Chronic Kidney Disease Guidelines

Chronic kidney disease is a condition characterized by a gradual loss of kidney function over time. Chronic kidney disease is also known as chronic renal disease. Early diagnosis is imperative for patients with chronic kidney disease. With an early diagnosis, intervention and secondary preventive measures can be put in place to help patients deal with the effects of this disease. Chronic kidney disease is characterized as a public health problem because of its prevalence among Americans and due to the outcomes of the disease. Prevention requires a clear understanding of the earliest stages of the disease, antecedent risk factors, appropriate treatments for populations at risk.

In general, patients can be placed into one of three categories:

  • Very High Risk – those already diagnosed with chronic kidney disease
  • High Risk – those with risk factors for developing chronic kidney disease
  • Low Risk – those without chronic kidney disease or its risk factors

The American population includes much higher numbers in the "low risk" category than the other two categories, however, due to its prevalence it must be considered as a public health problem. It is also imperative to understand that chronic kidney disease progresses and worsens over time. The risk of adverse outcomes in chronic kidney disease is very high, and this must be addressed with the patient in regards to treatment options.

One of the most notable guidelines in treating chronic kidney disease is early referral to a nephrologist. A nephrologist has the specialty needed for kidney care and treating diseases of the kidneys. Chronic kidney disease is measured in stages regarding kidney function. Kidney function is characterized as "normal" in Stage 1, and minimally reduced in Stage 2. Stages 3-5, with Stage 5 being the most severe, require management of chronic kidney disease, planning for renal failure, and endstage treatment choices.

Despite the increasing prevalence of chronic kidney disease, it is often under-recognized and under-treated. Guidelines that are set in place and regularly practiced can help patients dealing with kidney disease and progressed kidney failure to sustain a quality of life that is manageable. Because chronic kidney disease is a public health problem, three specific guidelines have been offered by the University of Michigan for the management of chronic kidney disease:

  1. Identify populations that may benefit from more systematic screening for chronic kidney disease and provide an overview of methods for screening and diagnosis.
  2. Outline treatment options for patients with chronic kidney disease to decrease progression of renal deterioration and potentially decrease morbidity and mortality.
  3. Highlight common co-morbid conditions such as cardiovascular disease and diabetes, emphasizing the importance of aggressive management of these conditions to potentially decrease morbidity and mortality among patients with chronic kidney disease.

By screening early and providing patients with intervention and management of early stage chronic kidney disease, physicians can provide more successful and reasonable treatment.

Chronic kidney disease tends to worsen over time. Therefore, the risk of adverse outcomes increases over time with disease severity. There are many disciplines in medicine in which related specialties have adopted classification systems based on severity to guide clinical interventions, research, and professional and public education. Hypertension, cardiovascular disease, diabetes, and transplantation are a few of these specialties. Such a model is necessary for the approach to management of chronic kidney disease. Proactivity is necessary to improve outcomes for those suffering from this debilitating and life-threatening disease.