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Abstract

A REVIEW ARTICLE ON CHRONIC KIDNEY INJURY

Rohit Bangwal*, Dr. Mashud Mohd. Essar Hussain

ABSTRACT

Chronic kidney disease (CKD) is the sixteen-leading cause of years of life lost worldwide. Appropriate screening, diagnosis, and management by primary care clinicians are necessary to prevent adverse CKD-associated outcomes, including cardiovascular disease, end-stage kidney disease (ESRD), and death. CKD is Defined as a persistent abnormality in kidney structure or function (eg, glomerular filtration rate [GFR] <60 mL/min/1.73 m2 or albuminuria ≥30 mg per 24 hours) for more than 3 months, CKD affects 8% to 16% of the population worldwide. In developed countries, CKD is most commonly attributed to diabetes and hypertension. However, less than 5% of patients with early CKD report awareness of their disease. Among individuals diagnosed as having CKD, staging and new risk assessment tools that incorporate GFR and albuminuria can help guide treatment, monitoring, and referral strategies. Optimal management of CKD includes cardiovascular risk reduction (eg, statins and blood pressure management), treatment of albuminuria (eg, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers), avoidance of potential nephrotoxins (eg, nonsteroidal anti-inflammatory drugs), and adjustments to drug dosing (eg, many antibiotics and oral hypoglycemic agents). Patients also require monitoring for complications of CKD, such as hyperkalaemia, metabolic acidosis, hyperphosphatemia, vitamin D deficiency, secondary hyperparathyroidism, and anaemia. Those at high risk of CKD progression (eg, estimated GFR <30 mL/min/1.73 m2, albuminuria ≥300 mg per 24 hours, or rapid decline in estimated GFR) should be promptly referred to a nephrologist. As a clinical pharmacist we search large quantity of many review articles and ward rounds participation experiences at the nephrology department then I am concluded, the chronic kidney disease (CKD) is the risk full for our health & life. CKD associated with many risks of complications and should be carefully managed by the clinical practice, non-pharmacologic and pharmacological treatment. The easiest procedure way for identifying CKD is to screen people. Current recommendations suggest screening of individuals with diabetes, thyroid, hypertension, cardiovascular disease etc and family history of kidney diseases in the course of routine health check-ups. Conclusions, relevance diagnosis, staging, and appropriate referral of CKD by primary care clinicians are important in reducing the burden of CKD worldwide.

Keywords: Chronic Kidney Disease, Glomerular Filtration Rate, Albuminuria, Clinical Pharmacist, Nephrologist.


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