How is chronic kidney disease (CKD) managed?

Updated: Oct 26, 2020
  • Author: Pradeep Arora, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The pathologic manifestations of CKD should be treated as follows:

  • Anemia: When the hemoglobin level is below 10 g/dL, treat with erythropoiesis-stimulating agents (ESAs), which include epoetin alfa and darbepoetin alfa after iron saturation and ferritin levels are at acceptable levels

  • Hyperphosphatemia: Treat with dietary phosphate binders and dietary phosphate restriction

  • Hypocalcemia: Treat with calcium supplements with or without calcitriol

  • Hyperparathyroidism: Treat with calcitriol or vitamin D analogues or calcimimetics

  • Volume overload: Treat with loop diuretics or ultrafiltration

  • Metabolic acidosis: Treat with oral alkali supplementation

  • Uremic manifestations: Treat with long-term renal replacement therapy (hemodialysis, peritoneal dialysis, or renal transplantation)


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