Why didn't my doctor start preventative treatment immediately after abnormal markers?
In Stage 2 CKD with stable markers and no proteinuria above a certain threshold, the current KDIGO guidelines do not recommend starting medications like ACE inhibitors or SGLT2 inhibitors as a default. The reason is not financial — it is that the risk-benefit calculation genuinely changes at different stages. Starting a nephroprotective medication in someone whose kidneys may stabilise on their own, with lifestyle changes alone, means exposing them to side effects and costs without a proven net benefit.
That said — if your markers showed proteinuria above 300mg/g, or if your blood pressure was consistently above 130/80, the guidelines would have supported earlier intervention.