CKD-MANAGEMENT

SUMMARY

1. Progression of CKD is slowed by ACEis or ARBs (target BP = < 130/80) and possibly by reduced protein intake (controversial).

2. ACE Is and ARBs decrease intraglomerular pressure, which decreases progression. They also suppress TNF-alpha, which stimulates fibrosis.

3. Management of comorbidities also decrease progression, so treat metabolic acidosis, hyperlipidemia and stop smoking.

4. Avoid nephrotoxins - especially contrast dye, NSAIDs, and aminoglycosides.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].