Medical therapy in patients with chronic kidney disease

Chronic kidney disease (CKD) is a broad term for diverse disorders affecting renal structure and function. The worldwide increase in the number of patients with CKD and consequent end-stage renal disease (ESRD) requiring renal replacement therapy is threatening to reach a global epidemic level. The economic burden is difficult to deal for both family and society. A change in the global approach to CKD from treatment of ESRD to much more aggressive primary and secondary prevention is therefore imperative. CKD can be detected with routine laboratory tests, and some treatments can prevent its development and slow disease progression, reduce complications of decreased glomerular filtration rate and risk of cardiovascular diseases, and improve survival and quality of life. In this article, I review the practical methods-including blood pressure control, anemia correction, management of mineral and bone disorders related with CKD-for the prevention of or slowing the progression of CKD. I also describe several essential drugs that are used frequently to treat the common complications of CKD.