Advances in chronic kidney disease pathophysiology and management

Chronic kidney disease (CKD) is a major health concern in Australia, with a prevalence of 9% among non-Indigenous adult Australians and 18% among Aboriginal and Torres Strait Islander people. CKD is a risk factor for cardiovascular disease, kidney failure and other complications.

The aim of this article is to outline recent advances in CKD pathophysiology and management, focusing on strategies for slowing disease progression and preventing cardiovascular and other complications.

All patients with CKD benefit from a healthy lifestyle including regular physical activity, avoiding smoking and obesity, and limiting sodium intake. Nephrotoxic medications and other risk factors for acute kidney injury should be avoided. Treatment of the underlying pathology is important, along with control of hypertension, reduction in albuminuria (if present) and treatment of dyslipidaemia. Patients with renal anaemia, mineral and bone disorder, or advanced disease should normally be cared for in partnership with a nephrologist.