Essential points from evidence-based clinical practice guideline for chronic kidney disease 2023

Essential points from evidence-based clinical practice guideline for chronic kidney disease 2023

Accepted: 22 March 2024 / Published online: 7 May 2024 | Japanese Society of Nephrology
The 2023 Evidence-Based Clinical Practice Guideline for Chronic Kidney Disease (CKD) outlines key aspects of CKD diagnosis, management, and prevention of complications. The guideline emphasizes the importance of early detection, collaboration between primary care and specialist physicians, and the prevention of CKD progression to end-stage renal disease and cardiovascular disease (CVD). It reflects the evolving understanding of CKD and its impact on public health, particularly in an aging population. The guideline is based on a rigorous evidence-based approach and has been revised to better suit the needs of both specialist and non-specialist physicians, as well as patients and their families. The guideline defines CKD as a condition characterized by reduced glomerular filtration rate (GFR) or evidence of kidney damage, with a diagnosis made when these abnormalities persist for more than three months. CKD severity is classified based on GFR and albuminuria levels, with higher stages indicating greater risk. Kidney function is evaluated using GFR estimation formulas, while proteinuria and albuminuria are critical for assessing CKD risk and guiding treatment. The cause of CKD is also important for determining the appropriate management strategy. The guideline provides specific recommendations for blood pressure management in CKD patients, emphasizing the importance of controlling hypertension to prevent CKD progression. It also addresses the use of renin-angiotensin (RA) system inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors in CKD patients. The guideline also includes recommendations for lifestyle modifications, such as smoking cessation, alcohol consumption, and exercise, which are important for CKD management. In addition, the guideline covers the management of CKD-related complications, including anemia, phosphate metabolism, and bone disease. It also provides guidance on the use of antiviral drugs, analgesics, and other medications in CKD patients, emphasizing the need for careful monitoring and dose adjustments. The guideline also addresses the management of CKD in pregnant women, the elderly, and patients with diabetes, as well as the initiation of dialysis and kidney transplantation. Overall, the 2023 guideline aims to improve the quality of care for CKD patients and reduce the burden of CKD on public health.The 2023 Evidence-Based Clinical Practice Guideline for Chronic Kidney Disease (CKD) outlines key aspects of CKD diagnosis, management, and prevention of complications. The guideline emphasizes the importance of early detection, collaboration between primary care and specialist physicians, and the prevention of CKD progression to end-stage renal disease and cardiovascular disease (CVD). It reflects the evolving understanding of CKD and its impact on public health, particularly in an aging population. The guideline is based on a rigorous evidence-based approach and has been revised to better suit the needs of both specialist and non-specialist physicians, as well as patients and their families. The guideline defines CKD as a condition characterized by reduced glomerular filtration rate (GFR) or evidence of kidney damage, with a diagnosis made when these abnormalities persist for more than three months. CKD severity is classified based on GFR and albuminuria levels, with higher stages indicating greater risk. Kidney function is evaluated using GFR estimation formulas, while proteinuria and albuminuria are critical for assessing CKD risk and guiding treatment. The cause of CKD is also important for determining the appropriate management strategy. The guideline provides specific recommendations for blood pressure management in CKD patients, emphasizing the importance of controlling hypertension to prevent CKD progression. It also addresses the use of renin-angiotensin (RA) system inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors in CKD patients. The guideline also includes recommendations for lifestyle modifications, such as smoking cessation, alcohol consumption, and exercise, which are important for CKD management. In addition, the guideline covers the management of CKD-related complications, including anemia, phosphate metabolism, and bone disease. It also provides guidance on the use of antiviral drugs, analgesics, and other medications in CKD patients, emphasizing the need for careful monitoring and dose adjustments. The guideline also addresses the management of CKD in pregnant women, the elderly, and patients with diabetes, as well as the initiation of dialysis and kidney transplantation. Overall, the 2023 guideline aims to improve the quality of care for CKD patients and reduce the burden of CKD on public health.
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