[Chronic kidney damage guidelines revision]

Abstract

Age has no effect on the diagnosis of 'chronic kidney damage'. Estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2 is to be considered 'abnormal' for patients of all ages. Albuminuria is classified as 'not abnormal', 'moderately elevated' and 'severely elevated'. Decreased eGFR and elevated albuminuria are independent risk factors for and predictors of cardiovascular and total mortality, progression of chronic kidney damage and end-stage kidney failure. Blood pressure target value is ≤ 130/80 mmHg. In case of an indication for blood pressure-lowering treatment for patients with chronic kidney damage and elevated albuminuria, an ACE inhibitor or angiotensin II receptor blocker is preferred. The general practitioner refers patients with chronic kidney damage and a highly elevated risk of mortality, cardiovascular disease, progression of kidney damage and end-stage kidney failure to the internist-nephrologist. Inform patients about drugs that can cause kidney damage and about the importance of dosage adjustments. When prescribing drugs to patients with eGFR < 50 ml/min per 1.73 m2, the pharmacist should, with the patient's approval, be informed of the eGFR.