Early Intervention to Slowing CKD Progression: A Review

Abstract

Chronic kidney disease (CKD) is a complex disease that encompasses abnormalities and damage to the kidneys, progressing from mild, moderate to severe end-stage renal diseases. Globally and in India, the prevalence of CKD is increasing at an alarming rate. Kidney disease is usually referred to as a silent disease, as there are often no symptoms until the damage to the kidneys is substantial. Besides, CKD is a progressive disease with irreversible loss of kidney function over a period of time. Glomerular filtration rate (GFR) and albuminuria are the key determinants to detect acute kidney injury (AKI), acute kidney diseases (AKD) and CKD in adults. Progression of CKD is associated with a series of complications, including accelerated incidence of cardiovascular disease, diabetes, dyslipidemia, anemia and metabolic bone disease. People with diabetes and/or hypertension are at a higher risk of developing CKD or are at a higher risk of worsening the kidney function. Optimal management of patients with CKD requires correct use of the markers and interpretation of stages for early disease detection; also, appropriate lifestyle modification and medical intervention for treatment of the underlying cause to reduce the risk of future complications. Many patients with decreased renal function may experience errors due to drug dosing and can lead to side effects and unfavourable outcomes. Thus, for optimal management, characteristics of both the patient and the drugs administered should be considered in patient with renal impairment. This review will highlight various aspects for early intervention to halt the progression of CKD.