management
Last edited 09/2021 and last reviewed 12/2022
Management of patients with chronic kidney disease (CKD) in primary care involves:
- regular measurements of kidney function using serum creatinine concentration and estimated GFR, depending on the severity of kidney impairment - see linked item
- advice on smoking cessation
- advice on weight loss if obese
- encouragement to take regular aerobic exercise
- advice to limit alcohol intake to no more than 3 units/day (men) or 2 units/day (women)
- oral antiplatelets and anticoagulants
- offer antiplatelet drugs to people with CKD for the secondary prevention of cardiovascular disease, but be aware of the increased risk of bleeding
- for guidance on oral anticoagulants for people with CKD, see NICE's guidelines on atrial fibrillation and venous thromboembolic diseases.
- meticulous control of hypertension if present - see linked item
- lipid lowering - see linked item
Indications for nephrology referral are linked.
Reference:
principles of management of stage 3 CKD
hypertension in chronic kidney disease (CKD)
anaemia in chronic kidney disease (CKD)
statin and antiplatelet drugs in CKD
bone metabolism and osteoporosis and CKD
hyperphosphataemia in chronic kidney disease (CKD)
referral criteria from primary care - kidney disease
monitoring protocol if stable chronic kidney disease (CKD)
monitoring protocol if unstable chronic kidney disease (CKD)