The Management of Chronic Kidney Disease not Requiring Renal Replacement Therapy in General Practice.

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Deutsches Arzteblatt international Pub Date : 2025-01-24 DOI:10.3238/arztebl.m2024.0230
Simone Kiel, Martha Negnal, Sylvia Stracke, Susanne Fleig, Martin K Kuhlmann, Jean-François Chenot
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Abstract

Background: Chronic kidney disease (CKD) is common in the German adult population, with a prevalence of 10%. This guideline, updated on the basis of current scientific evidence, contains recommendations for the management of CKD in general practice.

Methods: The updated guideline is based on a review and assessment of source guidelines and systematic reviews concerning individual questions. The recommendations were agreed upon in a moderated two-stage nominal group process by the mandate holders of the participating specialist societies, along with patient representatives.

Results: The risk of progression to renal failure requiring renal replacement therapy should be assessed with a risk score. Assessing this risk and determining the indication for treatment with SGLT2 inhibitors both require measurement of the urinary albumin-to-creatinine ratio. Pharmacotherapy is not recommended for asymptomatic hyperuricemia. An initial ultrasonographic examination of the kidneys and urogenital system is now recommended for all patients. The vaccination recommendations that differ for people with CKD have been integrated into the guideline.

Conclusion: The risk assessment of CKD and the treatment options have been expanded. The updated guideline can improve primary care for patients with CKD and the selection of patients for interdisciplinary care.

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背景:慢性肾脏病(CKD)在德国成年人中很常见,发病率为 10%。本指南在当前科学证据的基础上进行了更新,包含了在全科实践中对慢性肾脏病进行管理的建议:方法:更新后的指南是在对有关个别问题的来源指南和系统综述进行回顾和评估的基础上制定的。方法:更新后的指南是在对来源指南和有关个别问题的系统性综述进行回顾和评估的基础上制定的,由参与的专科学会的任务负责人和患者代表通过两阶段的名义小组程序达成一致意见:结果:应通过风险评分来评估进展为肾衰竭、需要进行肾脏替代治疗的风险。评估这种风险和确定 SGLT2 抑制剂的治疗适应症都需要测量尿白蛋白与肌酐的比值。对于无症状的高尿酸血症,不建议采用药物治疗。现在建议对所有患者进行肾脏和泌尿生殖系统的初步超声波检查。针对 CKD 患者的不同疫苗接种建议已纳入指南:结论:扩大了慢性肾脏病的风险评估和治疗方案。更新后的指南可以改善对慢性肾脏病患者的初级护理,并为跨学科护理选择患者。
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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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