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

### input:
Hello, Dr. Rynne, I ve been a type 2 diabetic since February 1999 and I m being treated for hypertension. Both conditions are presently well-controlled. On September 9 of this year, blood test revealed eGFR of 57, creatine 1.36, calcium 10.8. My physician told me I was mildly anemic (I told her that I had eaten any meat for 9 months) and she said she d test again in 3 months (end of November). She also said she suspected I was dehydrated and she directed me to resume eating meat and to report for biweekly B-12 shots. Blood test results taken during work-related physical on October 3 indicated eGFR of 54, creatine 1.36 (again) and calcium 10.8 (again). Showed second set of results to my physician who told me not to be too concerned and to await follow-up blood test scheduled for end of November. She doesn t believe I have CKD at this point and feels that the totality of my bloodwork doesn t justify this diagnosis. She stated that eGFR values can move up and down given many factors at time of testing. I have read that once eGFR diminishes, it cannot recover...Doctor, is it possible that I don t yet have kidney disease? And is it possible for eGFR to improve?

### output:

Hi, I appreciate your concerns. The risk factors for CKD in your case are diabetes and blood pressure of long duration. If the GFR remains below 60 for a duration of 3 months we label it as CKD stage 2. If you have significant amount of protein in the urine most likely you have kidney dysfunction secondary to diabetes. But there is nothing to worry as we have diagnosed it early and if taken precautions the EFR can be maintained for a long time. The key to prevent further progression at this point is a good control of blood sugar and blood pressure, weight reduction and regular follow up. The anemia is most likely secondary to nutritional deficiency as you are already taking vitamin supplements. I will e pleased to take any queries from you. Tx