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[What is confirmed in the treatment of chronic kidney disease?]
Robert Greite1, Kai Schmidt-Ott2
1Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover (MHH), OE 6840, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. greite.robert@mh-hannover.de.
Insights
Chronic kidney disease (CKD), marked by albuminuria or reduced GFR, affects 10% of people. Early detection and management by primary care physicians are crucial for preventing severe complications like cardiovascular events and dialysis dependency.
Area of Science:
- Nephrology
- Internal Medicine
- Public Health
Context:
- Chronic kidney disease (CKD) affects ~10% of the global population.
- Diabetes mellitus is the leading cause of CKD.
- CKD progression significantly increases risks for cardiovascular events, dialysis, and mortality.
Purpose:
- To provide a concise summary of current CKD treatment strategies and complications.
- To highlight current clinical practice guidelines (DEGAM, KDIGO) for CKD management.
- To discuss emerging therapeutic options for CKD.
Summary:
- CKD is characterized by persistent albuminuria or decreased glomerular filtration rate (GFR) over 3+ months.
- Referral to a nephrologist is recommended at specific GFR thresholds (≤30 or ≤60 ml/min/1.73 m²) with cofactors.
- General practitioners and internists manage the majority of CKD patients, necessitating awareness of current data.
Impact:
- Improved understanding of CKD management for primary care physicians.
- Potential for earlier detection and intervention in CKD patients.
- Facilitates integration of new therapeutic findings into clinical practice for better patient outcomes.
Abstract:
Chronic kidney disease (CKD) is defined as a relevant excretion of albumin into the urine or a reduction of the glomerular filtration rate (GFR) over a longer time period of ≥ 3 months. The causes of CKD are manifold, whereby the association with diabetes mellitus is the most frequent cause. Early stages of CKD affect approximately 10% of the total population. The frequency of cardiovascular events, the risk of dependency on dialysis and the all-cause mortality increase exponentially with a decrease in the GFR and an increase in albuminuria. The guidelines of the German College of General Practitioners and Family Physicians (DEGAM) and the organization Kidney Disease: Improving Global Outcomes (KDIGO) recommend referral to a nephrologist with a GFR of ≤ 30 or ≤ 60 ml/min/1.73 m2 in the presence of various cofactors. This means that the majority of CKD patients are treated by general internists or general practitioners. This article gives a concise summary of current data on the treatment of CKD and its associated complications in clinical practice. It refers to the current guidelines and also new study results which could perspectively expand the therapeutic repertoire.
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