Can the progression of Chronic kidney disease be slowed?
The diagnosis of Chronic kidney disease and assessment of the tempo of progression set the stage for implementing therapies directed at slowing progression and preventing the development of ESKD.
Therapy includes:
• Blood pressure control
• Inhibition of the renin-angiotensin-aldosterone system
• Dietary protein restriction (in certain populations and settings)
• Glycemic control in diabetics
• Bicarbonate supplementation when serum bicarbonate concentration is <22 mEq/L
Other principles of therapy include avoidance of nephrotoxic drugs such as NSAIDs or aminoglycoside antibiotics, and avoidance of radiographic contrast agents. In addition, attention should be paid to reversible causes of progression, such as urinary obstruction.
