My uncle has stage 3 CKD. How to monitor his kidney function?

Question

Hello doctor,

My uncle, aged 63, was diagnosed with stage 3 CKD two months ago. His creatinine is 1.9, eGFR 46, and potassium 5.6. He also has diabetes and takes Telmisartan for BP.

The nephrologist suggested a low-protein and low-salt diet, but we are not clear on how strict that should be. So, please give your opinions on-

Is it safe for him to take protein powder occasionally?
He has been feeling tired and has mild swelling in his feet. Would increasing water intake help reduce creatinine levels, or could it worsen swelling?
How often should kidney function tests be repeated to monitor changes accurately?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your uncle is suffering from CKD (chronic kidney disease) grade 3 with type 2 diabetes mellitus and hypertension (attachment removed to protect the patient's identity). As the doctor has advised a low salt and protein diet, you have to follow it. It can be caused by diabetic nephropathy.

No, you cannot give protein powder and more water; it will cause the retention of fluid, which causes an increase in swelling in the body. Increasing water intake will not help him improve.

It will not refuse the swelling, it will worsen the kidney function and create.

You need to get his kidney function test (KFT) every month, check whether the diabetes and hypertension are controlled, and the medications given are correct. Also, some other tests that you must get are:

CBC (complete blood count).
HbA1c (glycated hemoglobin).
Blood sugar fasting and post-prandial (FBS and PPBS).
Regular blood pressure monitoring.
LFT (liver function test).
KFT (kidney function test).

A few tips to manage your uncle's conditions are:

Low-sodium salt and water are to be restricted for use.
Avoid more oily foods and protein.
Add up daily brisk walking for 30 minutes.

Kindly give the prescription next time so that I can see what medication your uncle is on.

Follow up with the reports and medications. BP (blood pressure) should be monitored regularly.

I hope this helps.

Thank you.