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Review
. 2015 Jul;17(7):514-27.
doi: 10.1111/jch.12560. Epub 2015 Apr 27.

Defining, Treating, and Understanding Chronic Kidney Disease--A Complex Disorder

Dean Campbell  1 , Matthew R Weir  2
Affiliations
Review

Defining, Treating, and Understanding Chronic Kidney Disease--A Complex Disorder

Dean Campbell et al. J Clin Hypertens (Greenwich). 2015 Jul.

Abstract

Chronic kidney disease (CKD) is prevalent in more than 20 million people in the United States. The majority of care provided to patients with this disease comes from primary care physicians, although it is often poorly understood. After an extensive literature review, it is clear that it can be difficult to classify and there are many barriers to care. Risk factors for both incident CKD and disease progression include hypertension, poor glycemic control, sociodemographic factors, acute kidney injury, metabolic acidosis, and possibly hyperuricemia and dietary factors. Treatment of patients with CKD should focus on mitigating risk factors, as well as common comorbidities such as cardiovascular disease, anemia, and bone mineral disease. Novel therapies such as pirfenidone, pentoxifylline, and endothelin-1 antagonists are being investigated with promising results.

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Figures

Figure 1
Figure 1
Potential chronic kidney disease (CKD) treatment strategies. RAAS indicates renin‐angiotensin‐aldosterone system.
Figure 2
Figure 2
Glomerular filtration rate (GFR) and albuminuria categories for staging of chronic kidney disease (CKD).3
Figure 3
Figure 3
Outcomes of major trials assessing strict glycemic control vs traditional glycemic control in patients with chronic kidney disease (CKD). CVD indicates chronic kidney disease. See text for trial expansions.
Figure 4
Figure 4
Incidence of diabetic nephropathy in the Irbesartan Diabetic Nephropathy trial.
Figure 5
Figure 5
Fibroblast growth factor 23 (FGF‐23), parathyroid hormone (PTH) secretion, and serum calcium in chronic kidney disease (CKD). GFR indicates glomerular filtration rate; LVH, left ventricular hypertrophy.
See this image and copyright information in PMC

References

    1. Laliberte’ F, Bookhart BK, Vekeman F, et al. Direct all‐cause health care costs associated with chronic kidney disease in patients with diabetes and hypertension: a managed care perspective. J Managed Care Pharm. 2009;15:312–322. - PMC - PubMed
    1. National Institutes of Health NloDaDaKD2 . US Renal Data System, USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End‐Stage Renal Disease in the United States. Bethesda, MD: 2012.
    1. Levey AS, de Jong PE, Coresh J, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011;80:17–28. - PubMed
    1. Hemmelgarn BR, Manns BJ, Lloyd A, et al. Relation between kidney function, proteinuria, and adverse outcomes. JAMA. 2010;303:423–429. - PubMed
    1. Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2012;158:825–830. - PubMed

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