Journal article
Management of Chronic Kidney Disease: What is the Evidence?
Southern medical journal (Birmingham, Ala.), Vol.103(3), pp.222-230
03/01/2010
DOI: 10.1097/SMJ.0b013e3181ce0f48
PMID: 20134375
Abstract
Chronic kidney disease (CKD) is a strong risk factor for cardiovascular events and death. Hypertension, dyslipidemia, anemia, vascular calcification, and secondary hyperparathyroidism have all been implicated in the pathogenesis of cardiovascular disease associated with CKD. Numerous trials have been performed assessing the effects of modifying these risk factors on cardiovascular events and on the progression to end-stage renal disease. Many guidelines have been issued. In this article we review the guidelines and the strength of evidence supporting them. Specifically, we discuss blood pressure goals for patients with CKD, the role of renin-angiotensin system blocking agents for blood pressure control and proteinuria reduction, and the evidence for treatment recommendations of dyslipidemia. We review the trials addressing risks and benefits of different hemoglobin targets for treatment of anemia with erythropoietin. The use of phosphate-binding drugs to prevent and treat secondary hyperparathyroidism is likely beneficial, but few data support the use of vitamin D compounds. Supplementation with sodium bicarbonate may be an inexpensive treatment to retard progression to end-stage renal disease. The article concludes with a discussion of the case vignette presented in the previous article.
Details
- Title: Subtitle
- Management of Chronic Kidney Disease: What is the Evidence?
- Creators
- Godela Brosnahan - University of Arkansas for Medical SciencesMony Fraer
- Resource Type
- Journal article
- Publication Details
- Southern medical journal (Birmingham, Ala.), Vol.103(3), pp.222-230
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/SMJ.0b013e3181ce0f48
- PMID
- 20134375
- ISSN
- 0038-4348
- eISSN
- 1541-8243
- Number of pages
- 9
- Language
- English
- Date published
- 03/01/2010
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984359948502771
Metrics
6 Record Views