A Personal Introduction
Chronic Kidney Disease, commonly known as CKD, is a subject close to my heart. I have written several articles about this disease over the years, but those earlier articles were written before artificial intelligence tools became available to help me research medical developments.
Today, CKD is no longer just a scientific subject that interests me. It is part of my personal life.
Last year, I was diagnosed with Stage 4 CKD. I am now under the care of a nephrologist, a physician who specializes in kidney diseases. My background as a pharmaceutical chemist and my years working at the U.S. Food and Drug Administration (FDA) have taught me to appreciate both the promise of medical science and the importance of examining scientific evidence carefully.
At nearly 92, I have learned that growing older brings questions that we might never have considered when we were younger. One of mine is this: How much progress has medical science made in detecting kidney disease early, slowing its progression, and helping people live better lives with damaged kidneys?
I recently explored these questions with the help of AI. What follows is my personal summary of some important developments in kidney medicine as of October 2026.
1. What Is Chronic Kidney Disease?
Our kidneys are two remarkable organs, each roughly the size of a fist. They filter waste products and excess water from the blood, regulate important minerals, help control blood pressure, and contribute to the production of red blood cells.
When the kidneys become damaged, they gradually lose some of these functions. Waste products and excess fluid may accumulate, and complications involving blood pressure, anemia, bones, and the heart can develop.
CKD is generally defined as an abnormality of kidney structure or function that persists for at least three months.
The disease is divided into five stages, based primarily on the estimated glomerular filtration rate, or eGFR. This blood-test-based estimate indicates how effectively the kidneys filter the blood.
Stages 1 and 2: Evidence of kidney damage may be present even though filtration remains relatively well preserved.
Stage 3: Kidney function has declined moderately.
Stage 4: Kidney function is severely reduced, generally with an eGFR of 15–29.
Stage 5: Kidney failure, generally with an eGFR below 15.
My diagnosis of Stage 4 CKD means that I have significantly reduced kidney function. However, Stage 4 does not automatically mean that a person must immediately begin dialysis. The decision depends on the individual's symptoms, laboratory results, complications, overall health, and personal circumstances.
CKD can progress at different rates. Some people experience a gradual decline over many years, while others deteriorate more rapidly. The underlying cause and the quality of medical care can make a difference.
2. Early Detection: Two Simple Tests Can Make a Difference
One of the most important lessons in kidney medicine is that CKD can develop silently.
A person may have substantial kidney damage without feeling sick. There may be no pain, no obvious warning signs, and no noticeable change in daily activities.
This is why early detection is so important.
Two routine tests can provide valuable information:
First, a blood test measuring creatinine. Creatinine is a waste product that the kidneys normally remove. Its level, together with other information, is used to estimate the eGFR.
Second, a urine albumin-to-creatinine ratio, or uACR. Albumin is a protein that normally remains in the blood. When the kidneys are damaged, some albumin can leak into the urine. An elevated uACR can reveal kidney damage even when the eGFR is still relatively normal.
The two tests complement each other. A normal eGFR does not necessarily rule out early kidney disease, and a urine test can reveal abnormalities that a blood test alone might miss.
People with diabetes, high blood pressure, cardiovascular disease, a family history of kidney disease, or a previous episode of acute kidney injury should discuss appropriate screening with their healthcare providers.
The U.S. Centers for Disease Control and Prevention emphasized this approach in its September 2025 guidance on CKD screening. Early diagnosis allows treatment to begin when there is more kidney function to preserve.
For me, this is one of the most important messages I can share: Do not wait for symptoms before asking whether your kidneys are healthy.
3. Newer Treatments: Slowing the Disease Rather Than Simply Treating Its Symptoms
There is encouraging news in kidney medicine. Researchers have developed treatments that can slow kidney function decline and reduce the risk of complications in appropriately selected patients.
These medicines do not work for everyone, and none should be started without a clinician's assessment.
SGLT2 inhibitors: A major advance
Sodium-glucose cotransporter-2 inhibitors, usually called SGLT2 inhibitors, were initially developed to treat type 2 diabetes.
Examples include dapagliflozin and empagliflozin.
Researchers subsequently discovered that these medicines can also protect the kidneys and the heart in many patients with CKD, including some who do not have diabetes.
They work partly by changing how the kidneys handle glucose and sodium and by reducing pressure inside the kidney's filtering units. In eligible patients, they can slow kidney disease progression and reduce certain cardiovascular risks.
This has been a major change in medical practice. A medicine originally developed for diabetes can have important benefits beyond blood sugar control.
However, people with advanced CKD need individualized assessment. Whether an SGLT2 inhibitor is appropriate depends on factors including the eGFR, the cause of CKD, other medications, and the person's overall condition. Some patients already taking one may continue it as kidney function declines, while starting treatment at very low eGFR levels may not be recommended under current prescribing guidance.
GLP-1 medicines: More than diabetes and weight management
Another important development involves glucagon-like peptide-1 receptor agonists, known as GLP-1 medicines.
Semaglutide is one example. It is used for type 2 diabetes and, in certain formulations and circumstances, weight management.
Clinical research has demonstrated kidney and cardiovascular benefits in selected people with type 2 diabetes and CKD. These benefits may involve improved metabolic control, reduced inflammation, lower cardiovascular risk, and effects on kidney disease progression.
The FLOW clinical trial, published in 2024, provided important evidence that semaglutide could reduce major kidney-related and cardiovascular outcomes in people with type 2 diabetes and CKD.
This is promising, but the results should not be interpreted as proof that semaglutide is appropriate for every person with kidney disease. Its potential benefits, side effects, nutritional effects, and suitability must be evaluated individually.
Finerenone: An expanding area of research
Finerenone is a nonsteroidal mineralocorticoid receptor antagonist. It reduces harmful mineralocorticoid signaling involved in inflammation and scarring.
It is already used to reduce kidney and cardiovascular risks in eligible patients with CKD associated with type 2 diabetes.
A particularly interesting development occurred in June 2026, when the New England Journal of Medicine published results from the FIND-CKD trial. The study found that finerenone slowed the decline in kidney filtration over 32 months in adults with CKD who did not have diabetes.
In October 2026, the FDA accepted an application seeking to expand finerenone's use to adults with CKD without diabetes. Acceptance of an application does not mean that the expanded indication has been approved.
Finerenone can increase blood potassium, sometimes dangerously. Kidney function and potassium levels therefore require careful monitoring.
These findings are encouraging because kidney disease is not always caused by diabetes. A treatment that helps people with other forms of CKD could eventually benefit a broader population.
Sources for these developments include the FLOW and FIND-CKD clinical trials and the Kidney Disease: Improving Global Outcomes (KDIGO) clinical guidance.
4. What About People Already in Stage 4 CKD?
This is the question that matters most personally to me.
The treatments discussed above are not cures. They are tools that may help preserve remaining kidney function, depending on the patient's circumstances.
For people with Stage 4 CKD, medical care often focuses on several priorities:
Monitoring kidney function and the rate at which it changes.
Controlling blood pressure and diabetes when present.
Reviewing medicines that may protect the kidneys or treat complications.
Managing anemia, acid-base disturbances, and abnormal potassium or mineral levels.
Adjusting nutrition and fluid intake to individual needs.
Reducing cardiovascular risks and preserving strength and quality of life.
A nephrologist may also discuss what to expect if kidney function declines further, including dialysis, transplantation when appropriate, and comprehensive conservative kidney care.
These discussions do not mean that kidney failure is inevitable in the immediate future. They help patients understand their options and make decisions before a crisis develops.
For an older adult, treatment decisions must also take account of frailty, other illnesses, independence, and personal priorities. The most appropriate plan is not necessarily the one that involves the greatest number of medicines or procedures. It is the one that best serves the individual patient.
5. Artificial Intelligence: A New Tool for Early Detection
Artificial intelligence is beginning to influence how researchers identify and manage kidney disease.
As a longtime scientist and blogger who now uses AI to help research medical topics, I find this development especially interesting.
AI systems can examine large amounts of information, including laboratory results, medical histories, medications, and patterns in electronic health records.
A conventional review might examine a patient's latest creatinine result. An AI system may be able to analyze several years of results and detect a pattern of gradual decline that deserves attention.
Researchers are investigating several potential applications.
Early-warning systems: AI may identify patients at increased risk of developing CKD or experiencing a rapid deterioration in kidney function.
Medical-image analysis: Researchers are exploring whether AI can identify signs associated with kidney disease from medical images, including ultrasound and other imaging studies.
Risk prediction: AI may help clinicians estimate the likelihood of kidney failure or complications, potentially supporting earlier referrals and better planning.
Personalized treatment: In the future, AI may help doctors compare patient characteristics and predict which treatments are most likely to provide benefits with acceptable risks.
One interesting 2026 research report examined whether deep-learning systems could identify CKD from echocardiograms, ultrasound recordings of the heart. The researchers tested their model at multiple healthcare institutions. The results suggest that heart images may contain information useful for identifying patients who could benefit from kidney evaluation.
This is an intriguing idea because the heart and kidneys are closely connected. Disease in one organ can affect the other.
However, an experimental AI model is not the same as an established diagnostic test. Most AI applications for early CKD detection still need further evaluation to demonstrate that they improve patient outcomes in everyday clinical practice.
AI should support, not replace, clinical judgment. Its predictions must be checked against reliable medical tests, and its performance must be assessed across different populations.
I see AI as a promising additional tool in the physician's toolbox—not a substitute for the physician.
6. Prevention: Protecting the Kidneys We Have
Although not every case of CKD can be prevented, many risk factors can be reduced or managed.
The following measures are especially important.
Control blood pressure. High blood pressure can damage the kidneys, while kidney disease can make blood pressure harder to control. Appropriate treatment can help interrupt this cycle.
Manage diabetes. Persistently elevated blood glucose can damage the kidney's filtering structures. Individualized glucose control and kidney-protective treatment can reduce risks.
Avoid unnecessary kidney-harming medicines. Nonsteroidal anti-inflammatory drugs, commonly called NSAIDs, include ibuprofen and naproxen. These medicines can cause kidney injury, particularly in people with CKD, dehydration, or certain other medical conditions. People with kidney disease should ask their healthcare providers or pharmacists before using them.
Be cautious about supplements. Products advertised as natural or as cures for kidney disease are not necessarily safe. Certain herbs, high-dose vitamins, and supplements can cause harm or interact with prescription medicines. Claims that a product can reverse advanced CKD should be viewed skeptically unless supported by convincing clinical evidence.
Follow an appropriate diet. A kidney-friendly diet may involve limiting sodium and adjusting protein, potassium, phosphorus, and fluid intake. However, requirements differ according to laboratory results, medications, nutritional status, and CKD stage. People with advanced CKD should work with their nephrologist or a renal dietitian rather than following a restrictive diet found online.
Stay physically active within your abilities. Appropriate exercise can support cardiovascular health, mobility, and general well-being.
Avoid smoking and maintain regular medical follow-up. Smoking increases cardiovascular risks, and cardiovascular disease is closely linked to CKD.
There is no single diet, supplement, or lifestyle practice that guarantees protection against kidney disease. The goal is to reduce avoidable damage while maintaining overall health.
7. What I Have Learned From Living With CKD
My experience with CKD has reinforced something I learned during my scientific career: knowledge is valuable only when we use it wisely.
A diagnosis of Stage 4 CKD can be unsettling. It is natural to wonder how quickly the disease will progress and what the future will bring. Yet one laboratory result cannot tell the entire story. Trends over time, the underlying cause, other health conditions, and the response to treatment all matter.
I rely on the care of my nephrologist, and I believe patients should feel comfortable asking questions. What is my latest eGFR? Is there albumin in my urine? How quickly is my kidney function changing? Which medicines are appropriate for me? Are there supplements or over-the-counter drugs I should avoid?
These are practical questions, and the answers can help patients participate more actively in their care.
I also believe that patients should be cautious about promising new treatments. A laboratory experiment is not the same as a successful clinical trial. A successful clinical trial is not the same as an approved treatment. And an approved treatment is not necessarily suitable for every patient.
Having spent years working in pharmaceutical chemistry and drug regulation, I appreciate the importance of evidence, safety, and careful evaluation.
AI can help us understand complicated medical research, but it can also make mistakes. I use it as an aid to research and writing, not as a replacement for my physician.
Conclusion: Hope, Knowledge, and Living One Day at a Time
Medical science has made meaningful progress in the fight against chronic kidney disease. Better screening, kidney-protective medicines, more accurate risk prediction, and emerging AI technologies offer reasons for cautious optimism.
Yet millions of people around the world remain unaware that their kidneys are damaged. Many could benefit from simple blood and urine tests before the disease reaches an advanced stage.
For readers who have diabetes, high blood pressure, or other risk factors, I encourage you to discuss kidney screening with your healthcare provider. For those already living with CKD, regular monitoring and an individualized treatment plan remain essential.
As for me, I am approaching my 92nd birthday while living with Stage 4 CKD. I cannot predict what the coming years will bring, but I can continue learning, writing, maintaining my interests, and sharing what I discover with my readers.
I am grateful that modern technology, including AI, allows me to continue researching subjects that matter to me and to communicate with people around the world.
I do not expect medical science to solve every problem. But I welcome each genuine advance that helps people preserve their health, independence, and dignity.
Perhaps the most important lesson is this: We cannot always choose the illnesses that touch our lives, but we can choose to seek knowledge, ask questions, make informed decisions, and appreciate the days we have.
Disclaimer: This article is for educational purposes and reflects my personal interest in CKD. It is not a substitute for medical advice, diagnosis, or treatment. People with CKD, especially Stage 4, should consult their nephrologist before changing medicines, supplements, diet, or fluid intake.
Sources for further reading
These are useful references if you would like to add links to your blog post or explore the research further.
KDIGO 2024 CKD Clinical Practice Guideline - international recommendations on detection, risk assessment, and treatment. Read the guideline.
CDC: Screening for Chronic Kidney Disease (September 2025) - explains why people at increased risk should be screened. Read the CDC guidance.
CDCFIND-CKD trial, New England Journal of Medicine (June 2026) - research on finerenone in CKD without diabetes. Read the clinical trial.
New England Journal of MedicineKDIGO's 2026 guideline update announcement - explains the ongoing review of newer CKD therapies. Read the announcement.
KDIGOResearch review: Artificial intelligence in CKD - discusses AI's potential and limitations in early detection and risk prediction. Read the review.
PMC
AI suggestion before publishing: Because you are writing as someone personally living with Stage 4 CKD, the strongest feature of this post is the combination of your own experience and your scientific perspective. I would retain the personal introduction and conclusion even if you later shorten the technical sections.
- SGLT2 Inhibitors: Originally developed for type 2 diabetes (such as Jardiance and Farxiga), these medications have become a cornerstone of CKD care. They reduce pressure inside the kidney’s filtering units and significantly slow the progression of kidney decline, regardless of whether a patient has diabetes.
- GLP-1 Receptor Agonists: Drugs like Ozempic are widely recognized for metabolic health, but clinical evidence shows they also offer profound, independent anti-inflammatory and protective benefits for the kidneys.
- Non-Steroidal MRAs: Medications like Finerenone target specific pathways to directly reduce inflammation and fibrosis (scarring) in the kidneys, filling a critical gap in traditional care.
- Traditional RAS Blockade: ACE inhibitors or ARBs continue to serve as the baseline pillar for blood pressure and protein stabilization.
- C3 Glomerulopathy (C3G): Targeted complement inhibitors like iptacopan (Fabhalta) are available to directly reduce proteinuria.
- IgA Nephropathy (IgAN): Therapies such as atacicept-vymj (Trutakna) target underlying biological pathways to prevent disease progression in at-risk adults.
- Xenotransplantation: Successful bridge procedures utilizing genetically modified pig kidneys have cleared the path for large-scale clinical trials.
- Cellular and Artificial Tech: Researchers are actively evaluating engineered CAR-T therapies to solve complex transplant rejection issues, alongside ongoing developments in artificial kidney technology.
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| THE CKD SURVEILLANCE PAIR |
+------------------------------------+--------------------------------------------+
| 1. eGFR (Blood Test) | Measures how efficiently your kidneys |
| | filter waste products. |
+------------------------------------+--------------------------------------------+
| 2. uACR (Urine Test) | Checks for micro-amounts of albumin |
| | (protein) leaking through filters. |
+------------------------------------+--------------------------------------------+
- Plant-Predominant Nutrition: Emphasizing whole-food, plant-heavy diets reduces the acid load on the kidneys and simplifies the management of phosphorus and fluid balances.
- Careful Electrolyte Monitoring: Tracking and regulating the intake of sodium, phosphorus, and potassium prevents dangerous metabolic complications as kidney function declines.
- Consistent Activity:Combining low-impact cardiovascular movement with light strength training optimizes blood pressure control, improves systemic circulation, and preserves physical mobility
- My Photo of the Day- Halloween Candy Treat from my Neighbor
Thank You Sandi G, for your thoughtfulness. Happy Treat or Trick!
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