Q: My 51 years old father is suffering from diabetes. It's a genetic problem in our family from my grandmother to my father and his siblings. Two of my uncles have already died due to kidney failure. Now, my father and one of his sisters have also got this same problem. Now, my father's creatinine level is 2.5 mg/dl. He has started taking insulin injections (5 mg daily) with some tablets. Please suggest.

A:Your father has chronic kidney disease related to diabetes. The approximate kidney function is about 30% (calculated creatinine clearance -30 ml/min). He needs to see a nephrologist to find if there is any factor which can be corrected to improve kidney function. Many times one might find a reversible factor and kidney function might improve. In any case we need to preserve the kidney function or more realistically slow down the rate of deterioration of kidney function. The best strategy for that is to maintain blood pressure to less than 130/80 mmHg and keep blood sugar well controlled (check glycosylated haemoglobin HbA1C every three months and target it to less than 7 %). This indicates three months average sugar in the body and reflects the quality of blood sugar control. You need to keep your father under regular care and follow up of a nephrologist.