What are the pathologic manifestations of chronic kidney disease (CKD) and how are they treated?

Updated: Jul 21, 2021
  • Author: Pradeep Arora, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Treat these pathologic manifestations of chronic kidney disease (CKD) as follows:

  • Anemia: When the hemoglobin level is below 10 g/dL, treat with an erythropoiesis-stimulating agent (ESA) such as epoetin alfa or darbepoetin alfa; caution should be exercised in patients with malignancy

  • Hyperphosphatemia: Treat with dietary phosphate binders and dietary phosphate restriction
  • Hypocalcemia: Treat with calcium supplements with or without calcitriol

  • Hyperparathyroidism: Treat with calcitriol, vitamin D analogues, or calcimimetics

  • Volume overload: Treat with loop diuretics or ultrafiltration

  • Metabolic acidosis: Treat with oral alkali supplementation

  • Uremic manifestations: Treat with long-term renal replacement therapy (hemodialysis, peritoneal dialysis, or kidney transplantation)

  • Cardiovascular complications: Treat as appropriate

  • Growth failure in children: Treat with growth hormone


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