How quickly does CKD worsen despite self-care?

Question

Hi doctor,

My last blood tests showed that my eGFR has dropped to 48, and I have stage 3 chronic kidney disease (CKD). I am 58, diabetic, and taking Losartan for blood pressure.

I have been trying to drink more water and reduce my salt intake, but I am confused about what diet is actually safe. Different sources provide varying advice about protein, potassium, and phosphorus.

Should I be seeing a nephrologist now, or should I wait until my condition worsens?
Also, do the newer diabetes medications, like Jardiance or Farxiga, genuinely protect the kidneys?
I am worried about the possibility of my condition progressing to dialysis in the future. How quickly does CKD typically worsen if I take care of myself?

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand why this situation may be concerning, especially since your kidney function has declined to stage 3 chronic kidney disease (CKD), and living with diabetes adds extra complexity.

It is normal to feel uncertain about your diet, as recommendations for protein, potassium, and phosphorus can vary based on lab results and how well your kidneys are functioning.

Therefore, working with a nephrologist or a renal dietitian can provide you with personalized guidance and help prevent further decline.

Seeing a nephrologist at this stage is recommended, as they can monitor your kidney function, adjust medications safely, and advise you on dietary and lifestyle changes to slow progression.

Medications such as Jardiance empagliflozin) Or Farxigadapagliflozin, which is an SGLT2 (sodium-glucose co-transporter 2) inhibitor, has been shown in studies to help protect kidney function in people with diabetes, in addition to lowering blood sugar. This is not just a marketing claim.

With careful management of blood pressure, blood sugar, and avoiding medications that can harm the kidneys, along with following dietary advice, many people with stage 3 CKD are able to maintain stable kidney function for years. However, the rate of decline can vary between individuals.

It is completely understandable to worry about dialysis. Having a clear plan with your healthcare team can provide reassurance and help you take proactive steps to preserve your kidneys’ health

I hope this answers your query. Feel free to reach out anytime.

Thank you.