Family Practice Vol. 19, No. 5, 563-565
© Oxford University Press 2002
Selections from the Current Literature |
A simplified approach to the management of early chronic renal failure
Department of Family Medicine, Health Sciences Center L-4, 050, SUNY at Stony Brook, Stony Brook, NY 11794, USA.
Kopes-Kerr CP. A simplified approach to the management of early chronic renal failure. Family Practice 2002; 19: 563–565.
Received 1 March 2002; Accepted 13 May 2002.
| The first 150 words of the full text of this article appear below. |
After medical school, our comfort with renal pathophysiology tends to diminish rapidly. Most of us get enough hospital-based experience so that we are familiar with the basic parameters of acute renal failure; few of us ever get substantial experience managing chronic renal failure (CRF). CRF is estimated to occur in ~200 persons per 1 000 000 in the USA. The most common causes are diabetes and chronic hypertension. It is estimated that there are 240 000 patients with end-stage renal disease (ESRD) in the USA, and this number is increasing at ~6–7% per year; 71% of these patients go on dialysis and 29% have a functioning kidney transplant. The annual mortality for ESRD is ~22%, and the most common cause of death is cardiovascular..
A common primary care approach, once an elevated creatinine has been obtained and confirmed, is simply to refer to a specialist. Early CRF, however, is primarily
Setting your priorities
1. Control the blood pressure
2. Maintain the haemoglobin level above 10 g/dl
3. Prevent renal bone disease
4. Maintain acid–base balance
5. Treat dyslipidaemia
Conclusion