AR











GFR =0

You have Chronic Kidney Disease

You should see nephrologist to identify the cause and start the management

The aim is to:

  1. Slow down the progression
  2. Treat underling cause
  3. Manage the complications
  4. Preperation to fifth stage

Slow down the progression

  • control blood pressure
  • control blood suger
  • low protien diet, less than 0.8 gm per kg, avoid protein starvation
  • keep away from salts
  • never use pain killer except panadol
  • do not try non medical presecriptions
  • do not use Aminoglycosides antibiotics
  • drink suffecient amount of fluids, to prevent dehydration
  • Avoid Pickles and spices

    Treat underling cause

  • continue medical treatment


    Manage the complications

    evaluates complocations
    nurse.jpg Hemoglobin
    Potassium
    Phosphorus
    Calcium
    PTH
    Albumin
    Serum pH



    • Preparation to fifth stage

    you may progress to end stage kidney disease which require Renal Replacement Therapy

    Renal Replacement Therapy include two options :

  • Dialysis either Hemodialysis Or Peritoneal Dialysis
  • Kidney Transplant cadaver or living donor

    If you choose hemodialysis, it better to prepare for that

    the only thing is to prepare something called blood access

    the best blood access is called arteriovenous fistula

    Why to prepare it in advance:

  • It is the best among all the blood access types:
    1. It take time to mature, usually months
    2. It small incision under the skin, it may not noticed by others
    3. An AV fistula uses your own arteries and veins without the need for artificial material
    4. There are no artificial components used.
    5. They can function for years.
    6. Less chance to be infected or clotted.
    7. Provide good blood flow
    8. AV fistulas are less expensive
    AV-fistula.jpg stage 3.jpg