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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.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|April 24, 2021
PubMed
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.

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

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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.