Complications-treatment-chronic kidney disease (CKD)

(JAMA 2019;322:1294; KI 2021;99:S1)

• General: renal referral when GFR <30 or proteinuria, access planning (avoid subclavian lines, preserve an arm by avoiding phlebotomy, BP measurements, IVs)

• CV risk reduction: consider usual preventive Rx including statin, βB, etc.

• Dietary restrictions: Na (if HTN), K (if oliguric or hyperkalemic), PO4, mod protein.

• Diabetes: strict glc control; ACEI/ARB, SGLT2i and MRA (NEJM 2020;383:2219) slow CKD progression (↓ glomerular pressure)

• SGLT2i in chronic kidney disease

• BP control in chronic kidney disease

• Metabolic acidosis: sodium bicarbonate or sodium citrate if low HCO3 (JASN 2015;26:515)

• Hyperkalemia: 2-g K diet, see “Potassium Homeostasis”

• Anemia in chronic kidney disease

• Uremic bleeding: desmopressin (dDAVP) 0.3 μg/kg IV or 3 μg/kg intranasally

• Secondary hyperPTH

• Calciphylaxis

• Anticoagulant in chronic kidney disease

• Transplant evaluation