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Review
. 2024 Jul 26;13(15):4378.
doi: 10.3390/jcm13154378.

Care of Adults with Advanced Chronic Kidney Disease

Affiliations
Review

Care of Adults with Advanced Chronic Kidney Disease

Sanjivani Shrestha et al. J Clin Med. .

Abstract

Chronic kidney disease (CKD) impacts over 10% of the global population. Adults with CKD face significant morbidity and mortality. As kidney disease progresses, the risk of adverse outcomes increases. Here, we present an overview of strategies to care for adults with advanced CKD (stage 4-5 CKD, not receiving kidney replacement therapy). We aim to guide clinicians through several aspects of CKD care, ranging from recommended laboratory assessments to interdisciplinary support for patients as they plan for kidney replacement therapy (dialysis, transplantation, or conservative management). We incorporate considerations of health equity and person-centered care, empowering clinicians to deliver high-quality care to people with CKD.

Keywords: non-dialysis-dependent CKD; pre-dialysis care; supportive management.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Multifaceted care of adults with advanced CKD.
Figure 2
Figure 2
CKD heatmap, demonstrating the increase in risk of adverse outcomes for people with lower GFR and higher albuminuria levels [3]. Risk of adverse outcomes is low (green), moderately increased (yellow), high (orange), or very high (red). GFR: glomerular filtration rate.
Figure 3
Figure 3
Algorithm for evaluation and management of anemia in CKD. ESA: erythropoiesis-stimulating agent.
Figure 4
Figure 4
Components of comprehensive kidney replacement therapy (KRT) education. HD: hemodialysis; PD: peritoneal dialysis.

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