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Reducing Kidney Function Decline in Patients With CKD: Core Curriculum 2021
Teresa K Chen1, Christopher J Sperati2, Sumeska Thavarajah2
1Division of Nephrology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
Summary
Chronic kidney disease (CKD) affects millions globally. Management focuses on slowing progression through blood pressure control, renin-angiotensin-aldosterone system blockade, and newer therapies like SGLT2 inhibitors.
Area of Science:
- Nephrology
- Internal Medicine
- Public Health
Background:
- Chronic kidney disease (CKD) affects 8-16% of the global population, characterized by reduced glomerular filtration rate or albuminuria.
- CKD progression leads to severe outcomes like kidney failure, cardiovascular disease, disability, and mortality.
Observation:
- Identifying the specific cause of kidney disease is crucial for targeted therapy.
- Optimizing blood pressure and renin-angiotensin-aldosterone system blockade are key management strategies, especially with albuminuria.
Findings:
- Sodium/glucose cotransporter 2 (SGLT2) inhibitors show high efficacy in patients with diabetes and/or albuminuria.
- For type 2 diabetes patients, glycemic control and glucagon-like peptide 1 receptor agonists can reduce albuminuria.
Implications:
- Comprehensive CKD management includes lifestyle modifications: weight management, low-sodium/protein diets, and avoiding nephrotoxins.
- Early intervention and tailored therapies are essential to slow kidney function decline and improve patient outcomes.
Keywords:
AlbuminuriaCKD progressionblood pressure (BP)chronic kidney disease (CKD)diabetesestimated glomerular filtration rate (eGFR)glucagon-like peptide 1 receptor agonist (GLP1-RA)glycemic controlhypertension managementlifestyle modificationproteinuriarenal functionreviewsodium/glucose cotransporter 2 inhibitor (SGLT2i)uric acid
