@sultanvr I am diabetic (50ish years) and have a history of high blood pressure, as Ginger said these are the two most common causes of kidney disease. I also have been diagnosed with chronic kidney disease (CKD) stage 4.
I have an endocrinologist for the diabetes and a nephrologist for the CKD. The nephrologist has prescribed blood pressure meds (Amlodipine, Losartan and Torsemide) plus an OTC antacid because he felt my urine was too acidic. The Amlodipine is the smallest dose possible. I haven’t had any med changes in a long time and my blood pressure is now well controlled. I have a BP cuff at home to test and I keep the record to show my nephrologist at office visits.
My endocrinologist and nephrologist are in the same health care system. They can collaborate on my care and can share records. I also have seen a dietician/ nutritionist who is well versed in diabetes and renal nutrition requirements. This has been very helpful. There are dietary requirements for both conditions and for hypertension as well that you should be aware of.
For your questions:
1) Hydration - As Ginger said, your nephrologist can advise you on the proper amount of hydration.
2) It is the high blood sugars of Diabetes that is hard on the kidneys. My nephrologist said “it is like expecting the kidneys to filter syrup. It clogs them up over time and is damaging.” The “crashes” or low blood sugars aren’t harmful to the kidneys but are dangerous in so many other ways and can be life threatening! 47 is way too low!
3) Reduced flow of urine and enlarged prostate are concerns and questions for a urologist. I’m not sure if that would affect the eGFR.
4) Amlodipine - mentioned this above. There are lots of options for blood pressure meds. You can review it with your nephrologist on 2/3. If it isn’t working for you the doctor can probably recommend something else.
Hope all goes well with your appointment.