Optimizing care for chronic kidney disease: Considerations from A to Z

Area of Science:

• Nephrology
• Internal Medicine
• Pharmacology

Background:

• Chronic kidney disease (CKD) management demands a comprehensive, multidisciplinary strategy for optimal clinical outcomes.
• Evidence-based guidance is crucial for enhancing patient care and slowing disease progression.

Purpose of the Study:

• To systematically review and outline essential components of CKD care from A to Z.
• To provide evidence-based guidance for optimizing patient management in CKD.

Main Methods:

• Systematic review of current evidence and guidelines for CKD management.
• Analysis of therapeutic strategies for anemia, hypertension, cardiovascular risk, glycemic control, and nephrotoxicity.
• Evaluation of interventions for electrolyte/acid-base balance, fluid management, nutrition, and mineral/bone disorders.

Main Results:

• Anemia treatment involves iron, ESAs, and HIF-PH inhibitors.
• Optimal BP control with RAS inhibitors and CCBs, and cardiovascular risk management with statins, ezetimibe, PCSK9 inhibitors, and anticoagulation are key.
• Individualized glycemic control using SGLT2 inhibitors and GLP-1 RAs, avoidance of nephrotoxins, and management of electrolytes, acid-base, and fluid balance are crucial.
• Nutritional interventions, CKD-mineral and bone disorder therapies, lipid management, dialysis access, and arrhythmia detection improve outcomes.
• Addressing quality-of-life issues enhances patient-centered care.

Conclusions:

• A multidisciplinary approach is crucial for comprehensive CKD management.
• Evidence-based strategies across multiple domains significantly enhance patient outcomes and slow disease progression.
• Integrating pharmacological, nutritional, and supportive care optimizes the management of chronic kidney disease.