Doctor Ho Tan Thong, from the Nephrology - Dialysis Unit at Tam Anh General Clinic District 7, reported that Mr. Tan's blood creatinine level was 189 µmol/L, nearly double the normal range. His glomerular filtration rate (GFR) was 35 ml/min/1,73 m², accompanied by proteinuria. Doctors diagnosed Mr. Tan with chronic kidney disease stage 3b.

Mr. Tan also had hypertension, dyslipidemia, and diabetes – all risk factors for kidney disease progression and cardiovascular events. According to Doctor Thong, persistently high blood pressure can affect the heart and kidneys. Reduced kidney function impacts fluid balance and blood pressure, straining the heart. Some cardiovascular medications can also alter creatinine or blood potassium levels, particularly with declining kidney function.

Mr. Tan during a follow-up visit with Doctor Thong. Photo: Tam Anh General Hospital

Doctor Thong consulted with cardiologists and endocrinologists to develop a treatment regimen. This plan prioritized "dual protection" diabetes medications for the heart and kidneys, aiming to slow glomerular fibrosis and reduce heart failure risk. It also involved reducing medications that could negatively impact kidney function. Mr. Tan's blood sugar, blood pressure, kidney function, edema, fluid retention, and underlying conditions were closely monitored to adjust medication dosages promptly.

Mr. Tan adhered to the treatment regimen, limiting salty foods and avoiding processed or high-fat foods. His protein intake and water consumption were adjusted according to kidney function, rather than excessive restriction. At a follow-up after two weeks, Mr. Tan's GFR increased to 46 ml/min/1,73 m², and his creatinine dropped to 150 µmol/L. Three months later, his GFR continued to rise above 60 ml/min/1,73 m². His foamy urine and edema decreased, kidney function stabilized, and he continued monitoring and treating his underlying cardiovascular disease and diabetes.

Doctor Thong emphasized that patients should adhere to their diet, control blood sugar, blood pressure, and kidney function to prevent damage to renal and cardiac blood vessels. He advised drinking water as needed, about 1,5-2 liters daily, to ensure good renal perfusion. Patients should maintain protein intake from lean meat, fish, and chicken breast at 0,8 g/kg body weight/day and undergo regular check-ups.

The Ministry of Health estimates that over 10 million Vietnamese suffer from chronic kidney disease, accounting for about 12,8% of the population. According to Doctor Thong, early-stage kidney disease often presents no clear symptoms. Most patients only discover their condition incidentally during examinations for other ailments, or when the disease has already progressed significantly.

Doctors advise patients not to wait until they experience significant edema, infrequent urination, or fatigue before seeking medical attention, as this could miss the early detection stage. Individuals with persistent foamy urine should visit a hospital for examination and tests to determine the cause. Those with multiple underlying conditions must effectively control blood pressure and blood sugar, and use medications cautiously to avoid placing a heavy burden on the kidneys.

Ha Thanh

* Patient's name has been changed