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Nephrology Dialysis Transplantation 2007 22(Supplement 9):ix31-ix38; doi:10.1093/ndt/gfm447
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org


What are the best treatments for early chronic kidney disease?

A Background Paper prepared for the UK Consensus Conference on Early Chronic Kidney Disease

Walaa W. M. Saweirs and Jane Goddard

Department of Renal Medicine, Royal Infirmary of Edinburgh, UK

Correspondence to: Dr Walaa W. M. Saweirs, SpR Nephrology, Department of Renal Medicine, Royal Infirmary of Edinburgh, Little France, Old Dalkeith Road, Edinburgh EH16 4SU. Email: walaa.saweirs@luht.scot.nhs.uk

The first 150 words of the full text of this article appear below.



   Introduction
 
The two principle outcomes of chronic kidney disease (CKD) are progressive loss of renal function, and the development and progression of cardiovascular disease (CVD) [1]. The aim of this Background Paper is to discuss the evidence for treatments to slow the progression of both CKD and the attendant CVD, and to discuss treatments for the metabolic consequences of CKD. The evidence was gathered using a Medline search of primarily meta-analyses where available, as well as randomized controlled trials (RCTs) from 1996–2006.



   Slowing the progression of CKD
 
Although the rate of progression of CKD is related to some non-modifiable characteristics such as race, baseline renal function, male gender and increased age, there are a number of modifiable characteristics. It is important to note, however, that the three most widely studied interventions, blood pressure (BP), proteinuria and drugs to reduce both, are inextricably linked in their effects on glomerular filtration rate (GFR).

Blood pressure
Hypertension is both . . . [Full Text of this Article]



   Recommendation
 
Proteinuria


   Recommendation
 
Anti-hypertensive drugs
Proteinuria reduction
CKD progression


   Recommendation
 
Strict glycaemic control


   Recommendation
 
Lipid-lowering therapy


   Recommendation
 
Smoking and alcohol


   Recommendation
 
Dietary modification


   Recommendation
 
Exercise and weight loss


   Recommendation
 
Treating the consequences of CKD
Anaemia


   Recommendation
 
Acidosis


   Recommendation
 
Calcium and phosphate homeostasis


   Recommendation
 
Reducing the risk of cardiovascular disease
Hypertension
Aspirin
Lipids


   Recommendation
 


   Conclusions
 

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