The Singapore Family Physician

Back to issue Vol 47 No. 1 - Chronic Disease Management 2021 Update

Making Sense of Chronic Kidney Disease in Primary Care Part 2 – Management

Kwek Jia Liang
The Singapore Family Physician Vol 47 No 1 - Chronic Disease Management 2021 Update
64 - 68
1 January 2021
0377-5305
Chronic kidney disease (CKD) is common worldwide and in Singapore. The primary care physicians play an important role in managing patients with CKD, especially in the early stages of CKD. The primary objectives of CKD management are (1) slowing down the progression of CKD, (2) managing the complications of CKD, and (3) establishing the longterm kidney care plan. The interventions to slow down the progression of CKD are to identify the cause of CKD, use the renin-aldosterone system blocker and the sodium-glucose cotransporter-2 inhibitor in suitable CKD populations, optimise blood pressure and glycaemic control, correct acidosis, avoid acute kidney injury and nephrotoxin, and modify dietary and lifestyle habits. For complications of CKD, the focus is on reducing cardiovascular risk, and managing anaemia, mineral bone disease, electrolytes imbalances and fluid overload. Lastly, there is a need to establish CKD patient’s treatment goals and initiate advanced care planning in a patient with progressive CKD to facilitate future care.