I would like to know what nephrologists monitor during pre-CKD and what patients are told to do regarding diet, medications. Thank you.

I have never not answered a question … but this one is just a bit too general. You are, effectively, asking me to write a text book on the management of CKD.

Much as I would like to answer this, I would need to cover the entire process of CKD monitioring: renal function, blood pressure, anaemia, iron, calcium-phosphate-PTH, inflammatory status, cardiovascular health and/or morbidities, diabetes and its monitoring, infective status, gastrontestinal symptoms and associated symptoms, vascular health … and more.

I would need to deal with extensive dietary issues: the dietary management of diabetes, of protein and carbohydrate care, of weight control, of sodium and potassium balance, of lipid management … and more.

I would need to cover a vast array of potentially important tests - ones that need serial (repeated) follow-through … and these tests groups and the frequency of their monitoring, all vary, patient to patient, disease to disease, and also will vary relative to the severity of the CKD.

To be fair to me at this forum, I simply cannot cover all that (and more) in a single answer to your queston - yet, to answer you wisely and completely, I would need to encompass all those aspects of CKD manangement … and more.

If you scan back through the many, many posts and threads at this site over the years, you will find topics that will likely cover the individual parts of your ‘I-need-a-text-book’ question. These may help. Can I encourage you to spend a little time doing this.

Further, we have recently identified that some of the threads at the site are a little obscure as to the thrust of the question. The way the site currently works, the 1st few words of the question (and its answer) describe the thread or post. Sometimes, these words or phrases do NOT adequately set out the question or the answer by their primary intent.

Brian, our IT guru, is working on ways to better group threads into topics or ‘sections’ to allow easier identification of (1) the question or topic and (2) the answer.

Furthermore, Dori Schatell and I have been putting together a book for patients … a book that will explain all (and more) or the implications contained within your question. The text is done (it is a 190 page effort) and it is with a panel of reviewers right now. We hope it will be ready to go to the publishers by the end of the year. It is an easy-to-read attempt at simple explanations of complex problems - both at CKD and at dialysis levels. It should be available on the open market in bookstores (we hope) early next year.

Meantime, I hope you wont be too affronted by my reluctance to answer your question in full … it is beyond the scope of this site (or my answer-in-my-free-time-after-a-days-work capacity) to write a textbook-long answer!

However, if you want to come back with more targeted and specific questions, I would be happy to try to answer them.