Dr. Roach on how to combat chronic kidney disease

Key Points:

• Chronic kidney disease (CKD) is common, especially in older adults and those with diabetes, and effective treatment focuses on diet and medical care rather than supplements, which lack strong evidence for slowing CKD progression.
• Recommended dietary measures include limiting sodium intake to less than 2,000 mg daily, moderating protein intake to about 0.8 grams per kilogram per day with an emphasis on plant-based proteins, and adopting a mostly plant-based diet to reduce kidney failure risk and improve outcomes.
• Optimal blood pressure control (targeting around 130 mm Hg or lower) using ACE inhibitors, angiotensin receptor blockers, or finerenone is crucial, along with individualized blood sugar management (A1C goals between 6.5% and 7.5%) and use of medications like empagliflozin (Jardiance) and GLP-1 receptor agonists for kidney and heart protection.
• Oxybutynin, an anticholinergic medication for bladder symptoms, has been linked in observational studies to a small increased risk of dementia with long-term use, but the absolute risk remains low; alternatives like trospium or newer beta-3 agonists (mirabegron, vibegron) may offer similar benefits with fewer cognitive risks.