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1 in 10 have Chronic Kidney Disease – review Sept 2019

Chronic Kidney Disease Diagnosis and Management: A Review.

JAMA. 2019 Oct 1;322(13):1294-1304. doi: 10.1001/jama.2019.14745
Chen TK1,2, Knicely DH1, Grams ME1,2.
1 Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
2 Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland.

VitaminDWiki

Kidney category starts with

Kidney category listing has 186 items

see also Overview Kidney and vitamin D
Search VitaminDWiki for dialysis OR haemodialysis 1040 items as of Nov 2018
Search VitaminDWiki for kidney transplant 798 items as of June 2019
"Chronic Kidney Disease" OR CKD 874 items as of Jan 2018

Calcitriol category listing has 44 items along with related searches

Kidney Intervention trials using Vitamin D:


Overview Kidney and vitamin D contains the following summary

  • FACT: Kidney is the primary way to activate vitamin D
  • FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
  • FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
  • FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
  • FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
  • FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
  • Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
      Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
    Calcitriol - which bypasses the need for the kidney to activate vitamin D
      Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
        Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012
  • Category Kidney and Vitamin D contains 186 items

IMPORTANCE:
Chronic kidney disease (CKD) is the 16th 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, and death.

OBSERVATIONS:
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 hyperkalemia, metabolic acidosis, hyperphosphatemia, vitamin D deficiency, secondary hyperparathyroidism, and anemia. 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.

CONCLUSIONS AND RELEVANCE:
Diagnosis, staging, and appropriate referral of CKD by primary care clinicians are important in reducing the burden of CKD worldwide.

Created by admin. Last Modification: Wednesday October 2, 2019 18:12:20 GMT-0000 by admin. (Version 3)
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