As stated by Dr Rohit sir in absence of clear guidelines and research backed results it is best to not promise much in this case. But in general I would like to share my basic concept of CKD management which we can use for our patients.

In CKD the severity or prognosis of disease is measured by checking Sr creat and GFR of the patient. Oversimplifying the subject, creat ( by product of muscle damage/wear and tear) is something that has to be filtered out through kidneys and excreted by urine. When that doesn’t happen it usually indicates failing kidney function and shows up in form of Raised creat. In Ayurveda mutra is responsible for Kleda (vikrut/again related to mansa and meda dhatu) vahan , so if mutra utpatti is hindered Kleda sanchiti will occur.. even though Kleda and creat cannot be one and the same. I have treated patient on same principle. So Kledapachak and Kleda sodhak medicines should be used. In traditional formulations Arogyavardhini, Chandraprabha and Punarnava mandoor help. In Madhavbaug we can definetly use our medicines like Sothagni , punura in combination with Pachanvati or goodilax for good improvment. Keeping in mind most of Severe CKD paitent exhibit vaat prakop lakshna (karshya, karshnya etc)  too, using Siddha ghrit is also advised in those cases.. more so because Vrukka is referred to be medo moola.

Lastly USG grading of Kidney disease is also very important in prognistic prediction. A case with very poor corticomedulary diffentiation will show poor/slow response to any treatment.