How can my husband slow down his CKD progression at 55?

Question

Hello doctor,

My 55-year-old husband has stage three chronic kidney disease (CKD), likely due to long-standing hypertension and type 2 diabetes. He feels fatigued most of the time and has mild swelling in his ankles. We are careful with his diet, but his kidney function is slowly declining. Could you explain

What are the best ways to slow CKD progression?
Whether newer diabetes medications, like SGLT2 (sodium-glucose transport protein 2) inhibitors, help protect his kidneys?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Stage 3 chronic kidney disease caused by long-standing hypertension and type 2 diabetes requires a comprehensive approach to slow progression and protect remaining kidney function.

The most important steps for your husband are maintaining optimal blood pressure, usually aiming for around 130/80 millimeters of mercury, and controlling it with medications. Medicines such as ACE (angiotensin-converting enzyme, anti-hypertensive drug) inhibitors or ARBs (angiotensin II receptor blockers, anti-hypertensive drug) can help him reduce protein loss in urine. Good diabetes control is equally crucial for him, keeping HbA1c (hemoglobin A1C, glycated hemoglobin) in a safe target range without frequent hypoglycemia.

A kidney-friendly diet with reduced sodium, moderate protein intake, and limited processed foods can further protect his kidney health while managing fluid balance to reduce swelling. Regular monitoring of kidney function and electrolytes is essential to detect changes early.

Your husband can try newer diabetes medications like SGLT2 (sodium-glucose transport protein 2) inhibitors, such as Empagliflozin and Dapagliflozin. Studies have demonstrated that these medications can slow the progression of CKD, lower the chances of kidney failure, and improve heart health. These drugs function by decreasing pressure within the kidney's filtering units and boosting the overall resilience of the kidneys. However, they should be prescribed with caution, considering kidney function level and other health factors.

I would recommend lifestyle changes like:

Regular physical activity.
Avoiding NSAIDs (non-steroidal anti-inflammatory drugs).
Quitting smoking.
Maintaining a healthy weight.

These changes are necessary for your husband's health and play an essential role in preserving kidney function over time.

I hope this information helps you.

Feel free to ask further queries.

Thank you.