Special Issue "Management of the Progression and Complications of CKD"
Deadline for manuscript submissions: closed (15 December 2021) | Viewed by 34777
Interests: CKD; proteinuria; hypertension; anemia; ESAS; iron
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Chronic kidney disease (CKD) progression results in a worldwide clinical and economic burden for patients and society and, thus, its prevention and treatment are of paramount importance.
Proteinuria and elevated blood pressure (BP) are the most significant risk factors determining the progression CKD, and their treatment is crucial in CKD management. While it is well accepted that a stricter blood pressure control (≤130/80 mmHg) is indicated in patients with proteinuria, the exact degree of blood pressure reduction in CKD non-proteinuric patients is still under debate (<140/90 mm Hg?). The blockers of the renin–angiotensin system (RAS) are recommended as first line treatment in all CKD hypertensive patients, however, their nephroprotective efficacy is less relevant in non-proteinuric patients. Given that RAS blockers can cause acute derangements in kidney function and hyperkalemia, caution is needed regarding their use, especially in frail old nephroangiosclerotic patients or in the presence of advanced CKD. Dietetic–nutritional therapy (DNT) is an important component in conservative CKD management and should precede and be integrated in the pharmacological treatment. The objectives of DNT include the maintenance of an optimal nutritional status as well as the prevention and/or correction of signs, symptoms, and complications of CKD and, possibly, the delay in starting of dialysis. As part of the DNT, the modulation of protein and adequacy of caloric intake, control of cholesterol, sodium, potassium, and phosphorus intake is included. Finally, erythropoietin-stimulating agents and iron should be used for preventing severe anemia and associated symptoms.
Prof. Francesco Locatelli
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