Effect of diabetes on kidney function

Patient : My dad has diabetes; today he was informed that his kidney function has gone from a 42% down to a 26%...and he is stage 4 now. What does this mean? is it down hill from here, dialyse or what?
Doctor :   I understand your concern about your father’s kidney failure stage. At this stage the kidney filtration function is seve verely reduced. An estimate of 15-30% of renal function is maintained at this stage. Also this is one stage prior to end stage renal disease in which a decision for dialysis is granted, after that a possible kidney transplant might follow if dialysis fails. I would suggest him to comply with his Nephrologist’s indications and evaluations. He must stop any medication that might cause toxicity in the kidneys; Anemia must be screened and treated as well as acidic states and deficiency of vitamin D. I wish him the best.

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