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Deteriorating GFR: Going from Stage 3B CKD to Stage 4
Based on my analysis of blood tests, my 70-year old aunt currently has Stage 3b CKD and is actually close to Stage 4.

Back in 8/2008, her GFR was 49.5. A year later, it's 32. This is a loss of 17.5ml/min over 12 months. Every test I looked at, her BUN (22-23), Creatinine (1.3-1.6) and Choloride (112) are elevated.

I suspect it was out-of-control hypertension which caused her kidney function to deteriorate. I measured her BP at 200/110 several occasions over the weekend.  She says she was stressed out on weekends.  But her resting BP on weekdays was still around 160/100.

I don't know what her internist has been doing but they apparently thought her hypertension was under control. She stopped taking Hydrochlorothiazide 25mg, something she was on, a while ago.  

I put her back on it and made an appointment with her internist so that a nephrologist can be seen. What are we looking at here?  Am I correct in my analysis?  I had to self-teach nephrology in 2 days!  

I'm more concerned about the rapid decline in GFR than her 3b being so close to 4. We just ordered her November blood results to be sent and I'm afraid to look at the results and see really how low her GFR has gotten this time.
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bp is a big factor in renal failure, controlling is very important, is she on ace inhabitors if not why these can control bp, also no take out food or added salt to diet, is she on a renal diet if not WHY!.  water should be limited to 1.5 ltr a day, what is her weight and height and ethnic orign.
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She is about 5' and 95 lbs.  She's Asian.  She was on Hydrochlorothiazide (HCZD) for a while but inexplicably discontinued the medication a few months ago after discussing with her doctor; apparently they felt her BP had normalized.  Well, it clearly hasn't!  

I'm asking her to go on a low sodium diet.  My impression is, her sodium intake is high.  She likes spicy dishes.  


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these tablets are not for bp any way there for water balance, she must take ace inhibtors in kidney disease, ramipril is a good one, renal diet is essential, low salt low spice low potassium low fat, LOW PROTEIN, less oil, currys must be watery not spicy, i would limit protein to 40 grm a day or less, go and see a nephrologist, search the net for a good one,
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