Q: My 46 years old colleague had a kidney failure due to malignant hypertension. Later, kidney improved from 4.4 mg/dl serum creatinine to 3.25 mg/dl and creatinine clearance to 30. The doctor said that this would remain stable at this number. It has been stable for the last 4 years. He is taking Dilzem 30 mg and Atacand 12.5 mg daily. Is there any way to improve the situation?

A:Your colleague has chronic kidney disease probably resulting from elevated blood pressure, accounting for an irreversible damage to the kidneys with loss of more than 75% of kidney function at his age. Unfortunately, it is not possible to retrieve the lost function by any means. Instead, one could delay the progression of the disease process if not arrest it, by measures including continued strict control of BP (goal BP <130/80 mmHg) and avoidance of exposure to kidney toxic medicines including daily continuous intake of common pain medications like Voveran and Nimulid.