Primary prevention
Your Organisational Guidance
ebpracticenet urges you to prioritise the following organisational guidance:
Chronisch nierlijden (multidisciplinaire aanpak)Published by: WORELLast published: 2017GPC pluridisciplinaire sur la néphropathie chronique (IRC)Published by: Groupe de travail Développement de recommandations de première ligneLast published: 2017Modifiable lifestyle factors consistently predict the incidence of chronic kidney disease (CKD).[47] Evidence for prevention is, however, limited.
A goal HbA1c <53 mmol/mol (<7%), blood pressure (BP) target of <140/90 mmHg, tobacco cessation, and ideal body weight with BMI <27 is recommended to prevent the development of CKD.[30][34][48]
Secondary prevention
Prevention of further kidney function loss is the primary goal of conservative management of people with CKD.[60] Kidney-preserving care includes non-pharmacological (e.g., dietary and lifestyle adjustments) and pharmacological strategies.[60]
Protein restriction is recommended in late-stage (GFR category G4 or G5) disease to delay the initiation of dialysis; however, severe protein restriction may result in malnourishment and impact on quality of life.[171]
Patients with comorbidity
Underlying risk factors associated with disease states should be treated, including optimising BP and glycaemic control in diabetes to individualised targets.[1] Tobacco cessation, weight loss, salt restriction, and optimal lipid management with statin therapy are indicated. Use of low-dose aspirin is recommended for secondary prevention (of cardiovascular disease events) in patients with CKD and ischaemic cardiovascular disease.[1] There is a higher risk for minor bleeding than in the general population.
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