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Nephrology · Ahmedabad

Chronic Kidney Disease (CKD) Treatment in Ahmedabad

Chronic Kidney Disease is a gradual, lasting loss of kidney function present for more than three months. It is graded in five stages using eGFR and urine protein. CKD usually causes no symptoms until advanced, so it is detected through blood and urine tests. Early treatment can slow or halt progression and delay dialysis.

Reviewed by Dr. Pritish Shah, MBBS, MD (Internal Medicine), DrNB (Nephrology)Senior Consultant Nephrologist, Apollo Hospitals International Limited, Ahmedabad.

CKD is not a single illness — it is the end result of years of unnoticed damage, most often from diabetes or high blood pressure. Because the kidneys have enormous spare capacity, a person can lose more than half their kidney function and still feel completely well. That is precisely what makes CKD dangerous, and why blood tests matter more than symptoms.

The purpose of CKD care is not merely to record the decline. It is to change its slope. With correct staging, cause-directed treatment and modern kidney-protective medication, many patients hold stable function for years — and a meaningful number never reach dialysis at all.

Recognising it

Signs that may point to CKD

Swelling in the feet, ankles or around the eyes, especially in the morning
Foamy or persistently frothy urine, suggesting protein leak
Passing urine more often at night than you used to
Unusual fatigue, breathlessness on mild exertion, or poor appetite
Blood pressure that keeps rising despite medication
Itching, muscle cramps, or a metallic taste in the mouth
Anaemia that does not respond to iron supplements

In stages 1 to 3, most people have none of these. A normal-feeling body does not mean normal kidneys — only a test can tell you that.

Investigation

How CKD is confirmed and staged

Serum creatinine with eGFR

A blood test that estimates how much blood your kidneys filter each minute. eGFR is what assigns your CKD stage — creatinine alone can be misleading in people with low muscle mass.

Urine albumin-to-creatinine ratio (ACR)

Detects protein leaking into urine. Often the earliest abnormality of all, and a stronger predictor of progression than eGFR by itself.

Kidney ultrasound

Shows kidney size, structure, scarring, stones, cysts and any obstruction to urine flow. Small, shrunken kidneys usually indicate long-standing disease.

Cause-directed testing

Depending on the picture — HbA1c, autoimmune and immunological panels, hepatitis and HIV serology, serum electrophoresis, and occasionally a kidney biopsy when the diagnosis is unclear.

Staging

How CKD is staged

Your stage is set by eGFR — the percentage of normal filtering your kidneys still do. It determines how closely you need to be monitored and which treatments apply.

G190+Normal function,damage presentG260–89Mildly reducedG3a45–59Mild to moderateG3b30–44Moderate tosevereG415–29Severely reducedG5under 15Kidney failureeGFR (mL/min/1.73m²)Higher bar = more remaining kidney function
CKD is staged by eGFR — an estimate of how much blood your kidneys filter each minute. There are five stages, but stage 3 is split into G3a and G3b because the two behave differently, which is why six categories are shown. Stage alone is not the whole picture: protein in the urine independently predicts how fast the disease will progress, so a G2 with heavy protein leak can advance faster than a G3 without it.

Management

How CKD is managed

There is no single pill for CKD. Management works by attacking every factor that drives progression at the same time.

01

Treat the underlying cause

Tight glycaemic control in diabetes, immunosuppression in glomerular disease, relief of obstruction, or withdrawal of a nephrotoxic drug — whatever is actually driving the damage.

02

Blood pressure control

Usually targeting below 130/80 mmHg, typically with an ACE inhibitor or ARB, which lowers pressure inside the filtering units and reduces protein leak.

03

Kidney-protective medication

SGLT2 inhibitors, and in selected cases non-steroidal MRAs, have been shown to slow decline in both diabetic and non-diabetic CKD. These are among the most important advances in nephrology in decades.

04

Managing the complications

Anaemia, metabolic acidosis, high potassium and phosphate, vitamin D deficiency and CKD–mineral bone disorder each need correction — they cause symptoms and independently worsen outcomes.

05

Diet, calibrated to your stage

Practical, Gujarati-diet-aware guidance on salt, protein, potassium and phosphate. Restrictions are matched to your actual stage, not applied as blanket rules.

06

Avoiding further injury

Stopping habitual painkillers, checking contrast exposure before scans, dose-adjusting medicines, and treating infections early.

See a nephrologist promptly if

Any of these warrant a specialist review rather than watchful waiting.

  • Your eGFR is below 60, or has fallen on two readings taken three months apart
  • Protein or blood is present in your urine on more than one occasion
  • You have diabetes or hypertension and have never had a kidney test
  • Your blood pressure needs three or more drugs to control
  • There is kidney disease, dialysis or transplant in your immediate family
Book a consultation

Questions

Chronic Kidney Disease — frequently asked

Established scarring cannot be reversed, but progression can very often be slowed or stopped. The earlier CKD is found, the more function there is to protect. Many patients diagnosed at stage 2 or 3 maintain stable kidney function for years with correct treatment.

Please note: This page is general health information, not personal medical advice. Kidney disease varies significantly between individuals. Please consult a qualified nephrologist about your own reports before making any change to your treatment.