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Chronic Kidney Disease

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Chronic kidney disease (CKD) is defined as structural or functional kidney damage or a glomerular filtration rate (GFR) less that 60 mL/min per 1.73 m2 for at least 3 months.1 Approximately 1 of 3 adults with diabetes and 1 of 5 adults with high blood pressure has CKD.2 We estimate that more than 10% of adults in the United States (more than 20 million people) may have CKD. Men with CKD are 50% more likely than women to have kidney failure.2 Due to increased risk for cardiovascular disease, individuals with CKD are 16 to 40 times more likely to die than to reach ESRD.2

The most common risk factors for CKD are diabetes and hypertension.1 Other risk factors associated with progression include those that may be consequent to the underlying …show more content…

When the GFR remains <15mL/min per 1.73 m2 renal replacement therapy, either dialysis or transplantation is indicated.3 TK is CKD stage 3 with 38 …show more content…

An increased risk of hyperkalemia was associated with this class when combined with ACEI or ARB.5 Thus, aliskiren is not recommended for our patient at this time.

Other antihypertensive drugs have little or no effect on protein excretion. Beta blockers (BB), diuretics, and alpha-1 blockers have a lesser antiproteinuric effect than renin-angiotensin system inhibitors.5 A meta-analysis showed that ACEI lowered protein excretion by 40% compared with 16% for BB, and 14% for other non-calcium channel blocker antihypertensive

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