Chronic kidney disease

Chronic kidney disease (CKD) is currently defined as either functional or structural kidney damage or a glomerular filtration rate (GFR) less than 60 mL/min per 1.73 m² for at least 3 months (1). CKD affects as many as 25 million people in the United States, and more than 500 000 have end-stage renal disease (2, 3). The most common risk factors for CKD are diabetes and hypertension. Patients with CKD are at increased risk for cardiovascular disease. In fact, the risk for dying of cardiovascular disease in older patients with CKD is often higher than the risk for progression to treated end-stage renal disease (4, 5). Other complications of CKD include anemia, secondary hyperparathyroidism, bone disease, vascular complications, and electrolyte disturbances. The main goals of treatment are to slow the decline in renal function, prevent cardiovascular disease, and treat complications. Collaboration between the primary care physician and nephrologists can improve the care of patients with this challenging condition.