Dear Achilles Heel
I hate to defer an answer to a question, but my role at the Home Dialysis Central site and the brief I have sustained here for the last 5 years or so has been to answer questions regarding haemodialysis - and, in particular, home haemodialysis.
To open the can of worms into early or mid-CKD3, long before the preparatory phase for dialysis needs to begin, would open this largely altruistic service to a far greater degree than I can hope to manage.
These questions are for your advisor(s) … whether they be nephrologists, endocrinologists, dietetics, or others. In all these areas, slow but cumulative inroads are being made into the slowing of CKD progression, the remodelling of CKD-related damage already done, and the improving of symptomatic CKD in the later phases. Your advisors will - or should - know as much (or more) than I do of these incremental advances. They, not I, are your best avenues for optimising your individual care.
As each patient is different, as each has unique issues, circumstances, and co-morbidities, CKD treatment plans should (and must) vary, patient to patient, and there is no one-size-fits-all. If I give you any advice on this issue, it is that: seek the best individualised plan - for you, as an individual - and avoid generic fast-fixes. As the latter often are fed by generic advice or comment made at Internet sites, you will, seriously, do better if you channel your energies into working with ‘real people’ in your local area.
I can only encourage you to form strong relationships with your face-to-face team, and not become so Internet-hooked that you begin to cherry-pick nebulous advice from the net - whether that be from me, or others in this space - in preference to adopting hard-worked treatment plan with the experts who know you.
Your best way to stave off what may still prove to be the inevitable, is to work with your home team, and not some unknown-to-you ‘advisor’ on the Internet.
Good luck …