Does my father need dialysis for his stage 3 CKD at 62?

Question

Hello doctor,

My father is 62 years old. Recently told he has stage 3 chronic kidney disease (CKD). His creatinine is 2.1, and the estimated glomerular filtration rate (eGFR) is about 38. He has diabetes for 10 years. We are very anxious. Please tell me,

Does this mean dialysis will be needed soon?
Can diet slow the kidney damage?
He likes eating dal, milk, and bananas. Should he avoid them because of potassium?
What are the best steps to protect the kidneys at this stage?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I understand your anxiety, but stage 3 chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) of 38 does not mean dialysis is imminent. Many people remain in stage 3 for years with stable kidney function if risk factors are well controlled.

Dialysis is usually considered much later, typically when eGFR falls closer to 10 to 15, and symptoms develop. So right now, the focus should be on slowing progression. The most important steps are tight blood sugar control, maintaining blood pressure ideally below about 130/80. The doctors can suggest to him the following things,

Angiotensin-converting enzyme inhibitors (ACE inhibitors) or Angiotensin II receptor blockers (ARBs), if prescribed, protect the kidneys.
Avoiding painkillers like nonsteroidal anti-inflammatory drugs (NSAIDs).
Stopping smoking if applicable.
Maintaining a healthy weight and regular nephrology follow-up.

Diet absolutely plays a role in his well-being. It can include,

Moderate protein intake (about 0.8 grams per kilogram per day) is recommended. Remember, for such patients, not zero protein, but avoiding excessive portions is good.
Dal and milk are allowed in controlled portions; they are protein sources, so quantity matters.
Bananas are high in potassium, but potassium restriction is only necessary if blood potassium levels are elevated. Many stage 3 patients can still eat them in moderation if reports are normal.
Reducing salt (less than 2 grams of sodium/day) is especially important to control blood pressure and swelling.

Rather than eliminating foods blindly, it is best to formulate the diet based on his potassium, phosphorus, and urine protein levels, ideally with a renal dietitian. At this stage, consistent monitoring and lifestyle adjustments can significantly delay progression, and many patients with stage 3 CKD never require dialysis if well managed.

I hope this information helps you.

Feel free to ask further queries.

Thank you.