How is chronic kidney disease, managed in intrarenal azotemia?

Updated: Sep 19, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

It is important that patients with chronic kidney disease (CKD) be referred early to a nephrologist for the management of complications and for the transition to renal replacement therapy (ie, hemodialysis, peritoneal dialysis, and renal transplantation). There is some evidence that early referral of patients with CKD improves short-term outcome.

Disease progression can be slowed by means of various maneuvers, such as aggressive control of diabetes, hypertension, and proteinuria; dietary protein and phosphate restriction; and specific therapies for some of the glomerular diseases, such as lupus. Anemia, hyperphosphatemia, acidosis, and hypocalcemia should be aggressively managed before renal replacement therapy.


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