Management
Management of patients with chronic kidney disease (CKD) in primary care involves:
- regular measurements of kidney function using serum creatinine concentration and estimated GFR, depending on the severity of kidney impairment - see linked item
- advice on smoking cessation
- advice on weight loss if obese
- encouragement to take regular aerobic exercise
- advice to limit alcohol intake to no more than 3 units/day (men) or 2 units/day (women)
- oral antiplatelets and anticoagulants
- offer antiplatelet drugs to people with CKD for the secondary prevention of cardiovascular disease, but be aware of the increased risk of bleeding
- for guidance on oral anticoagulants for people with CKD, see NICE's guidelines on atrial fibrillation and venous thromboembolic diseases.
- meticulous control of hypertension if present - see linked item
- lipid lowering - see linked item
Indications for nephrology referral are linked.
Reference:
- UK eCKD Guide. February 2024. UK CKD Guidelines.
- NICE. Chronic kidney disease: assessment and management. NICE guideline NG203. Published August 2021, last reviewed September 2024.
Related pages
- Principles of management of stage 3 CKD
- Hypertension in chronic kidney disease (CKD)
- Anaemia in chronic kidney disease (CKD)
- Statin and antiplatelet drugs in CKD
- Bone metabolism and osteoporosis and CKD
- Hyperphosphataemia in chronic kidney disease (CKD)
- Reversible factors
- Fluid & electrolytes
- Diet in renal disease
- Musculoskeletal
- Neurological
- Renal dialysis
- Renal transplantation
- Referral criteria from primary care - kidney disease
- Monitoring of chronic kidney disease (CKD)
- Deteriorating eGFR in CKD
- Proteinuria
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