Chronic Kidney Disease (CKD) affects about 10% of adults worldwide. The kidneys gradually lose function over time, progressing through five stages (with stage 5 being kidney failure). While damage is often irreversible, progression can be slowed with proper management. **Stages of CKD:** 1. Stage 1: Normal function (GFR >90) with kidney damage markers 2. Stage 2: Mild reduction (GFR 60-89) 3. Stage 3: Moderate reduction (GFR 30-59) 4. Stage 4: Severe reduction (GFR 15-29) 5. Stage 5: Kidney failure (GFR <15 or dialysis) **Comprehensive Management Approach:** 1. **Medical Monitoring:** - Regular blood tests (creatinine, BUN, electrolytes) - Urine tests (protein/albumin levels) - Blood pressure monitoring (target <130/80) - Anemia management (common in CKD) - Bone health monitoring (calcium, phosphorus, PTH) 2. **Dietary Modifications:** - **Protein**: Moderate intake (0.6-0.8g/kg for advanced CKD) - **Sodium**: Limit to 2,000mg/day to control blood pressure - **Potassium**: May need restriction in later stages - **Phosphorus**: Limit dairy, processed foods - **Fluids**: May need restriction in advanced CKD - Work with renal dietitian for personalized plan 3. **Medication Management:** - ACE inhibitors or ARBs (protect kidney function) - SGLT2 inhibitors (new class showing kidney benefits) - Phosphate binders (if phosphorus high) - Erythropoietin (for anemia) - Adjust doses of medications cleared by kidneys 4. **Lifestyle Factors:** - Maintain healthy weight - Exercise regularly (as tolerated) - Don't smoke - Limit NSAID use (can harm kidneys) - Control blood sugar if diabetic - Manage cholesterol levels 5. **Preparing for Advanced Stages:** - Learn about dialysis options (hemodialysis vs peritoneal) - Understand transplant evaluation process - Create vascular access plan if hemodialysis needed - Discuss advanced directives with healthcare team **Emerging Treatments:** - New diabetes medications with renal benefits - Anti-fibrotic therapies in development - Improved dialysis technologies - Xenotransplantation research **Complication Prevention:** - Cardiovascular disease (leading cause of death in CKD) - Mineral bone disorders - Metabolic acidosis - Uremic symptoms (nausea, itching) - Electrolyte imbalances Regular nephrology visits are crucial, with frequency increasing as CKD progresses. Blood pressure control and diabetes management (if applicable) are particularly important for slowing progression. Patient education about disease process and treatment options leads to better outcomes.