KEY POINTS
Steps to stabilize renal function include blood pressure
and diabetes control.
Patients have a very high risk of cardiovascular disease,
and one should try to reduce modifiable risk factors
such as hypertension (which is also a risk factor for the
progression of CKD) and hyperlipidemia.
In addition to controlling blood pressure, angiotensin-converting
enzyme inhibitors and angiotensin receptor blockers
reduce proteinuria, a risk factor for progression of CKD.
Patients with CKD develop secondary hyperparathyroidism,
hyperphosphatemia, and, in advanced CKD, hypocalcemia,
all leading to disorders of bone mineral metabolism.
Low vitamin D levels should be raised with supplements,
and high phosphorus levels should be lowered
with dietary restriction and phosphate binders.