Lifestyle and dietary modifications are effective for specific types of CKD. Clinicians should advise all patients with CKD to quit smoking; exercise for 30 minutes most days of the week; limit alcohol intake (1 drink/day for women, 2 drinks/day for men); maintain body mass index within the normal range (18.5–
24.9 kg/m2); and eat a diet high in fruit, vegetables, and whole grains (34–35). The DASH diet is recommended for patients with a
GFR >60 mL/min/1.73 m2 and high-normal blood pressure or stage 1 hypertension but not those with lower GFR (CKD stages 3 or 4) because it contains a higher-than-recommended amount of protein, potassium, and phosphorous (34). Although salt restriction in the …show more content…
In a study of primary angioplasty, 119 patients were assigned to a double dose of N-acetylcysteine,
116 patients to standard-dose Nacetylcysteine, and 119 patients to placebo. All patients received intravenous fluids for 12 hours after the procedure at a rate of 1 mL/ kg/h. Contrast medium–induced nephropathy, defined as an increase in the serum creatinine of 25% or more, was observed in 8% of patients in the double-dose group, 15% of pa-
Diagnosis... CKD is defined as kidney damage or a GFR <60 mL/min/
1.73 m2 for a period longer than 3 months. CKD should be classified based on levels of GFR and albuminuria. The first step in diagnosis is to determine whether a patient has diabetic nephropathy; hypertensive nephropathy; or nondiabetic, nonhypertensive kidney disease. The history and physical examination often point to a cause, but a definitive diagnosis requires various diagnostic tests, renal ultrasonography, and sometimes renal biopsy.
CLINICAL BOTTOM LINE
34. Kidney Disease Outcomes
(K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease.
Am J Kidney Dis.