Important causes of chronic kidney disease in South Africa
In hypertensive patients without chronic kidney disease (CKD) the goal is to keep blood pressure (BP) at <140/90 mmHg. When CKD is present, especially where there is proteinuria of >0.5 g/day, the goal is a BP of <130/80 mmHg. Lifestyle measures are mandatory, especially limitation of salt intake, ingestion of adequate quantities of potassium, and weight control. Patients with stages 4 - 5 CKD must be carefully monitored for hyperkalaemia and deteriorating kidney function if angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) are used, especially in patients >60 years of age with diabetes or atherosclerosis. BP should be regularly monitored and, where possible, home BP-measuring devices are recommended for optimal control. Guidelines on the use of antidiabetic agents in CKD are presented, with the warning that metformin is contraindicated in patients with stages 4 - 5 CKD. There is a wide clinical spectrum of renal disease in the course of HIV infection, including acute kidney injury, electrolyte and acid-base disturbances, HIV-associated glomerular disease, acute-on-chronic renal disease and side-effects related to the treatment of HIV.
| Main Authors: | , , , |
|---|---|
| Format: | Digital revista |
| Language: | English |
| Published: |
South African Medical Association
2015
|
| Online Access: | http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742015000300034 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|