Chronic Kidney Disease
Conditions We Treat
Chronic Kidney Disease
CKD is a long-term condition — but with the right specialist, its progression can often be slowed significantly. Early, aggressive management changes outcomes.
What is chronic kidney disease?
Chronic kidney disease is a progressive condition in which the kidneys gradually lose their ability to filter waste, excess fluid, and toxins from the blood. It affects roughly 37 million Americans — most of whom don't know they have it, because early CKD produces no symptoms.
The kidneys perform dozens of functions beyond filtration: they regulate blood pressure, produce hormones that stimulate red blood cell production, activate vitamin D, and maintain the precise balance of electrolytes that every organ in the body depends on. When kidney function declines, all of these systems are affected.
CKD is classified into five stages based on estimated glomerular filtration rate (eGFR) — a measure of how well the kidneys are filtering. The goal of nephrology management is to keep patients at the lowest possible stage for as long as possible, and to prepare them well if dialysis eventually becomes necessary.
CKD Stages
How we approach CKD
Identify and treat the cause
CKD has many causes — diabetes, hypertension, glomerulonephritis, genetic disease. Treating the underlying cause is the most powerful lever we have for slowing progression.
Aggressive blood pressure control
Hypertension accelerates kidney decline. We target blood pressure below 130/80 mmHg using agents that also protect the kidneys — ACE inhibitors, ARBs, and SGLT2 inhibitors.
Metabolic management
Anemia, bone disease, acidosis, and electrolyte imbalances are common CKD complications. We manage each proactively rather than waiting for them to become symptomatic.
Dialysis planning
For patients approaching Stage 5, we begin dialysis education early — explaining options, creating vascular access, and ensuring the transition is planned rather than emergent.
Frequently asked questions
What is chronic kidney disease?
Chronic kidney disease (CKD) is a long-term condition in which the kidneys gradually lose their ability to filter waste products, excess fluid, and toxins from the blood. It is defined by a GFR below 60 mL/min/1.73m² or evidence of kidney damage — such as protein in the urine — persisting for more than three months.
What are the stages of CKD?
CKD is classified into five stages based on estimated glomerular filtration rate (eGFR). Stage 1 (eGFR ≥90) indicates kidney damage with normal function. Stage 2 (eGFR 60–89) is mildly reduced. Stage 3a and 3b (eGFR 45–59 and 30–44) are moderately reduced. Stage 4 (eGFR 15–29) is severely reduced and requires dialysis planning. Stage 5 (eGFR <15) is kidney failure.
What causes CKD?
The two most common causes are diabetes and high blood pressure, together accounting for roughly two-thirds of all cases. Other causes include glomerulonephritis, polycystic kidney disease, recurrent kidney infections, prolonged use of certain medications (especially NSAIDs), and obstruction of the urinary tract.
Can CKD be reversed?
CKD cannot be reversed, but its progression can often be significantly slowed with the right treatment. Early diagnosis and aggressive management of underlying causes — particularly blood pressure and blood sugar — can preserve kidney function for many years.
When should I see a nephrologist for CKD?
Referral to a nephrologist is recommended when eGFR falls below 30, when there is significant proteinuria, when blood pressure is difficult to control, or when the cause of kidney disease is unclear. Earlier referral — at Stage 3 — leads to better outcomes.
Managing CKD requires a specialist.
Our nephrologists see patients at our Newport Beach office, affiliated with Hoag Hospital. We are accepting new patients.