For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
65
views
20
references
 Top references
cited by
86
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      574
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Chronic Kidney Disease

      review-article

      Read this article at

      SciELOPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          SUMMARY Chronic kidney disease is highly prevalent (10-13% of the population), irreversible, progressive, and associated with higher cardiovascular risk. Patients with this pathology remain asymptomatic most of the time, presenting the complications typical of renal dysfunction only in more advanced stages. Its treatment can be conservative (patients without indication for dialysis, usually those with glomerular filtration rate above 15 ml/minute) or replacement therapy (hemodialysis, peritoneal dialysis, and kidney transplantation). The objectives of the conservative treatment for chronic kidney disease are to slow down the progression of kidney dysfunction, treat complications (anemia, bone diseases, cardiovascular diseases), vaccination for hepatitis B, and preparation for kidney replacement therapy.

          Related collections

          Most cited references20

          • Record: found
          • Abstract: not found
          • Article: not found

          KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease

          K Disease, Kidney Group, Kidney Disease Improving Global Outcomes … (2013)
          Article 0 comments Cited 466 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Bicarbonate supplementation slows progression of CKD and improves nutritional status.

            Ione de Brito-Ashurst, Mira Varagunam, Martin J. Raftery … (2009)
            Bicarbonate supplementation preserves renal function in experimental chronic kidney disease (CKD), but whether the same benefit occurs in humans is unknown. Here, we randomly assigned 134 adult patients with CKD (creatinine clearance [CrCl] 15 to 30 ml/min per 1.73 m(2)) and serum bicarbonate 16 to 20 mmol/L to either supplementation with oral sodium bicarbonate or standard care for 2 yr. The primary end points were rate of CrCl decline, the proportion of patients with rapid decline of CrCl (>3 ml/min per 1.73 m(2)/yr), and ESRD (CrCl <10 ml/min). Secondary end points were dietary protein intake, normalized protein nitrogen appearance, serum albumin, and mid-arm muscle circumference. Compared with the control group, decline in CrCl was slower with bicarbonate supplementation (5.93 versus 1.88 ml/min 1.73 m(2); P < 0.0001). Patients supplemented with bicarbonate were significantly less likely to experience rapid progression (9 versus 45%; relative risk 0.15; 95% confidence interval 0.06 to 0.40; P < 0.0001). Similarly, fewer patients supplemented with bicarbonate developed ESRD (6.5 versus 33%; relative risk 0.13; 95% confidence interval 0.04 to 0.40; P < 0.001). Nutritional parameters improved significantly with bicarbonate supplementation, which was well tolerated. This study demonstrates that bicarbonate supplementation slows the rate of progression of renal failure to ESRD and improves nutritional status among patients with CKD.
            Article 0 comments Cited 220 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Predictors of the progression of renal disease in the Modification of Diet in Renal Disease Study.

              Lawrence G Hunsicker, Sharon G. Adler, Arlene Caggiula … (1997)
              The Modification of Diet in Renal Disease (MDRD) Study examined the effects of dietary protein restriction and strict blood pressure control on the decline in glomerular filtration rate (GFR) in 840 patients with diverse renal diseases. We describe a systematic analysis to determine baseline factors that predict the decline in GFR, or which alter the efficacy of the diet or blood pressure interventions. Univariate analysis identified 18 of 41 investigated baseline factors as significant (P < 0.05) predictors of GFR decline. In multivariate analysis, six factors--greater urine protein excretion, diagnosis of polycystic kidney disease (PKD), lower serum transferrin, higher mean arterial pressure, black race, and lower serum HDL cholesterol--independently predicted a faster decline in GFR. Together with the study interventions, these six factors accounted for 34.5% and 33.9% of the variance between patients in GFR slopes in Studies A and B, respectively, with proteinuria and PKD playing the predominant role. The mean rate of GFR decline was not significantly related to baseline GFR, suggesting an approximately linear mean GFR decline as renal disease progresses. The 41 baseline predictors were also assessed for their interactions with the diet and blood pressure interventions. A greater benefit of the low blood pressure intervention was found in patients with higher baseline urine protein. None of the 41 baseline factors were shown to predict a greater or lesser effect of dietary protein restriction.
              Article 0 comments Cited 132 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Adriano Luiz Ammirati: Role: ND
                Journal
                Journal ID (publisher-id): ramb
                Title: Revista da Associação Médica Brasileira
                Abbreviated Title: Rev. Assoc. Med. Bras.
                Publisher: Associação Médica Brasileira (São Paulo, SP, Brazil )
                ISSN (Print): 0104-4230
                ISSN (Electronic): 1806-9282
                Publication date (Print and electronic): 2020
                Volume: 66
                Issue: suppl 1
                Pages: s03-s09
                Affiliations
                [2] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Ambulatório de Uremia Brazil
                [1] São Paulo orgnameUniversidade Federal de São Paulo Brazil
                Article
                Publisher ID: S0104-42302020001300003 Publisher ID: S0104-4230(20)06600000003
                DOI: 10.1590/1806-9282.66.s1.3
                PubMed ID: 31939529
                SO-VID: 56c7571c-eacf-403d-b49e-da340349c5ed
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 0
                Product

                SciELO Brazil

                Categories
                Subject: Review Article

                Keywords: Doença renal crônica,Renal Failure,Chronic Kidney Disease End Stage,Conservative Kidney Management,Tratamento conservador,Doença renal crônica estágio final
                Data availability:
                Keywords: Doença renal crônica, Renal Failure, Chronic Kidney Disease End Stage, Conservative Kidney Management, Tratamento conservador, Doença renal crônica estágio final

                Comments

                Comment on this article

                scite_

                Similar content574

                See all similar

                Cited by85

                See all cited by

                Most referenced authors541

                See all reference authors