Can stage 3 CKD with diabetes be stopped from progressing?

Question

Hello doctor,

I am a 57-year-old with type 2 diabetes for 15 years. Recently, my nephrologist told me I am in stage 3 CKD. My creatinine has slowly risen to 2.0 mg/dL, and my eGFR is around 38. I feel very fatigued, and my ankles often swell. I have cut salt, trying to reduce protein, but confused about what diet is truly safe. Will dialysis be unavoidable one day, or can I stop it from progressing? Also, are there new kidney-protective drugs beyond ACE inhibitors?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

You have chronic kidney disease stage 3, with eGFR (estimated glomerular filtration rate) around 38. This means your kidneys are moderately reduced but still functioning. Many people remain in stage 3 for years with proper care. Your fatigue can be due to anemia, toxin buildup, or diabetes itself. Ankle swelling happens because the kidneys cannot remove salt and water efficiently. This can often be controlled with diet and proper medicines.

Dialysis is not inevitable for everyone. Progression can be slowed significantly if blood sugar and blood pressure are tightly controlled. Many patients never reach dialysis if managed properly.
Strict diabetes control is very important. A good HbA1c (glycated hemoglobin) target (usually around 7 % or individualized) reduces further kidney damage. Avoid sudden sugar fluctuations.
Blood pressure control is critical. ACE (angiotensin-converting enzyme inhibitors) inhibitors or ARBs (angiotensin II receptor blockers) protect the kidneys beyond just lowering BP. Target BP is usually below 130/80 mmHg.
There are newer kidney-protective drugs now. Empagliflozin and other SGLT2 (sodium-glucose co-transporter 2) inhibitors have shown strong kidney protection in diabetic CKD (chronic kidney disease). They slow progression and reduce heart risk.
Another option is Finerenone, which further reduces kidney and cardiovascular damage in diabetic CKD.
Diet should be balanced, not extreme. Moderate protein intake is advised, not zero protein. Reduce salt strictly. Avoid processed foods, pickles, and packaged snacks. Potassium restriction is needed only if blood potassium is high.
Avoid painkillers like NSAIDs (nonsteroidal anti-inflammatory drugs), as they worsen kidney function. Stay hydrated, but do not overdrink.

Regular monitoring of creatinine, potassium, urine protein, and hemoglobin every three to four months is important. With modern medicines and tight control, progression can be slowed significantly. Many patients maintain stable function for long periods. If you share your HbA1c and urine protein level, I can guide more specifically.

I hope this information helps you.

Revert in case of queries.

Regards.