Chronic Kidney Disease: Strategies to Retard Progression

Abstract

Chronic kidney disease (CKD), defined as the presence of irreversible structural or functional kidney damages, increases the risk of poor outcomes due to its association with multiple complications, including altered mineral metabolism, anemia, metabolic acidosis, and increased cardiovascular events. The mainstay of treatments for CKD lies in the prevention of the development and progression of CKD as well as its complications. Due to the heterogeneous origins and the uncertainty in the pathogenesis of CKD, efficacious therapies for CKD remain challenging. In this review, we focus on the following four themes: first, a summary of the known factors that contribute to CKD development and progression, with an emphasis on avoiding acute kidney injury (AKI); second, an etiology-based treatment strategy for retarding CKD, including the approaches for the common and under-recognized ones; and third, the recommended approaches for ameliorating CKD complications, and the final section discusses the novel agents for counteracting CKD progression.

The Dynamics and Plasticity of Epigenetics in Diabetic Kidney Disease: Therapeutic Applications Vis-à-Vis

“…To prevent CKD progression, the optimized control of hyperglycemia, hypertension, and dyslipidemia is fundamental. The avoidance of repeated acute kidney injury (AKI), the use of reno-protective medications such as renin-angiotensin-aldosterone system blockers in patients with hypertension or sodium glucose cotransporter 2 inhibitors in patients with diabetes mellitus (DM), and the prompt correction of complications such as anemia, metabolic acidosis, and electrolyte imbalances, are important approaches for retarding CKD and reducing morbidity/mortality [5]. Other factors such as genetic susceptibility and epigenetic dysregulations also play a role in the progression of CKD [6].…”

Molecular Mechanisms of Cellular Injury and Role of Toxic Heavy Metals in Chronic Kidney Disease

“…These patterns can be classified into very fast, fast, moderate, or slow decline, depending on the rate at which renal function declines. The differences in these patterns of decline reflect the heterogeneity of CKD origins and the related pathologies, adjunct comorbidities, and other harsh environmental exposures [ 6 , 7 ]. Diabetes mellitus, hypertension, obesity, and older age are the primary risk factors, while other risk factors include cardiovascular disease and a family history of CKD [ 2 , 3 ].…”

The consequences of the arbitrary herbal and analgesics on renal function

“…The most common renal disease associated with deteriorated kidney function or structure is chronic kidney disease (CKD). CKD has multiple complications and irreversible damage leading to a constant deterioration of the kidney structure or function (Yan et al, 2021). High mortality associated with CKD can occur in the general adult population, particularly those with comorbidities, such as diabetic and hypertensive patients (Kalantar-Zadeh et al, 2021).…”

“…High mortality associated with CKD can occur in the general adult population, particularly those with comorbidities, such as diabetic and hypertensive patients (Kalantar-Zadeh et al, 2021). The core of CKD treatment is to prevent the prevention of the disease and its complications (Yan 2021). The key determining factor of CKD is hypothetically modifiable risk factors (Dehghani et al, 2022).…”