🩺 General MedicineRenal / NephrologyStudentInternResident

Chronic Kidney Disease (CKD)

Also known as: CKD · chronic renal failure · chronic kidney disease

Longstanding (≥3 months) reduced kidney function and/or kidney damage. The goals are to slow progression, protect the heart, and manage complications.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Diabetes and hypertension are the leading causes; also glomerular disease, obstruction and polycystic kidney disease. Risk rises with age and after episodes of AKI.

Red flags — escalate / refer

Rapidly declining eGFR, refractory hyperkalaemia/fluid overload/acidosis, or uraemic symptoms → nephrology and renal-replacement planning.
New heavy proteinuria or haematuria → investigate for glomerular disease.

Work-up / diagnosis

1Stage by eGFR (G1–G5) and albuminuria (A1–A3) on ≥2 occasions ≥3 months apart.
2Find the cause; check BP, urine ACR, electrolytes, Hb, calcium/phosphate/PTH and a renal ultrasound.

Management — overview

Slow progression: tight BP control with an ACE inhibitor or ARB (especially with albuminuria) plus an SGLT2 inhibitor; optimise diabetes.
Reduce cardiovascular risk (statin, lifestyle, stop smoking); avoid nephrotoxins and dose-adjust drugs.
Manage complications: anaemia (iron ± erythropoiesis-stimulating agent), CKD–mineral-and-bone disorder (phosphate/vitamin D), acidosis and hyperkalaemia.
Prepare for renal replacement therapy (dialysis/transplant) in advanced CKD; vaccinate.

In-depthFull dosing & advanced protocol

Drug dosing

ACE inhibitor / ARB

Renoprotection (esp. albuminuria)

Adult dose: Up-titrate as tolerated; monitor K⁺ and eGFR after starting/increasing
Route: Oral

OtherKDIGO Clinical Practice Guideline for Acute Kidney Injury ↗

SGLT2 inhibitor

Slows CKD progression (diabetic & non-diabetic)

Adult dose: Once daily, per eGFR eligibility
Route: Oral

OtherKDIGO Clinical Practice Guideline for Acute Kidney Injury ↗

Complication-directed therapy

Anaemia / CKD-MBD / acidosis / K⁺

Adult dose: Iron ± ESA; phosphate binders/vitamin D; treat acidosis and hyperkalaemia
Route: Oral / IV

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Staging grid, complications & RRT

Use the eGFR (G) × albuminuria (A) grid to gauge risk and referral need.
Balance RAAS-inhibitor renoprotection against hyperkalaemia; manage CKD-MBD and anaemia to targets.
Plan renal replacement (dialysis/transplant) and vascular access ahead of end-stage disease.

OtherKDIGO Clinical Practice Guideline for Acute Kidney Injury ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

HypertensionPersistently raised arterial pressure (≥140/90 mmHg) — a leading, modifiable cause of stroke, heart attack, heart failure and kidney disease.DengueAn Aedes-borne viral febrile illness. Most cases self-limit, but plasma leakage can cause severe dengue — early recognition of warning signs and careful fluid therapy save lives.MalariaA mosquito-borne protozoal (Plasmodium) febrile illness. In India P. vivax and P. falciparum predominate; prompt diagnosis and species-specific treatment prevent severe disease.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

ACE inhibitor / ARB

SGLT2 inhibitor

Complication-directed therapy

📈 Staging grid, complications & RRT

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

ACE inhibitor / ARB

SGLT2 inhibitor

Complication-directed therapy

📈 Staging grid, complications & RRT

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Staging grid, complications & RRT

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Staging grid, complications & RRT

References