[SEMERGEN position paper on chronic kidney disease]

Area of Science:

• Nephrology
• Primary Care Medicine
• Public Health

Background:

• Chronic kidney disease (CKD) prevalence in Spain ranges from 7-30%.
• CKD significantly increases risks for kidney disease progression, cardiovascular events, and mortality.
• Underdiagnosis of CKD necessitates improved screening in at-risk populations like those with hypertension and diabetes.

Purpose of the Study:

• To provide recommendations for improving CKD care in primary care settings.
• To address the gap between clinical guidelines and current practice for CKD management.
• To facilitate early diagnosis and optimal treatment of CKD patients.

Main Methods:

• Review of clinical trial evidence for pharmacological interventions in CKD.
• Analysis of current CKD screening and management practices.
• Development of a position paper for primary care physicians.

Main Results:

• Recommended pharmacological treatments for diabetic CKD include RAS inhibitors, SGLT2 inhibitors, finerenone, and GLP1 receptor agonists (e.g., semaglutide).
• For non-diabetic CKD, RAS inhibitors and SGLT2 inhibitors are the preferred treatments.
• Primary care is identified as the ideal setting for CKD screening, diagnosis, and management.

Conclusions:

• Early and comprehensive treatment, including combination therapy, is essential for managing CKD.
• There is a need to enhance the implementation of CKD guidelines in clinical practice.
• Improving primary care's role in CKD management can lead to better patient outcomes.