Chronic Kidney Disease Care in Southlake, TX

Chronic kidney disease is usually found on a routine blood test, and the early stages are managed well right here. The goal is straightforward: slow the decline, protect your heart, and avoid the medications that make it worse.

Diagnosis and staging

We stage using eGFR from a blood test alongside the urine albumin-to-creatinine ratio. Both matter, and using only the blood test misses a great deal of early disease, particularly in people with diabetes.

One abnormal eGFR is not a diagnosis. Dehydration, a recent illness, a heavy protein meal and even a hard workout move it. We repeat it, ideally three months apart, before labeling anyone with a chronic condition.

We also look for a cause. Diabetes and high blood pressure account for most of it, but we check for obstruction, kidney stones, autoimmune disease, myeloma in older patients, and medication effects, because some causes are reversible if you catch them.

What slows it down

• Blood pressure control, targeting under 130 over 80 for most people. The highest-yield intervention available. See high blood pressure.
• ACE inhibitors or ARBs when there is protein in the urine. They protect kidneys beyond their blood pressure effect, and a small creatinine rise after starting one is expected rather than alarming.
• SGLT2 inhibitors, which slow kidney decline in people with and without diabetes. This is the largest change in kidney care in decades and it remains underused.
• Glucose control where type 2 diabetes is the driver.
• Avoiding NSAIDs. Regular ibuprofen and naproxen do real damage to compromised kidneys, and most people taking them daily have no idea.
• Finerenone in diabetic kidney disease with albuminuria, which adds protection on top of the above.

Monitoring

Stage 1 to 3 with stable numbers gets labs every six to twelve months. Faster decline or heavier protein loss means every three months.

We watch potassium and bicarbonate, screen for anemia and bone mineral changes as function drops, and keep a close eye on your cholesterol, because cardiovascular disease kills far more people with CKD than kidney failure does. See high cholesterol.

Home blood pressure data makes a real difference here, and many CKD patients qualify for our remote patient monitoring program.

Medication safety

Kidney function changes how a lot of drugs are dosed, and this is where avoidable harm happens.

We check every prescription against your current eGFR, adjust metformin and gabapentin and several antibiotics accordingly, and flag anything that needs holding around contrast imaging. Bring us your supplements too, since several herbal products are directly nephrotoxic.

Diet, realistically

Reducing sodium helps blood pressure and is worth real effort. Protein restriction is more nuanced than the internet suggests and we would rather you not lose muscle chasing it.

Potassium and phosphorus restrictions become relevant at later stages, not early ones. We will tell you when they apply to you rather than handing you a generic renal diet sheet at stage 2.

When we involve nephrology

An eGFR under 30, rapid decline, heavy proteinuria, difficult potassium problems, or an unclear cause. We refer, send records with the referral, and keep co-managing rather than handing you off entirely.

Kidney care runs through our chronic condition management program. See our primary care Southlake practice overview.