My creatinine level is 1.4 and egfr reading is 58.73 ml/min/1.73 m2. Last month creatinine was 1.33 and egfr was 62.31 ml/min/1.73m2. I am taking losar 25 mg by a nephrologist. I want answer by a nephrologist if possible as am I going in a right direction as decline in these values are disturbing me. This time doctor has advised to take nefrosave too. Value for hba1c is 5.9. Please suggest.

Dr. Mahesh RokadeNephrologist22yrs exp

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You probably have chronic kidney disease (ckd). Etiology you have not mentioned. You need to understand that- ckd is a progressive disorder and with medications you can achieve retardation of the progression of the disease. In short, despite medicines, the creatinine values are going to progress over the years. Focus should be on factors which will help in reducing this progression. They are- 1. Strict control of blood pressure. Target bp should be 130/80mmhg. 2. Control of blood sugar- hba1c less than 6.5% (if you are a diabetic) 3. Low protein diet (0.4-0.6g/kg/d) with alpha keto analogues. Avoid red meat especially. 4. Avoidance of pain killers tablets/injections, over the counter medicines, ayurvedic/herbal/naturopathy medications as these are known to worsen kidney failure. 5. If you are passing protein in urine and you have primary glomerulonephritis, achieving proteinuria control below 1g/day should be the target. The lower the better. This is usually achieved with medicines called ace inhibitors or arbs. The egfr is estimated to decline by around 5 ml/min/1.73m2 every year despite achieving above mentioned targets. As long as your egfr is not deteriorating at a faster pace than expected, you are in the right direction. 

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