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Table 1 Guidelines for PCPs on management of progression and complications of CKD, adapted from KDOQI clinical practice guidelines

From: Impact of superimposed nephrological care to guidelines-directed management by primary care physicians of patients with stable chronic kidney disease: a randomized controlled trial

Blood pressure and proteinuria
 First-line drug: ACEIs or ARBs in patients with proteinuria or diabetic nephropathy.
 Aim: BP ≤130/80 mmHg or ≤ 125/75 mmHg if proteinuria > 1 g/24 h; Proteinuria < 500 mg/24 h.
Diabetes
 Use of antidiabetic drugs appropriate to renal function.
 Aim: Glycated Hb < 7%.
Dyslipidemia
 Statins prescription.
 Aim: LDL cholesterol < 2.6 mmol/l.
Anemia
 Iron supplementation; Erythropoietin prescription when appropriate.
 Aim: Hb 100–110 g/l.
Metabolic bone disease
 Low-phosphate diet, prescription of phosphate binders, and vitamin D analogs when appropriate.
 Aim: Phosphate < 1.8 mmol/l, Calcium 2.2–2.6 mmol/l, PTH 14–21 pmol/l.
Metabolic acidosis
 Prescribe oral sodium bicarbonate if serum bicarbonate < 22 mmol/l.
 Aim: Serum bicarbonate > 23 mmol/l.
Lifestyle changes
 Medical and dietitian counseling, prescription of low-sodium and low-phosphate diets, low-protein, low potassium diet when appropriate.
 Aim: smoking cessation, increase of physical activity, and adapted diet to CKD stages.