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Chronic Kidney Disease

Tyler Martin West, M.D. and Mark L. Higdon, DO, FAAFP Reviewed 06/2022
 


BASICS

Chronic kidney disease (CKD) is defined as structural or functional abnormalities of the kidney, as determined by either pathologic abnormalities or markers of damage (abnormalities in blood or...

DIAGNOSIS

HISTORY

Patients with CKD stages 1 to 3 are usually asymptomatic; can present with oliguria, nocturia, polyuria, change in urinary frequency, bone disease, edema, HTN, dyspnea, fatigue, depre...

TREATMENT

MEDICATION

  • HTN: Adults with elevated blood pressure and CKD G1-3 should be treated to a target systolic blood pressure of 120 using standardized office measurements. Renal transplant patients...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Monitor for changes in blood pressure, serum creatinine, and serum potassium within 2-4 weeks of initiation of ACE-I or ARB. If >30% increase...

REFERENCES

1
Moyer VA. Screening for chronic kidney disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157(8):567-70.
2
Kidney Disease: Improving Global Outcomes ...

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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