Early detection and treatment are important in slowing the progression and preventing complications in chronic kidney disease (CKD).  An article in the Mayo Clinic Proceedings, discussed ways to avoid common pitfalls in recognizing and treating CKD.  The evidence-based pearls given in the article are to help primary care physicians who encounter patients with renal disease in their daily practice:

1. A "normal" serum creatinine level may not be normal.
2. Know the medications that spuriously elevate the serum creatinine level.
3. Patients with decreased GFR or proteinuria should be evaluated to determine the cause; positive urine dipstick tests results for protein should be followed up with a spot urine protein to urine creatinine ratio.
4. In patients with early-stage CKD, periodic evaluation and intervention are appropriate to slow the progression of renal disease and avoid its complications.
5. Do not automatically discontinue an ACEI or ARB solely because of a small increase in the serum creatinine or potassium level.
6. Anemia in patients with CKD should be treated with erythrocyte-stimulating agents such as recombinant human erythropoietin but should not be overtreated.
7. Phosphate-containing bowel preparations should be used with caution.
8. Patients with severe CKD should avoid magnesium or aluminum-containing oral preparations. Concomitant use of citrate-containing preparations and aluminum-containing oral preparations is potentially hazardous because it can lead to acute aluminum toxicity.
9. Although most patients with hypertension should not be screened for secondary hypertension, certain clinical clues may suggest the presence of an underlying cause that when addressed, may resolve or improve the patient's hypertension.
10. In patients with recurrent stone disease, an in-depth metabolic evaluation is needed to identify and treat modifiable risk factors, thereby preventing further episodes and/or promoting stone dissolution.

Adapted From Mayo Clin Proc 2009; 84 (2):180-186

For a complete discussion of CKD and other renal conditions discussed in this article, click here to go the cited reference.