Diagnostic studies : chronic kidney disease

  • Diagnostic studies
    • History and physical examination
    • Identification of reversible kidney disease
    • Renal ultrasound, renal scan, CT scan
    • Renal biopsy
    • BUN, serum creatinine, and creatinine clearance levels
    • Serum electrolytes
    • Lipid profile
    • Urinalysis
    • Protein-to-creatinine ratio in first morning voided specimen
    • Hematocrit and hemoglobin levels
  • Management
    • Correction of extracellular fluid volume overload or deficit
    • Renal replacement therapy (dialysis, kidney transplant)
    • Nutritional therapy
    • Measures to lower potassium
  • Drug Therapy
    • Calcium supplementation, phosphate binders, or both
    • Antihypertensive therapy
    • Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs)
    • Erythropoietin therapy
    • Lipid-lowering drugs
    • Adjustment of drug dosages to degree of renal function
  • Risk factors for Chronic Kidney Disease

Risk Factors

Prevention and Management

Diabetes

Achieve optimal glycemic control.

Hypertension

Maintain BP in normal range with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs).

Age >60 yr.

Prevent insult or injury to kidneys.

Cardiovascular disease

Institute aggressive risk factor reduction.

Family history of CKD

Teach about increased risk and assist with appropriate screening (BP measurement, urinalysis).

Exposure to nephrotoxic drugs

Limit exposure and give sodium bicarbonate as treatment.

Ethnic minority (e.g., African American, Native American)

Teach about increased risk and assist with appropriate screening (BP measurement, urinalysis).