Can CKD be slowed down with good blood sugar control?

Question

Hi doctor,

My father is 55 years old and has chronic kidney disease (CKD) stage three with creatinine 2.1 and an estimated glomerular filtration rate (eGFR) of 40.

His urine report showed proteinuria, and he has had diabetes for ten years. He is currently on Losartan and Insulin. So, my concerns are:

Does having protein in urine mean his kidney function will get worse quickly?
Can strict sugar and blood pressure control slow the decline?
Are there new drugs like sodium glucose cotransporter two (SGLT2) inhibitors useful in such patients to preserve kidney function?
At what point should we start planning for dialysis or transplant evaluation, or is it too early to think about those options?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Your father’s condition of stage three chronic kidney disease (CKD) with protein in urine indicates ongoing stress and damage to the kidney’s filtering units.

This can increase the risk of further decline if not properly managed. However, progression can be slowed significantly with the right treatment and close follow-up.

However, let me tell you the important steps to keep in mind:

Strict blood sugar and blood pressure control. High glucose levels and elevated pressure inside the kidneys accelerate damage.
Maintain blood pressure below one hundred thirty over eighty.
Keep HbA1c (glycated hemoglobin) near the target range as advised by his doctor.

Let me share what medications may help with this condition below:

Losartan is beneficial, as it lowers blood pressure and reduces protein loss in urine.
SGLT2 inhibitors (sodium-glucose cotransporter 2 inhibitors) such as Dapagliflozin and Empagliflozin help protect kidney function in diabetic and nondiabetic CKD, especially when eGFR (estimated glomerular filtration rate) is above thirty. These drugs lower kidney workload and slow progression.
The nephrologist can decide if your father is suitable for one of these medicines.

Also, kindly follow a few lifestyle changes and precautions, which can help you. I am mentioning them below.

Avoid painkillers like NSAIDs.
Follow a low-salt diet.
Keep protein intake moderate.
Stay well hydrated and maintain a healthy weight.
It is essential to monitor stage 3 CKD, which is an early to moderate phase. Many patients remain stable for years with proper care.
Dialysis is usually discussed when eGFR falls below twenty or symptoms appear, so it is too early now.
Regular checkups every three to six months are important to monitor progress.

With healthy lifestyle habits, strict medical control, and newer kidney-protective therapies, his condition can remain stable for a long time.

I hope this helps you.

Please contact us for further queries.

Thank you.