Chronic Kidney Disease Management

Patients at CKD stage 3b (eGFR 30–44) or beyond benefit most from specialist care, as this is when the risk of progression to ESRD and complications (anemia, bone disease, cardiovascular events) increases significantly. However, if you lack access to a nephrologist at home or have been told your CKD is progressing faster than expected, earlier specialist input is valuable. Patients at stage 4–5 who are approaching the need for dialysis particularly benefit from proactive pre-ESRD planning, including AV fistula creation — ideally 6–12 months before dialysis is needed. Our partner nephrologists will review your trajectory and help you decide on the optimal timing and modality of renal replacement therapy.