[(How) can progression of chronic kidney diseases be retarded?]

Area of Science:

• Nephrology
• Internal Medicine
• Cardiovascular Medicine

Background:

• Chronic kidney diseases (CKD) can progress to end-stage renal disease, increasing cardiovascular morbidity and mortality.
• Irreversible scarring of renal tissue triggers maladaptive mechanisms leading to progressive kidney function loss.
• Currently, no specific medical treatments directly inhibit profibrotic processes in CKD.

Purpose of the Study:

• To critically discuss treatment options for retarding the progression of chronic kidney diseases.
• To review established and emerging interventions for managing CKD progression.
• To highlight the importance of cause-specific treatments and preventative measures.

Main Methods:

• Review of established and emerging medical treatments for CKD progression.
• Analysis of lifestyle modifications and preventative strategies.
• Discussion of the limitations of current therapeutic approaches.

Main Results:

• ACE inhibitors and angiotensin receptor blockers are the most established interventions for retarding CKD progression in proteinuric patients.
• Alkali supplementation shows promise in slowing CKD advancement.
• Moderating salt intake, smoking cessation, and avoiding acute kidney injury episodes are likely beneficial.

Conclusions:

• While specific anti-fibrotic therapies are lacking, established treatments and supportive measures can significantly retard CKD progression.
• Identifying and treating the underlying cause of renal disease is crucial.
• A multi-faceted approach including medication, lifestyle changes, and avoidance of 'second hits' is essential for managing CKD.