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

### input:
Hi! I am Rajesh Ajmera, staying in Mumbai, aged 58 years, I am a CKD patient since more than 10 years. My Creatinine  levels today is 5.88, BUN is 39, Blood Urea is 86. Before 10 years my Creatinine level was 2.2 to 2.5. All my other parameters are within range since the last 10 years. My Hg level today is 13.5 which was 15.2 before 6 months. Kindly suggest whether Dialysis/Transplant is required in the near future? Can it be delayed or completely eliminated? Kindly suggest ways & means , if possible.

### output:

Hello sir, As you have already told your biochemical picture looks like CKD. If you don't have problem with eating food with no nausea, no severe swelling of the body, no weakness, then you can postpone hemodialysis for now. You may require renal replacement therapy (RRT)In the future ...but when it is difficult to predict. You have three modes of RRT at present hemodialysis, peritoneal Dialysis and kidney transplantation. You can choose either of them based on your feasibility . Renal transplantation is the best form of RRT provided you have a donor. I would suggest you to get an AV fistula operation done at the earliest so that you can avoid Dialysis catheter insertion once Dialysis is initiated. For now, you need to keep few things under control such as Restrict fluid intake to 1 liter per day, restrict salt, non veg food, avoid food rich in potassium i.e. fruits, juices coconut water, keep your BP under control, keep your sugars under control, avoid painkillers. Please get monthly creatinine, electrolytes tested and review with your physician . Hope I was of help. Please get back to me for further queries