What every doctor needs to know about chronic kidney disease

Chronic kidney disease is a global health problem that affects over 10% of adults worldwide. All doctors should have a basic knowledge of chronic kidney disease because it may complicate the management of many other medical conditions and is associated with numerous adverse outcomes. Chronic kidney disease should be regarded as a clinical syndrome rather than a specific diagnosis and attempts should always be made to identify the cause. Simple risk prediction tools have been developed to inform management decisions. Management is directed at slowing progression of chronic kidney disease and reducing the associated cardiovascular risk by treating hypertension, use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers as first-line therapy in high-risk cases, treatment with statins and lifestyle measures. Patients at high risk of rapid progression or requiring specific therapy as well as those with chronic kidney disease stage 4 or 5 should be referred to a nephrology service.