Continuing Medical Education

Recent important strategies in the management of chronic kidney disease

A M Meyers, M Davies


The burden of chronic kidney disease (CKD) is considerably higher in low- and middle-income countries, which are less able than the developed world to cope with treating advanced renal failure owing to financial constraints. Prevention, early diagnosis and implementation of existing knowledge can improve outcomes. This review presents several recent advances to assist with avoiding and slowing down CKD progression and reducing common comorbid complications. The following are discussed: the possible use of metformin in patients with type 2 diabetes-related CKD; recent inexpensive important developments in the treatment of autosomal-dominant polycystic kidney disease; prevention of acidosis and the early dietary reduction of red meat consumption; and the therapeutic lowering of uric acid in persistent hyperuricaemia. Finally, an active and monitored exercise programme should be undertaken whenever possible. All of these recommendations have been shown to significantly slow the progression of CKD and increase cardiovascular protection.

Authors' affiliations

A M Meyers, National Kidney Foundation of South Africa, Johannesburg; School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg; Faculty Practice Centre, Donald Gordon Medical Centre, Johannesburg; and Renal Dialysis Unit, Klerksdorp Hospital, South Africa

M Davies, Division of Nephrology, Charlotte Maxeke Johannesburg Academic Hospital; and School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Chronic kidney disease; Slowing CKD progression; CKD treatment strategies

Cite this article

South African Medical Journal 2017;107(9):730-733. DOI:10.7196/SAMJ.2017.v107i9.12366

Article History

Date submitted: 2017-08-25
Date published: 2017-08-25

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