Mayne, K. J., Hanlon, P. and Lees, J. S. (2024) Detecting and managing the patient with chronic kidney disease in primary care: A review of the latest guidelines. Diabetes, Obesity and Metabolism, (doi: 10.1111/dom.15625) (PMID:38699995) (Early Online Publication)
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Abstract
Chronic kidney disease (CKD) is a major global health problem, affecting about 9.5% of the population and 850 million people worldwide. In primary care, most CKD is caused by diabetes and/or hypertension, but a substantial proportion of cases may have alternative causes. During the early stages, CKD is asymptomatic, and many people are unaware that they are living with the disease. Despite the lack of symptoms, CKD is associated with elevated risks of cardiovascular disease, progressive kidney disease, kidney failure and premature mortality. Risk reduction strategies are effective and cost-effective but require early diagnosis through testing of the estimated glomerular filtration rate and albuminuria in high-risk populations. Once diagnosed, the treatment of CKD centres around lifestyle interventions, blood pressure and glycaemic control, and preventative treatments for cardiovascular disease and kidney disease progression. Most patients with CKD should be managed with statins, renin-angiotensin-aldosterone system inhibitors and sodium-glucose cotransporter-2 inhibitors. Additional treatment options to reduce cardiorenal risk are available in patients with diabetes, including glucagon-like peptide-1 receptor agonists and non-steroidal mineralocorticoid receptor antagonists. The Kidney Failure Risk Equation is a new tool that can support the identification of patients at high risk of progressive kidney disease and kidney failure and can be used to guide referrals to nephrology. This review summarizes the latest guidance relevant to managing adults with, or at risk of, CKD and provides practical advice for managing patients with CKD in primary care.
Item Type: | Articles |
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Status: | Early Online Publication |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Hanlon, Dr Peter and Lees, Jennifer and Mayne, Dr Kaitlin |
Authors: | Mayne, K. J., Hanlon, P., and Lees, J. S. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | Diabetes, Obesity and Metabolism |
Publisher: | Wiley |
ISSN: | 1462-8902 |
ISSN (Online): | 1463-1326 |
Published Online: | 03 May 2024 |
Copyright Holders: | Copyright © 2024 The Authors |
First Published: | First published in Diabetes, Obesity and Metabolism 2024 |
Publisher Policy: | Reproduced under a Creative Commons licence |
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