Treatment of Disorders of Sodium Balance in Chronic Kidney Disease

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

Extracellular fluid volume expansion is nearly universal in patients with CKD. Such volume expansion has features similar to the syndrome of heart failure with preserved ejection fraction, which not only leads to symptoms but can also lead to further organ damage. Unique treatment challenges are present in this patient population, including low glomerular filtration, which limits sodium chloride filtration, intrinsic tubule predisposition to sodium chloride retention, and proteinuria. In addition, pharmacokinetic considerations alter the disposition of diuretics in patients with CKD and nephrotic syndrome. Maintaining extracellular fluid volume near to normal is often necessary for hypertension treatment in this population, but it may also help prevent progressive cardiovascular and kidney damage. Although powerful diuretics can often accomplish this goal, this often comes at a cost of competing adverse effects. An approach to reduce extracellular fluid volume while avoiding adverse effects, therefore, requires a nuanced yet aggressive therapeutic approach.

Original languageEnglish (US)
Pages (from-to)332-341
Number of pages10
JournalAdvances in Chronic Kidney Disease
Volume24
Issue number5
DOIs
StatePublished - Sep 1 2017

Fingerprint

Extracellular Fluid
Chronic Renal Insufficiency
Sodium
Diuretics
Sodium Chloride
Nephrotic Syndrome
Proteinuria
Population
Therapeutics
Heart Failure
Pharmacokinetics
Hypertension
Kidney
Costs and Cost Analysis

Keywords

  • Diuretics
  • Extracellular fluid volume expansion
  • Nephrotic syndrome
  • Salt-sensitive hypertension

ASJC Scopus subject areas

  • Nephrology

Cite this

Treatment of Disorders of Sodium Balance in Chronic Kidney Disease. / Ellison, David.

In: Advances in Chronic Kidney Disease, Vol. 24, No. 5, 01.09.2017, p. 332-341.

Research output: Contribution to journalReview article

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