<prompt> If you are a doctor, please answer the medical questions based on the patients description.Two month back my father got a brain stroke due to high bp...while medication and tests performed it was found dat hehas cronic kidney disease too and from last month his cretenine vary in between 3 to 4. Doctr has given aplazaar 2tab trice a day and two days back suggested for espogen 4000 once a week. Hemoglobin is 10.2. Is the medicine ok to avoid dialysis.  <response>: Hi, Chronic Kidney Disease CKD is due to persistent underlying disease like diabetes, uncontrolled high blood pressure, untreated kidney stones, rarely it may develop as a consequence to AKA Acute Kidney Injury. In your fathers case I want to know-1 Presence of Diabetes, Blood pressure, Cholesterol problems if any and treatment taken for it.2 Any habits like smoking, alcohol. Stage of CKD depends on EFR Glomerular Filtration Rate it depends upon Age, gender, serum creatinine, weight. Treatment of CKD is to prevent or to slow the process of deterioration of kidney function. It requires-1 Diet with adequate vegetarian proteins.2 Control of Diabetes, blood pressure, cholesterol.3 Avoidance of nephrotoxic food and medicines like pain killers4 Water intake needs to be restricted if there is tendency to retain water.5 Low Potassium intake avoid intake of fruit and fruit juices, coconut water in case there is potassium retention in body.6 Maintain calcium, phosphorus, uric acid levels under control.7 Avoid smoking, alcohol. 8 Screening for complication on heart. As you have mentioned your father has got stroke it means he is at increased risk for other vascular events like heart attack coronary artery diseaseRegarding medicines you have mentioned-APLAZAAR: it is a nutritional supplement containing amino acids and other nutrients for kidney that help in containing kidney function but not necessarily it will avoid dialysis. SPOKEN: It contains erythropoietin a hormone needed for hemoglobin formation and is produced by kidney. It is used in CKD because deterioration of kidney function is associated with decreased production of erythropoietin and low hemoglobin. Treatment of CKD is to prevent or to slow the process of deterioration of kidney function. It requires-1 Diet with adequate vegetarian proteins.2 Control of Diabetes, blood pressure, cholesterol.3 Avoidance of nephrotoxic food and medicines like pain killers4 Water intake needs to be restricted if there is tendency to retain water.5 Low Potassium intake avoid intake of fruit and fruit juices, coconut water in case there is potassium retention in body.6 Maintain calcium, phosphorus, uric acid levels under control.7 Avoid smoking, alcohol. Need for Hemodialysis depends on on-1 Amount of Urine production daily.2 Serum electrolyte mainly Potassium.3 Serum Creatinine level.4 Arterial Blood Gas ABG analysis which denote degree of acid accumulation in blood.5 Signs of water retention like breathing difficulty, swelling over body, puffiness of face. 