Treatment of chronic kidney disease

Area of Science:

• Nephrology
• Internal Medicine
• Pharmacology

Background:

• Chronic kidney disease (CKD) management aims to delay progression to end-stage renal disease (ESRD).
• Current therapeutic options for CKD are limited, necessitating exploration of novel treatment strategies.
• Existing treatments, including blood pressure and glycemic control, show some efficacy but are insufficient alone.

Purpose of the Study:

• To review current and emerging therapeutic targets for slowing CKD progression.
• To identify limitations in existing CKD treatments and their application.
• To highlight practical barriers hindering optimal patient outcomes in CKD.

Main Methods:

• Literature review of established and investigational therapies for CKD.
• Analysis of evidence supporting blood pressure and glycemic control in CKD management.
• Examination of metabolic disturbances and other pathological processes as therapeutic targets.

Main Results:

• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) for blood pressure control and glycemic control in diabetes are the most evidenced therapies.
• Metabolic disturbances like acidosis, hyperphosphatemia, and vitamin D deficiency present potential therapeutic targets but require further investigation.
• Emerging drug classes targeting endothelin, fibrosis, oxidation, and advanced glycation end products are in various developmental stages.

Conclusions:

• While some therapies exist, effective treatments to halt CKD progression remain limited.
• Incomplete application of current treatments, patient education, and transition to ESRD care are significant practical challenges.
• Further research into metabolic targets and novel drug development is crucial for improving CKD patient outcomes.