A basic approach to CKD management at the primary care level in low resource settings

Abstract

Chronic kidney disease (CKD) is defined as abnormal kidney function or structure that persists for >3 months, with implications for health. It is a common condition and a significant risk factor for cardiovascular disease. The most common causes of CKD are diabetes and hypertension, and its prevalence increases with age. In addition, CKD is associated with the risk of kidney failure, significant healthcare expenditure, and increased morbidity and mortality. Early detection is necessary to slow progression and prevent cardiovascular disease. Primary care providers (PCPs) are well suited to managing CKD, especially in low resource settings with shortage of nephrologists. Here, we review published guidelines and online resources to provide a practical approach to CKD management in primary care, focusing on low resource settings. The spectrum of kidney care discussed includes screening, detection, and management of CKD. We also describe novel decision-support aids to predict kidney failure and to help PCPs navigate care for patients with advanced kidney disease, especially when access to kidney replacement therapy is limited.