Preventing CKD and its Progression

  CKD is a very common condition that affects a large number of Americans. It is a silent disease and most patients do not get any symptoms till the kidney function has decreased significantly. Fortunately, we know a lot about how it is caused and what conditions are typically associated with it. More than 90% of patients who have chronic kidney disease have hypertension (high blood pressure), diabetes or both. In a minority of patients, CKD is caused by entities such as polycystic kidney disease or certain immune-mediated diseases that damage the microscopic filtering units in the kidneys. 

In the vast majority of patients, CKD is potentially preventable up to a certain point. If you have diabetes mellitus or hypertension, it is extremely important to control them optimally to prevent CKD. Treatment of other conventional cardiovascular risk factors such as high cholesterol is important as well. If you already have CKD, then there is a greatest risk of adverse effects with certain medications, and the dosage of certain medications may also need to be adjusted for the level of kidney function. 

Here are some recommendations for prevention or worsening of CKD: 

• Optimal control of blood pressure
• Optimal control of diabetes mellitus (type 1 and 2)
• Avoidance of certain medications

                   - Non-steroidal agents such as Motrin, Ibuprofen Aleve, and Naprosyn.                

                   - Bactrim, Metformin (used for treatment of diabetes)

• Avoidance of intravenous contrast that is used with CT scans
• Avoidance of Gadolinium contrast that is used with MRI scans
• Avoid herbal products especially "chinese herb"