This ACE Clinical Guidance (ACG) highlights the importance of personalised management for patients with early-stage chronic kidney disease (CKD) to delay progression and reduce cardiovascular complications. The ACG offers evidence-based recommendations on optimising blood pressure and albuminuria, with considerations for management in the context of associated comorbid conditions. Principles of tailored lifestyle intervention, regular follow-up, and options for shared or multidisciplinary care are also discussed.
CKD – delaying progression and reducing cardiovascular complications (Oct 2023)
CKD – delaying progression and reducing cardiovascular complications references (Oct 2023)
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||Personalise the management plan based on CKD stage, including underlying cause.
||Optimise blood pressure control and albuminuria management with an ACE inhibitor or ARB, and titrate to maximum tolerated dose as needed.
||Add an SGLT2 inhibitor to ACE inhibitor/ARB therapy for patients with CKD and persistent albuminuria, regardless of DM status.
||Optimise management of CKD-related comorbidities.
||Encourage and provide education on lifestyle intervention through shared decision-making.
||Regularly follow up all patients with CKD, with more frequent review for those at increased risk of disease progression.
||Consider shared or multidisciplinary care depending on CKD progression and other clinical needs.
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