Recent therapeutic strategies based on the stage of chronic kidney disease

Kim, Yeong Hoon

Abstract

Chronic kidney disease (CKD) is a major public health problem. It is estimated that 400-600 million adults worldwide have CKD. Furthermore, more than 5% of the adult population has some form of kidney damage. CKD is not an isolated disease, but is strongly linked to other health problems, such as diabetes and cardiovascular diseases (CVD), with high blood pressure as the main indicating risk factor. For example, every year millions die prematurely of CKD-linked CVD alone. However, adverse outcomes of CKD can be prevented through early detection and treatment. Earlier stages of the disease can be detected through routine laboratory measurements. Therefore, a clinical action plan should be developed for each patient, based on the stage of disease. The basic principle of treatment for CKD is to prevent the further deterioration of renal function and to minimize complications, including cardiovascular events. For this purpose, treatment should include specific therapy based on the underlying disease; an evaluation of comorbid conditions; a method of slowing the loss of renal function; the prevention and treatment of CVD as well as complications associated with decreased renal function; and replacement treatment for renal function, using dialysis and transplantation, if signs and symptoms of uremia are present.