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

### input:
Dear Doctor Sir, I am 62yrs, 62kg, 5 1 female from India. I am Diabetic & Hypertensive and is on medication since last 14 years. Due to aggravation of urinay infection I was hospitalized in April, 2011, in a state of severe hypotensive and tachypneic condition. ABG showed severe metabolic acidosis with pH 6.9. I developed hypoxia and bradycardia for which I was intubated and put on ventilator. Doctors could manage with mechanical ventrilator, Vesopressors and haemodylasis for two days. Since then I am under a Nephrologist but my Creatinine, Serum level is increasing and reached the present level of 5.3 mg/dL . I have no remarkable body swelling except a bit of swelling in ankles. Feet get swelled if standing or walking for long time. I am very much worried and apprehensive about the prospect of dialysis during rest of my life span, which not started yet. May I seek your advice in this regard. Thanks & regards.----- Saswati D. Sikdar

### output:

Hi you are probably case of chronic kidney disease. Reduction in salt intake may slow the progression of diabetic CKD. Water restriction as needed to avoid volume overload. Avoid food containing high amount of potassium like juices and banana etcImmunise with hepatitis B vaccination. Control of blood pressure and blood sugar is very important to prevent progression of CKD. Treatment of high cholesterol if present. Avoidance of radio contrast media, painkillers and aminoglycosides Arrange for surgical creation of primary arteriovenous fistula. Renal transplantation is the best option for treatment of CKD if donor available. Take care.