### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am 32 Year old female suffering from CKD since 6 years. I was diagonised with CKD 6 years ago. It was initially 1.4 and slolwly progressed to 5.6 last November over the past 6 years. Now my Creatinine is fluctuating between 4 and 4.4. I have very Normal BP (between 100 and 110) and no Diabetes. No history of CKD. My Ultrasound revealed that my size of kidneys are 7 cm. I have good appetite and no swelling. I Urinate well, sometimes more that usual. Biopsy was not done as I missed that timeframe. Is it possible to maintain this? How to Maintain? I am vegetarian? Can I take Cudo Forte? Will that help? Appreciate your response in this regard.

### output:

Your disease is progressive. It cannot be reversed. Based on your weight you may be in stage IV or V. You need to be prepared for the next options. That is called renal replacement. It can be dialysis (either hemodialysis or peritoneal dialysis) or a preemptive renal transplantation. You need to have access for dialysis that is to be created now. Regarding food current guideline suggest taking a low protein diet, since you are a vegan avoid pulses. Restrict fruit/fruit juice intake. Measure your urine volume at least once a week and adjust your daily fluid intake accordingly. Be alert for any decrease in urine output, swelling of body or breathlessness. Visit your nephrologist at least once a month, check your serum creatinine and serum potassium at least once in a fortnight.