[Management of mild and moderate forms of chronic kidney disease]

The prevalence of chronic renal insufficiency, the cost related to its presence and the associated high cardiovascular risk are increasing. Early detection is needed, with, in parallel, identification of all frequently associated cardiovascular risk factors. The general practitioner here plays a major role. Sometimes, a first reference to the nephrologist is requested, for instance in the presence of a nephritic or nephrotic syndrome, of an alteration of glomerular filtration rate without any clear explanation , or of a rather advanced renal dysfunction (a GFR < 60 ml/min in people < 65 years or < 45 ml/min in the others). This paper is concerned with mild and moderate forms of kidney disease (stages 1 to 3). In case of progression, a closer collaboration must exist between the general practitioner, the nephrologist and a trained dietician to slow down this progression, limit its consequences and delay as long as possible the initiation of kidney function supplying techniques.