Making Sense of Chronic Kidney Disease in Primary Care Part 2 – Management

ABSTRACT

@#Chronic kidney disease (CKD) is common worldwide and in Singapore. The primary care physicians play an important role in managing patients with CKD, especially in the early stages of CKD. The primary objectives of CKD management are (1) slowing down the progression of CKD, (2) managing the complications of CKD, and (3) establishing the longterm kidney care plan. The interventions to slow down the progression of CKD are to identify the cause of CKD, use the renin-aldosterone system blocker and the sodium-glucose cotransporter-2 inhibitor in suitable CKD populations, optimise blood pressure and glycaemic control, correct acidosis, avoid acute kidney injury and nephrotoxin, and modify dietary and lifestyle habits. For complications of CKD, the focus is on reducing cardiovascular risk, and managing anaemia, mineral bone disease, electrolytes imbalances and fluid overload. Lastly, there is a need to establish CKD patient’s treatment goals and initiate advanced care planning in a patient with progressive CKD to facilitate future care.