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

### input:
My GFR was as low as 50 and should never be below 60. With symptoms such as kidney flushing 24/7 and peeing 45 times a day and falling asleep my Doctor was not concerned but he upped my thyroid meds to much and told me my body would adjust in 6-8 weeks. I asked for my blood work the last two years and found  I had moderate to chronic kidney disease.I do not no the cause have seen a specialist a couple of times. He let me know we have a kidney dialysis in our hospital.And there is medication  I can take. Is there no other recourse? I drank chinese herbs for 1 1/2 years it just stablized it and stopped the symptoms and did not fall asleep. I have since found something I can take daily all natural and never felt better.Do not know how long it will last. But for now it is great. Thankyou just want to know the cause.

### output:

Hi. According to the information that you provided, you are correct in mentioning that you have moderate chronic kidney disease i.e, CKD 3 (GFR= 30-89). Well at this level of GFR dialysis is not initiated, but preparation like AV fistula formation can be considered if the rate of fall of GFR is very steep. There are many causes of chronic kidney disease as I will mention, but Herb Nephropathy seems likely in your case, according to the history you provided. Among the notable causes are Diabetes, Hypertension, Chronic Glomerulonephritis, Obstruction of the bladder or urethra or both of the ureters, Autosomal dominant Polycystic Kidney Disease, Chronic Pyelonephritis due to reflux nephropathy, Interstitial nephritis (One of the cause is Balkan or herb nephropathy)and some other rare inherited diseases. Regads