The management of chronic kidney disease (CKD) involves regular follow-up in primary care, with the frequency depending on clinical judgement NICE NG203.
Assess and manage risk factors and comorbidities, including underlying causes of CKD and potential reversible causes, and treat accordingly NICE NG203.
Monitor for disease progression, considering the person's stage of CKD, risk factors, and clinical judgement NICE NG203.
Manage lifestyle risk factors such as encouraging exercise, achieving a healthy weight, and smoking cessation NICE NG203.
Offer dietary advice tailored to CKD severity, including potassium, phosphate, calorie, and salt intake, with supervision to prevent malnutrition NICE NG203.
Do not offer low-protein diets (less than 0.6 to 0.8 g/kg/day) to adults with CKD NICE NG203.
Provide education and support for self-management, including information about blood pressure, smoking cessation, diet, and medicines, and enable access to medical data through systems like Renal PatientView NICE NG203.
Arrange regular follow-up, with the frequency depending on CKD stage and risk factors NICE NG203.
Assess for and manage risk factors for CKD progression, including hypertension, and treat with ACE inhibitors or ARBs if ACR is over 30 mg/mmol NICE NG203.
Set blood pressure targets based on ACR and CKD stage, aiming for below 140/90 mmHg if ACR is less than 70 mg/mmol, or below 130/80 mmHg if ACR is 70 mg/mmol or more NICE NG203.
Offer immunizations for influenza and pneumococcal disease to reduce infection risk NICE NG203.