Management of Chronic Kidney Disease and its Complications

DeckerMed Medicine Pub Date : 2018-10-21 DOI:10.2310/im.1053
Joshua S. Hundert, Ajay K. Singh
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Abstract

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia
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慢性肾脏疾病及其并发症的处理
早期肾功能衰竭的管理有助于减少或预防终末期肾脏疾病。本章讨论了肾功能的监测,包括一个表,显示了常用的监测方法。慢性肾衰竭的危险因素包括中风和心脏病。肾脏疾病进展的危险因素有糖尿病、高血压、蛋白尿、吸烟、蛋白质摄入和高脂血症。慢性肾功能衰竭的并发症包括钠和水失衡、钾失衡、酸中毒、钙和磷失衡以及贫血。还有一个部分,讨论的情况下,早期转诊到肾病专家。表中给出了用于估计肾小球滤过率(GFR)的公式;慢性肾脏疾病的分期及其管理的适当步骤;慢性肾脏疾病的危险因素,其中蛋白尿检测和GFR的估计是必要的;慢性肾病患者的适当饮食;以及诊断和治疗慢性肾脏疾病引起的贫血的指南。一种算法概述了肾脏疾病患者钙和磷酸盐管理的步骤。【关键词】终末期肾病,慢性肾病,肾小球滤过率,肾病患者饮食改变,蛋白尿肾病,高尿酸血症
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