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Chronic kidney disease (CKD) affects 15% of the Spanish population, and its main causes are diabetes mellitus, arterial hypertension, and glomerulonephritis. Primary care is essential in the prevention, early diagnosis, and control of progression factors and complications of CKD. The diagnosis is made by the decrease in the estimated glomerular filtration rate or the presence of markers of kidney damage. The article discusses the calculation of the estimated glomerular filtration rate (eGFR) based on cystatin C as an endogenous marker to evaluate kidney function. It also mentions alterations that suggest kidney damage, such as increased protein or albumin excretion in the urine. Screening for CKD is recommended by evaluating eGFR and the albuminuria/creatinine ratio in certain patient groups. Additionally, CKD is classified into stages based on the cause of the disease and the severity of eGFR. The article also mentions treatment goals, including slowing down disease progression, preventing cardiovascular diseases and their complications, addressing the underlying disease, and controlling progression factors. Lifestyle changes, pharmacological treatment, and measures to avoid pharmacological iatrogenesis are recommended. Blood pressure control is especially important as hypertension contributes to the progression of CKD. Regarding glycemic control, a glycated hemoglobin (HbA1C) target below 7% is recommended for most adults with diabetes and CKD. In the case of proteinuria, the use of ACE inhibitors/ARBs is recommended as the first option, and SGLT2 inhibitors can be added if proteinuria persists. Regarding dyslipidemia, lipid control is recommended in patients with CKD, especially those at high cardiovascular risk. For hyperuricemia, hypouricemic drugs are recommended after the first gout attack in patients with CKD. The text provides information on the treatment and prevention of complications in patients with CKD. It also discusses the prevention of nephrotoxicity and mentions some drugs that can potentially be toxic to the kidneys. Additionally, common complications of CKD are addressed, such as anemia, hyperkalemia, acidosis, and disorders of bone and mineral metabolism. The text talks about CKD and its impact on mineral metabolism. It mentions that patients at high risk of fracture may benefit from certain medications, although the FRAX tool does not take CKD into account in its algorithm. CKD can affect calcium and phosphorus levels in the body, which can have consequences on bone and cardiovascular health. Regular laboratory tests are recommended to evaluate calcium, phosphorus, intact parathyroid hormone (iPTH), and vitamin D levels in patients with CKD. Treatment for secondary hyperparathyroidism (SHPT) is based on dietary changes, phosphate binders, and vitamin D supplements. The follow-up of patients with CKD should be based on the severity of the disease and the risk of progression. Referral to nephrology is recommended in cases of accelerated progression, high albuminuria, or a significant decrease in estimated glomerular filtration rate (eGFR). [Extracted from the article]

Why you should read this article: • To enhance your knowledge of prescribing for adults with stable chronic kidney disease (CKD) • To increase your understanding of pharmacokinetics in the context of renal impairment • To recognise the importance of dose adjustment when prescribing for people with CKD Kidney disease is a common occurrence and alters how the body processes many drugs. Therefore, prescribers must consider the person's renal function before prescribing medicines and may need to amend the dose of renally excreted drugs. At present, there is limited data regarding dose adjustment in renal impairment, so prescribers require knowledge of pharmacokinetics. Prescribers also need to understand how the kidneys process drugs when functioning normally to be able to predict how renal impairment may affect pharmacokinetics. This article offers practical guidance on prescribing for adults who have stable chronic kidney disease and do not meet the criteria for specialist assessment. It also explores important steps that prescribers can take to optimise medicines use in this population. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of the causes and diagnosis of chronic kidney disease (CKD) • To recognise the comorbid conditions and complications associated with CKD • To understand what is involved in the treatment of patients with CKD Chronic kidney disease (CKD) is a common long-term condition and is associated with increased mortality and a reduction in healthy years of life. Early identification and appropriate treatment of CKD can reduce these risks. The inclusion of CKD in any discussions with people about other long-term health conditions such as cardiovascular disease and diabetes mellitus is also essential. All nurses need to understand the risks associated with CKD so that they can develop the confidence to routinely discuss the condition with patients and support them to improve their health. [ABSTRACT FROM AUTHOR]

Acute kidney injury affects up to 15% of in patients in the acute hospital setting. Although accurate history-taking, careful physical examination and meticulous monitoring of volume balance are essential, there is, to-date, little evidence supporting any intervention that may reverse this process. Acute kidney injury presents a unique set of metabolic derangements that, if untreated, will result in death. We outline the initial management of acute kidney injury as well as specific treatments that may be required. Some consideration is also given to the use of renal replacement therapies. [ABSTRACT FROM AUTHOR]

This article looks at the value of cystatin C in assessing renal function in older people. While it appears to be reliable and accurate, it is still relatively untested in most clinical settings and there is much to learn before its value in the day-to-day assessment of renal function can be determined. [ABSTRACT FROM AUTHOR]

The article reports on the study conducted by Doctor Kamiar Mireskandari and colleagues on rat models to examine the effects of anti-vascular endothelial growth factor (anti-VEGF) medications to the body. Based on the results, the drugs have no substantial effects to the lung, brain, liver or kidney weights. However, their adverse effects include pulmonary hypertension and cardiac hypertrophy.

The article offers news briefs across medical care as of November 2013. A meta-analysis of 16 studies showed that Estimated glomerular filtration rate (eGFR) accuracy improves the use of cystatin C. A systematic reviews of five databases showed that use of two different phosphates in patients suffering from chronic kidney diseases (CKD) can cure Hyperphosphataemia. A cohort study in Great Britain showed that in patients suffering from CKD moderate to severe psoriasis risk is associated.

The article discusses nephrotoxic risks associated with the combined use of diuretics, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and non-steroidal anti-inflammatory drugs (NSAID). Commonly prescribed to elderly patients with hypertension and heart conditions, the potential interaction between these drugs is reportedly increasing. It explains tendency of the kidney to suffer from acute glomerular filtration reduction due to growing serum creatinine.

The article discusses a study which found that early intensive treatment of type 1 diabetes could also lower the risk of impaired glomerular filtration rate (GFR).

The article offers a look on the findings from the Strategies for Management of Anti-Retroviral Therapy (SMART) study which suggest that glomerular filtration rates and albuminuria levels of people with human immunodeficiency virus (HIV) are associated with increased risk for cardiovascular disease and heart failure.

The article focuses on a study which examined the association between proteinuria and glomerular filration rate and the risk of developing thromboembolism in patients with nonvalvular atrial fibrillation.

The article reports on the risk of end-stage renal disease that plumbers and welders may face due to solvent exposure. Screening for proteinuria in workers may stop the progression of glomerulonephritis to end-stage renal exposure (ESRD). Reserchers in France investigated the role of solvents by occupation, product and type. The outcome measure was ESRD defined by glomerular filtration rate or dialysis.

The article discusses research being done dialysis for end-stage renal disease. It references a study published in the 2007 issue the "Annals of Internal Medicine" journal. The study found that those patients who started dialysis in 2003 had a higher glomerular filtration rate and a lower increase incidence of chronic kidney disease-related morbidity.

Presents renal failure self-assessment for continuing professional development of nurses. Main function of the kidneys; Glomerular filtration rate; Normal creatinine level.