CKD in Diabetes: Diet, Meds, and Safer Bladder Treatments
Dr. Roach says CKD management hinges on solid diabetes care and lifestyle, not supplements: keep sodium under 2,000 mg daily, favor plant-based protein, and tightly control blood pressure with ACE inhibitors/ARBs (target ~130 mm Hg, possibly lower). Medications like finerenone may help when BP goals aren’t reached; SGLT2 inhibitors (e.g., empagliflozin) slow kidney decline, and GLP-1 drugs can offer heart/kidney protection with weight loss. An A1C goal of about 6.5–7.5% is typical but individualized. For bladder symptoms, long-term anticholinergics such as oxybutynin carry a small dementia risk; trospium has lower risk, and beta-3 agonists (mirabegron, vibegron) are often preferred when possible.