6 steps to slowing progression of CKD:
NB: Remember CHD risk equivalent
1. ACE inhibitor or Angiotensin receptor blocker (slow progression to ESRD with additional advantages over blood pressure lowering alone)
2. Tight blood pressure control
- Multiple antihypertensive medications and dietary sodium restriction may be required
- Targets: < 140/90 mmHg without DM, < 130/80 mmHg with DM
3. Use of a statin in patients with dyslipidemia (target LDL < 2 mmol/L) - shown to prevent CV events and may slow the rate of decline
4. Recommend smoking cessation (independent risk for development/progression of CKD)
5. glycemic control in patients with diabetes mellitus (HbA1C < 7%)
6. Patients with eGFR <
[...] ml/min/1.73m2 should avoid
[...] ,
[...] and other nephrotoxins such as
[...] if possible