Q: My husband is 25 years old. Two years back he was diagnosed with congenital reflux nephropathy and that both his kidneys were affected. He has never suffered from urine infection and has been controlling his BP through medicines like Listril 5mg, Covance 50mg, Odoxyl 125mg, Persantin 25mg and Becousule. His creatinine two years back was 2.2 and now it is 2.3. He follows a strict diet and has also reduced weight. At what rate is his kidney functioning and is his problem progressing at a fast rate? Will he need transplant soon or can dialysis and transplant be delayed with healthy eating habits and controlled BP?

A:It is unfortunate that reflux nephropathy failed detection until recently. Rough estimation of his kidney function would be between 37-42%. Since only one value of creatinine is provided it is difficult to comment on if and how fast is his kidney function getting worse. If his kidney function stays at the same level and does not deteriorate, he would do well. He may start getting different symptoms once his kidneys worsen to less than 25-20%. One does not require dialysis until kidney function is less than 10% (15% for diabetics). If his kidneys do deteriorate to less than 18-20% a preemptive transplant may be considered which shall avoid him ever needing dialysis. Unfortunately, little can be done to reverse the damage already incurred. However, rate of progression may perhaps be slowed by strict control of BP to < 130/80 mm Hg, quitting smoking, controlling cholesterol and reducing proteinuria, promptly correcting anaemia if he ever develops during the course of disease.