Early identification of chronic kidney disease (CKD) provides an opportunity to implement therapies to improve kidney function and slow progression. The goal of this article is to review established and developing clinical therapies directed at slowing progression. The importance of controlling blood pressure will be discussed along with the target blood pressure that should be achieved in CKD patients. Therapy directed at inhibiting the renin-angiotensin-aldosterone system remains the mainstay of treatment with single-agent inhibition of this system being as good as dual blockade with fewer adverse effects. Other therapies that may be used include correction of metabolic acidosis, dietary protein restriction, and new models for delivering care to patients with CKD. Emerging therapies targeting endothelin, uric acid, kidney fibrosis, and oxidant stress hold promise for the future.
Bibliographical noteFunding Information:
This work was supported in part by National Institutes of Health/National Institute of Digestive Diseases, Diabetes, and Kidney Disease (NIDDK) grant K23DK087919 (PD). MER has also received consulting fees from CytoPherx and the American Society of Nephrology. MER has received grant support from the US Department of Veterans Affairs. Publication costs for this article were supported by the Turkish Society of Hypertension and Renal Diseases, a nonprofit national organization in Turkey.
- Blood pressure target
- chronic kidney disease