[Management of Patients with CKD in Clinical Practice]

Area of Science:

• Nephrology
• Internal Medicine
• Geriatrics

Background:

• Chronic kidney disease (CKD) is prevalent in Europe, affecting 3-17% of the population, with increased risk in the elderly.
• CKD is often comorbid with diabetes mellitus, arterial hypertension, and autoimmune diseases.
• Age-related decline in renal function necessitates careful consideration, independent of medication.

Purpose of the Study:

• To summarize key aspects of chronic kidney disease (CKD) management.
• To highlight the importance of individualized therapy and lifestyle modifications in CKD patients.
• To emphasize the need to prevent acute-on-chronic renal failure.

Main Methods:

• Review of current understanding and therapeutic approaches for CKD.
• Discussion of risk factors, comorbidities, and age-related renal function changes.
• Emphasis on pharmacotherapy adjustments, lifestyle interventions, and avoidance of nephrotoxic insults.

Main Results:

• CKD management requires careful medication review, especially for antibiotics and painkillers, with dose adjustments often necessary.
• Lifestyle modifications including weight reduction, salt and fructose restriction, adequate hydration, and control of blood glucose, blood pressure, and hypercholesterolemia are crucial.
• Diuretics and RAAS inhibitors are identified as beneficial therapeutic agents in CKD.

Conclusions:

• Effective CKD management hinges on a multifactorial approach, integrating pharmacotherapy, lifestyle changes, and vigilant monitoring.
• Avoiding polypharmacy and preventing acute kidney injury are essential to preserve renal function, particularly in older adults.
• Individualized treatment strategies are paramount for optimizing outcomes in patients with chronic kidney disease.