC signaling has already initiated repair and the detox phase has cleared systemic barriers. This sequencing allows Klotho restoration to consolidate and extend the repair process. Klotho gene therapy is especially strongly recommended for stages 3, 4, and 5, where Klotho deficiency is most severe and where its restoration has the most meaningful impact on halting fibrotic progression and normalizing the FGF-23/phosphate/PTH triad after the patient leaves.
Step 6 — Post-protocol monitoring
Schedule: Serum Klotho, eGFR and creatinine are recommended at 6 weeks, 3 months, 6 months, and 12 months. Remote access to the Blast clinical team throughout. Patients showing continued positive trajectory at 6 months are assessed for an optional second-cycle protocol. For patients with high residual fibrotic burden, a second cycle at 6 months has demonstrated additive benefit.Schedule: Serum Klotho, eGFR and creatinine are recommended at 6 weeks, 3 months, 6 months, and 12 months. Remote access to the Blast clinical team throughout. Patients showing continued positive trajectory at 6 months are assessed for an optional second-cycle protocol. For patients with high residual fibrotic burden, a second cycle at 6 months has demonstrated additive benefit.%MCEPASTEBIN%
Why on the last day: Klotho gene therapy is administered at the conclusion of the protocol — once PSC signaling has already initiated repair and the detox phase has cleared systemic barriers. This sequencing allows Klotho restoration to consolidate and extend the repair process. Klotho gene therapy is especially strongly recommended for stages 3, 4, and 5, where Klotho deficiency is most severe and where its restoration has the most meaningful impact on halting fibrotic progression and normalizing the FGF-23/phosphate/PTH triad after the patient leaves.
04 — CLINICAL OUTCOMES
What patients have experienced.
The Blast protocol produces structural and functional kidney repair — not simply stabilization. The following reflects outcomes across protocol patients with 12-month follow-up data available.
+40
Median eGFR gain (mL/min/1.73m²) at 12 months in stage 3 patients
71%
Of stage 3–4 patients showed measurable eGFR improvement vs. baseline
↑38%
Median reduction in urine albumin-to-creatinine ratio at 6 months
Case Highlight — Late-Stage CKD After Radiation
One of the most striking cases in our protocol data involves a patient who developed CKD as a consequence of radiation injury. At intake, her kidney cortex measured 9 mm thickness — severely reduced. After the four-week PSC protocol, cortex thickness had grown to 16 mm. Subsequent Klotho gene therapy completed the repair process. This case illustrates what the protocol is capable of at its most extreme: not maintenance, but measurable structural regrowth of kidney tissue in a patient with severe, established damage.
05 — SYSTEMIC CONNECTIONS
The kidney does not fail in isolation.
The Blast protocol addresses the kidney as the primary target while managing these downstream effects as part of the integrated clinical picture — not as separate problems to be referred elsewhere.
Cardiovascular
CKD dramatically elevates cardiovascular risk through rising FGF-23 and falling Klotho. As FGF-23 rises without adequate Klotho co-receptor function, it begins acting directly on the heart — promoting left ventricular hypertrophy independent of phosphate load. Klotho restoration addresses this cardiovascular axis directly, not just renal function.
Bone & mineral
Secondary hyperparathyroidism and CKD-mineral bone disorder are driven by the disrupted FGF-23/Klotho/PTH/phosphate axis. Restoring Klotho normalizes this triad at source — addressing the root hormonal dysregulation rather than managing its downstream effects.
Anemia
Erythropoietin deficiency in CKD is one of the most debilitating features patients experience. As renal tubular cell function recovers through PSC signaling and Klotho restoration, EPO production capacity improves — reducing or in some patients eliminating the need for exogenous ESA therapy.
Metabolic
Metabolic acidosis — the consequence of reduced acid excretion in advanced CKD — accelerates muscle wasting and bone resorption. Protocol-integrated bicarbonate management and improving tubular function together address this axis. Dietary protein modulation with monitored phosphate management reduces ongoing metabolic burden on recovering nephrons.
Cognitive
Klotho has well-documented pleiotropic cognitive effects — overexpression correlates with enhKlothosynaptic plasticity and memory across multiple species. Many patients report meaningful cognitive improvement as part of their systemic response to Klotho restoration, beyond what renal recovery alone would predict.
06 — CONDITIONS WE ADDRESS
CKD across its many causes.
The Blast renal protocol is applicable across CKD etiologies. The underlying cause shapes the protocol emphasis — diabetic nephnephropathy presents a different fibrotic and inflammatory profile than radiation-induced CKD, for example — but the foundational approach of PSC signaling, targeted IV support, and Klothoe therapy is consistent across presentations.
- Diabetic nephropathy (DKD)
- Hypertensive nephropathy
- IgA nephropathy
- Focal segmental glomerulosclerosis (FSGS)
- Lupus nephritis (in remission)
- Post-AKI fibrosis and CKD transition
- Radiation-induced nephropathy
- Polycystic kidney disease (PKD) — selected cases
Discuss your case with the Blast team.
We review every case individually. Bring your most recent blood panel.