An Updated Insight About Chronic Kidney Disease

Abstract

Background: Chronic kidney disease is encountered by the primary care physician, in a large number of population owing to the high rates of hypertension and diabetes, the 2 most common etiologies of chronic kidney disease in the United States. As a primary care physician, it is important to understand the epidemiology, pathophysiology, and evaluation methods of chronic kidney disease even before a referral to nephrology. Additionally, the primary care physician plays a vital role in mitigating the risks of chronic kidney disease as well as the complications and comorbidities. Chronic kidney disease is highly prevalent (10-13% of the population), irreversible, progressive, and associated with higher cardiovascular risk. Patients with this pathology remain asymptomatic most of the time, presenting the complications typical of renal dysfunction only in more advanced stages. Its treatment can be conservative (patients without indication for dialysis, usually those with glomerular filtration rate above 15 ml/minute) or replacement therapy (hemodialysis, peritoneal dialysis, and kidney transplantation). The objectives of the conservative treatment for chronic kidney disease are to slow down the progression of kidney dysfunction, treat complications (anemia, bone diseases, cardiovascular diseases), vaccination for hepatitis B, and preparation for kidney replacement therapy.