| Theme |
Medical treatment, nursing care, and life support for patients with advanced CKD stages |
| Title |
Points of clinical practice guidebook for diagnosis and treatment of CKD 2012 |
| Author |
Enyu Imai |
Nakayamadera Imai Clinic |
| [ Summary ] |
The Japanese Society of Nephrology revised its Clinical Practice Guidebook for Treatment of CKD in 2012. These guidelines were made in relation to revisions in the Clinical Practice Guideline for the Evaluation and Management of CKD in the publication by Kidney Disease Improving Global Outcomes in 2012. Major changes in the new CKD guidebook include the use of CKD classifications based on cause, GFR or albuminuria. Predicting CKD prognoses defined by GFR or albuminuria are illustrated by heat map graphics. If the patients are thin, GFR can be estimated by using a formula based on cystatin C as well. Target blood pressure levels should be 130/80 mmHg or lower. Target blood glucose levels should be HbA1c< 6.9 % for diabetic patients. Target hemoglobin levels for CKD patients with anemia should be 10-12 g/dL. CKD patients with levels of GFR<60 mL/min/1.73 m2 and have undergone to arterial imaging or have levels of GFR<45 mL/min/1.73 m2 or undergoing venous imaging should be infused with isotonic saline before and after imaging. Doses of drugs excreted from the kidneys should be reduced in relation to GFR. |