Management of CKD in Diabetes (1)

Management of chronic kidney disease (CKD) is summarized in two slides1,2 Slide 1 of 2 Complications of kidney disease correlate with level of kidney function When the eGFR is <60 mL/min/1.73 m2, screening for complications of CKD is indicated, as summarized on this slide (Table 13) Consider referral to a physician experienced in the care of kidney disease when there is uncertainty about the etiology of kidney disease (heavy proteinuria, active urine sediment, absence of retinopathy, rapid decline in GFR, resistant hypertension) Other triggers for referral may include difficult management issues (anemia, secondary hyperparathyroidism, metabolic bone disease, or electrolyte disturbance) or advanced kidney disease The threshold for referral may vary depending on the frequency with which a provider encounters diabetic patients with significant kidney disease Early vaccination against hepatitis B is indicated in patients likely to progress to end-stage kidney disease94References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S37; Table 13. Adapted from http://www.kidney.org/professionals/KDOQI/guideline_diabetes/.