4th July 2024

Management

Most patients with evidence of CKD are managed by a nephrologist, with referral once GFR is sustained below 30 mL/minute/1.73 m². In addition, evidence of the sequelae of CKD should also prompt referral, for instance, refractory hypertension, persistent electrolyte abnormalities, as well as consistent evidence of albuminuria. Management is often focused on slowing the progression of disease. Hypertension management tends to be more robust in those with CKD and tends to include the use of an ACEi or ARB. Diabetic management focuses on reducing HbA1c, whilst lipid management is also important. Avoidance of nephrotoxic medications also plays a part. Renal replacement therapy is considered for appropriate patients once GFR is 5-10 mL/minute/1.73 m²