Management of CKD

The goal of therapy is to slow down or halt the progression of CKD to stage 5. Control of blood pressure and treatment of the original disease, whenever feasible, are the broad principles of management.

CKD Management: Stage 1 and 2 (eGFR more than 60 mL/min/1.73m2)
Reducing blood pressure is very important, weight (reduced or gained) and urine dipstick (microalbuminuria if diabetes present), diagnose and treat kidney disease, reduce cardiovascular risk and slow progression of kidney disease. Additionally, any medications should be reviewed, as the dose may need to be altered and some drugs may need to be avoided as they could damage the kidneys further. Laboratory assessment including :obtain creatinine and electrolytes, fasting lipids, biochemical profile including urea, fasting glucose can reduces the rate of progression of kidney diseasa, observe eGFR: Once the GFR falls below 30, an additional important task is to prepare the patient for a smooth transition to renal replacement therapy.

CKD management Stage 3 (eGFR 30–59mL/min/1.73m2)
Adjustment of medication doses and treat complications, appropriate for kidney functions, avoidance of renally-excreted and nephrotoxic medicines, reduce cardiovascular risk and reduce progression of kidney disease. Laboratory assessment including:  observe for fasting lipids, iron stores, full blood count, eGFR, parathyroid hormone, fasting glucose calcium and phosphate.


CKD management Stage 4 and 5
Prepare for kidney replacement therapy and Initiate kidney replacement therapy
(dialysis or transplantation) if uremia is present. In CKD stages 4 and 5 it is usually necessary to get advice from a kidney specialist, especially in stage 5 because kidney failure may become life threatening.