Controversial issues in CKD clinical practice: position statement of the CKD-treatment working group of the Italian Society of Nephrology

Abstract

This position paper of the study group "Conservative treatment of Chronic Kidney Disease-CKD" of the Italian Society of Nephrology addresses major practical, unresolved, issues related to the conservative treatment of chronic renal disease. Specifically, controversial topics from everyday clinical nephrology practice which cannot find a clear, definitive answer in the current literature or in nephrology guidelines are discussed. The paper reports the point of view of the study group. Concise and practical advice is given on several common issues: renal biopsy in diabetes; dual blockade of the renin-angiotensin-aldosterone system (RAAS); management of iron deficiency; low protein diet; dietary salt intake; bicarbonate supplementation; treatment of obesity; the choice of conservative therapy vs. dialysis. For each topic synthetic statements, guideline-style, are reported.

Keywords: Bicarbonate; CKD; Conservative therapy; Diabetes; Iron; Low protein diet; Obesity; Overweight; Position statement; Protein intake; RAAS; Renal biopsy; Salt intake.