Chronic kidney disease: overview and clinical management

Chronic Kidney Disease (CKD) is an ongoing and serious health issue affecting thousands of Americans across the nation as well as hundreds of thousands of individuals worldwide. Addressing this issue with effective interventions is a strong reason for conducting additional studies concerning CKD. This study seeks to determine what CKD treatments and interventions are currently in use as well as what new technologies and treatments are being introduced.

There is a plethora of literature currently available on the various methodologies, interventions, treatments and approaches used to combat and treat CKD. Dialysis, both Peritoneal Dialysis and Hemodialysis, seems to be the most common treatment at present. As with any treatment, however, there are risks associated with dialysis. As one recent study determined "the incidence of New Onset Diabetes Mellitus of chronic kidney disease patients receiving PD was 2.4 per 100 patients/year and 3.7 per 100 patients/year in those receiving HD" (Chou, Liang, Kuo, Chang, Liu, Lin, Wang, Yang, Huang, 2014, p. 5). The onset of diabetes, according to the Chou et al. study, leads to increased health problems, especially for those individuals already receiving dialysis.

Other CKD treatments are also used especially before the kidneys reach the stage where dialysis becomes the most preferred treatment. Many patients who are diagnosed early enough are given medicines that focus on maintaining certain levels of health within the body. A primary focus can be on cholesterol-lowering treatments. CKD specialists are almost always concerned about the risk of kidney failure and death, and as a recent SHARP (Study of Heart and Renal Protection) determined a "simvastatin and ezetimibe combination therapy reduced the risk for major atherosclerotic events (coronary death, MI, nonhemorrhagic stroke, or any revascularization)" (Tonelli, Warner, 2014, p. 184, Baigent, Landray, Reith, Emberson, Wheeler, Tomson, 2011).

Originally, this study was determined to offer a treatment to CKD based on the fact that there are not a whole lot of treatments available. However, there are a lot of treatments available, and the current literature provides plenty of information concerning those treatments. Additionally, there are treatments depending on what stage of CKD in which the patient is categorized. A 2013 study determined that "CKD is categorized into five stages that are based on disease severity defined by GFR (3) (Table 1), stages 1 to 3 are considered to be early-stage CKD" (Qaseem, Hopkins, Jr., Sweet, Starkey, Shekelle, 2013, p. 835). Depending on whether the patient is in early-stage vs. late-stage prognosis, the patient will be offered different treatments and approaches to managing the disease and its effects.