Our approach to managing CKD
Chronic kidney disease usually can’t be cured, but its progress can often be slowed — sometimes a great deal. That’s the heart of what we do. (For what CKD is, its stages, and what your numbers mean, see our in-depth chronic kidney disease guide.)
Good CKD management isn’t one thing — it’s a few proven goals pursued together, and adjusted to you over time:
Treating the cause
When diabetes or high blood pressure is driving the disease, controlling it is the single most important step.
Protecting with medication
Certain medicines do more than manage blood sugar or blood pressure — they shield the kidneys and slow the disease. Newer options have meaningfully changed what’s possible in recent years.
Supporting healthy habits
Eating well, staying active, and not smoking all help; some patients benefit from working with a dietitian.
Monitoring closely
Tracking your eGFR, urine protein (uACR), and blood pressure over time lets us catch changes early and adjust.
A CKD diagnosis today is not what it was a decade ago. Started early, the right combination of treatments holds many people’s kidney function steady for years.
This approach is reinforced by our participation in value-based care programs, where the quality of your care is judged by how well you do over time rather than how many visits you have. It’s a commitment to results that shapes everything from how often we check your labs to how quickly we adjust your plan.
The numbers we track — and why they matter
CKD is one of the few conditions where you can, and should, know your own numbers. Three measures tell most of the story, and the trend over time matters more than any single reading:
- eGFR — how well your kidneys filter. We watch whether it’s holding steady or slipping, and how fast.
- Urine protein (uACR) — how much albumin is leaking into your urine. Bringing this down is one of the clearest signs treatment is working.
- Blood pressure — checked at visits and, ideally, at home. Good control protects both kidneys and heart.
Where an office has an on-site lab, your doctor will order labs to be completed about a week before each visit, so your latest numbers are ready to review when you’re seen. We’ll always tell you your latest numbers and what they mean — and it’s worth writing them down and asking for them at every visit.
Kidney-protecting medications
This is where kidney care has changed the most. Not long ago, the main tools were blood pressure control and managing diabetes. Today there are several medications proven to protect the kidneys directly — and used together, their benefits add up. Current national guidelines frame treatment around a few “pillars”:
RAS inhibitors
ACE inhibitors and ARBs lower blood pressure and reduce urine protein — first-line when albuminuria is present.
SGLT2 inhibitors
Now used for many people with CKD and protein in the urine — with or without diabetes — slowing kidney decline and protecting the heart.
Nonsteroidal MRAs
Such as finerenone — for many with type 2 diabetes and CKD, further lowering kidney and heart risk. We monitor potassium when it’s used.
GLP-1 receptor agonists
Used in type 2 diabetes, these also show kidney-protective benefits and help with weight. A statin is often added to lower cardiovascular risk.
Not everyone needs every medication — the right combination depends on your cause, your numbers, your other conditions, and what you tolerate. Part of our job is deciding which pillars fit you, starting them safely, and adjusting as we watch your response. (For the specific program we offer around these newer therapies, see our advanced therapies for slowing CKD.)
Want to know if you're a candidate for the newer kidney-protecting medications?
Request an AppointmentWhat managing CKD with us looks like
For most people, CKD care settles into a steady rhythm. Here’s the shape of it:
Set the plan
We identify what’s driving your CKD, set blood pressure and blood sugar targets with you, and decide which kidney-protecting medications fit.
Check in regularly
Visits and lab checks on a schedule that fits your stage and stability — convenient where an office has an on-site lab.
Read the trend
We track your eGFR, uACR, and blood pressure over time to catch changes early — and explain what your numbers mean in plain language.
Adjust as life changes
Medications, diet, and the monitoring schedule are tuned as your numbers and your life change — not set once and forgotten.
How often you’re seen depends on your stage and how stable you are — more often when something’s changing, less when it’s steady. You’ll always know your latest numbers and what they mean.
Diet, lifestyle, and medication safety
Medication does a lot, but day-to-day habits do a lot too — and some of the most important kidney protection happens outside the office:
- Watch sodium. Less salt helps control blood pressure and fluid — a major lever for the kidneys. A dietitian can help you find lower-sodium swaps that still taste good.
- Tailor protein, potassium & phosphorus when needed. These matter more as CKD advances, and the right diet is individual rather than one generic restriction.
- Keep moving, and don’t smoke. Both directly affect kidney and heart health.
- Be careful with certain medications. Some over-the-counter pain relievers (NSAIDs like ibuprofen and naproxen) and supplements can stress the kidneys — tell us everything you take so we can review it.
A simple rule: don’t start or stop a medication or supplement without checking with us first. We’d rather you ask.
Coordinating your care
CKD rarely travels alone — it’s closely tied to diabetes, high blood pressure, and heart health. That’s why we coordinate with your primary care doctor and any specialists, like your endocrinologist or cardiologist, so everyone’s working from the same page rather than in silos.
Because the kidneys and the cardiovascular system are deeply linked, protecting your kidneys protects your heart at the same time — one reason several of the modern medications above were chosen for their heart benefits too. Good CKD care is, in a real sense, whole-body care. (See how this plays out in diabetic kidney disease and high blood pressure & kidneys.)
Planning ahead, if it’s ever needed
If CKD reaches a later stage, we talk with you well in advance about what comes next — including dialysis and transplant — so you have time to understand the options rather than face them in a rush. In the earlier stages the focus is protecting function; as CKD advances, care also shifts to managing its effects, such as anemia and bone and mineral changes.
And because our physicians provide medical direction and care at more than 30 dialysis centers across metro Atlanta, your care can stay connected even if dialysis ever becomes part of it. (See our dialysis care page for how that continuity works.)
Many people with CKD never need dialysis. If the disease advances, you’ll have time to understand every option — not face them in a rush.
