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Can I avoid dialysis?

Q: I am 46 years old and found blood in urine eight months ago. I was told that I had polycystic kidney disease. My serum creatinine levels show fluctuation from the first test to recent test - 2.7, 2.4, 2.0, 2.1 and 2.4. I found that when my blood pressure is under control the creatinine levels go down. I want to know how long will I be able to avoid dialysis and what diet and exercises I should follow? My blood pressure is usually 150/100 mmHg to 130/90 mmHg.

A:Based on persistently elevated serum creatinine level of over 2.0 and associated polycystic kidney disease, you have an advanced chronic kidney disease with less than 30 % of normal kidney function at your age. You would need to constantly focus on strict blood pressure control (target BP <130/80mmHg), avoidance of exposure to kidney toxic medications, cut back on protein intake down to 50 grams per day along with diet low in simple carbohydrates and saturated fat, and checking and treating elevated blood cholesterol and sugar level if present. All these interventions are intended to delay the progression of kidney disease to the stage of complete failure. It is difficult to foresee need for dialysis in near future; however, if you end up with poor blood pressure control and increased leakage of protein in urine over period of time, then that would be a poor prognostic indicator of things to come, namely faster progression to the end stage renal disease.

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