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Chronic Kidney Disease

Reviewed 06/2018
 


BASICS

Chronic kidney disease (CKD) is defined as structural or functional abnormalities of the kidney for ≥3 months, as determined by either pathologic abnormalities or markers of damage—including ab...

DIAGNOSIS

HISTORY

Patients with CKD stages 1 to 3 are usually asymptomatic; can present with 
  • Oliguria, nocturia, polyuria, hematuria, change in urinary frequency

  • Bone disease

  • Edema, HTN, dyspnea

  • Fatigue, ...

TREATMENT

GENERAL MEASURES

  • Lowering salt intake to <2 g/day of sodium in adults, unless contraindicated (5)[C]

  • Minimize radiocontrast exposure; prehydrate; N-acetylcysteine use is controversial. Avoi...

ONGOING CARE

DIET

Nutrition consult for CKD diet (2)[C

PATIENT EDUCATION

  • Annual influenza vaccine unless contraindicated (2)

  • Polyvalent pneumococcal vaccine if GFR <30 mL/min/1.73m2 and those at high...

REFERENCES

1
1 Earley A, Miskulin D, Lamb EJ, et al. Estimating equations for glomerular filtration rate in the era of creatinine standardization: a systematic review. Ann Int Med.  2012;156(11):7...

SEE ALSO

  • Hydronephrosis; Nephrotic Syndrome; Polycystic Kidney Disease; Proteinuria

  • Algorithm: Anuria or Oliguria

CODES

ICD10

  • N18.9 Chronic kidney disease, unspecified

  • Q63.9 Congenital malformation of kidney, unspecified

  • N18.3 Chronic kidney disease, stage 3 (moderate)

  • Q61.4 Renal dysplasia

  • Q61.8 Other cystic kidney d...

CLINICAL PEARLS

  • CKD is defined based on >3 months of kidney functional or structural abnormalities and classified based on GFR and albuminuria.

  • ACE-I and ARB are first line for HTN treatment in CKD ...

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