Iam 79 years old and was diagnosed with stage 3 ckd five years ago . My primary keeps tabs on my blood work and since I have stayed at the same level for five years he feels no need to see a neprologist. I take carvedilol,amlodipine and lisinopril for hypertension. Iam on no special diet except for watching my sodium.intake. I wonder if I should be doing more.

@rozalia, you and I are almost twins with our CKD, hypertension, and medications (although our dosages may differ). I'm curious about why you were prescribed Carvedilol (a beta blocker) and Amlodipine (a calcium channel blocker) at the same time; I used the latter then switched to the former. Lisinopril and I have been friends for years! Dosages for me are Carvedilol (25mg twice a day), Lisinopril (40 mg once). My third medication is Amiloride (10mg twice a day) as a diuretic; it signals my main difference with you -- a potassium-sparing diuretic that accommodates a genetic tendency in my kidneys that fails to reclaim potassium after filtering it out with sodium.

The dispute you cite -- regarding the proper target level for your BP -- is mine as well, involving the same specialists. My nephrologist favors higher targets for me (an "elderly" 81) than my cardiologist, although he has not challenged the higher targets of 140/90 or less. My primary also accepts my preference for nephrology in dealing with BP.

Your primary sees no role for nephrology in your stable CKD and yields to your cardiologist on BP. In my case, nephrology is the priority specialty on BP, and cardiology is focused especially on the heart and my circulatory system. In one sense, I see an advantage for you in the tension between cardiology and nephrology. Do you think your primary sees nephrology dealing with familiar kidney functions only, not including blood pressure?

My lab tests are ordered mainly by my primary physician to maintain a data base on me; neither specialist has ordered lab tests for three years. All agree that my CKD is stable and unremarkable, and I don't have any symptoms from it. Now if my medical team can figure out what problem a-fib is causing, I'll be totally under control of my physical condition.

I can not go to a nephrologist until stage 4 in Canada,our government medical does not allow it. I see a dietitian for free in 3 weeks at my local hospital. I am 54 and 2 years a go my kidney function was 92%, 4 months a go 70%, 3 months a go 70%. It is considered a problem to change so fast and I am arranging to get some blood tests on this. It is considered a problem if it changes 10% a year, even if in the normal range. I have 3 blood clots in one lung, 3 months a go found out my kidneys are not producing the hormone that makes hemoglobin and was given a hormone replacement shot and Iron pills. My blood tests showed white and red blood cells were both damaged,wrong shape and size and not enough of both. I am on Xarelto for 3 blood clots in one lung from 3 months a go and will arrange on my own for blood tests to see if improved. I was told to add salt daily to keep my blood pressure at 96/65 otherwise it is 80/60 daily and 120 with no exercise for 3 days and immediately down after my gym class. If I exercise daily blood pressure is the same before and after exercise. Maybe it is all kidney related.??

@lindaw, I'm surprised that you cannot see a nephrologist in your province until you are Stage 4. Which province do you live in?

Here is information about referrals from the Kidney Foundation of Canada https://www.kidney.ca/information-and-referral Perhaps you could contact them to get more information.

Hi, @lindaw. I saw your two other messages on the Diminished Kidney Function discussion and want you to know that we at Mayo Connect get related to people like you and want to help in some small way to smooth your path to feeling better and gaining strength.

Your last question points directly at my primary advice: Find out if your kidneys are at the core of your problems as soon as you can. That answer probably would come from a nephrologist. In cases of kidney failure, a dietician is usually called in to get that side of your therapy in order, but nephrology and endocrinology may be where your problem can be defined concretely -- endocrinology because of the hormone involvement you have and because your hypotension may be related to hormones that involve your kidneys and the adrenal glands attached to them.

The cause of your blood clots also needs concrete definition. Has your medical team explained what might have caused them and what steps to take -- beyond an anti-coagulant medication -- to protect you in the future?

I also wondered whether you are bearing the major responsibility for finding out how to diagnose your conditions and treat them. I'd be lost if I tried to assume that much responsibility. I do enough research and consultation that I can come up with relevant questions for medical professionals to answer, but I don't let them off the hook on the main medical questions. I expect them to give me the best medical advice, as well as treatment, that they can, and I try to develop a relationship with them in which they feel primary accountability for diagnosis and therapy. And I soon let them know that I prefer to search for cures not for simply maintenance nostrums. This has worked for me; my doctors have all thanked me for keeping up on the medical issues and therapy choices.

Please keep us abreast of your journey through medical care. We want to see you get on the upward road to tomorrow.

Has anyone worked with an Australian doctor with a program called A KIDNEY SOLUTION. HE promises a cure. Is he for real or bogus ?

Hello @rickgc. First, welcome to Connect and thank you for joining in. You are right to question anyone promising a cure. Is this a treatment recommended by your physician, or a treatment that you have discussed with your medical provider? A good rule of thumb, whether a product works or not, is to always keep your medical provider in the loop on anything that you ingest, from supplements, to foods, when you are dealing with a serious disease or diagnosis. Typically, someone promising a cure that is not affiliated with a medical institution is cause for some questions and concerns.

@rickgc, what does the program include? If you don't mind sharing, have you been diagnosed with CKD?

Yes. At present, I am CKD, Stage 4. GFR NOW AT 24. Took Lithium dosage of at least 2,000 mg/day for 30 years. In 2006, I was diagnosed with CKD Stage 3 due to Lithium. Stopped taking Lithium in 2006. Used diet and exercise to maintaind Stage 3, GFR 35,1 for 10 years. Prescribed Dexilant in October of 2016 to correct a strained voice, hoarseness condition. E.N.T. doctor said it was "Lerd." This is similar to GERD but effects the larynx. When a routine blood test was taken in December of

2016, GFR DOWN TO 20. Hoping to avoid dialysis or transplant is why this ad from Dr. Duncan Capicchiano, ND caught my attention. Has anyone had dealings with his program? If it's bogus, I do not want to waste my Nephrologist's time or my money to review it
https://healthskeptic.org/kidney-disease-solution-review/

@rickgc,, Hi, I am a liver/kidney recipient and a volunteer mentor. I am speaking from my own experience. I have learned that kidney failure can be due to many causes. For instance, mine was acute renal failure related to end stage liver disease.

I can understand why this site caught your eye. And I think that you should discuss it with your nephrologist. If this remedy does "reverse all types of kidney disease", as it states, then your nephrologist will want to know more about it himself. I don't believe he would consider it to be a waste of his time to bring it up.

I would like to share with you links to Mayo Clinic's information on end stage kidney disease and chronic kidney disease
https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/symptoms-causes/syc-20354532
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521
When is your next appointment? and How are you feeling?
Rosemary