Chronic Kidney Disease Management in Primary Care

Chronic kidney disease (CKD) is a progressive disorder characterised by declining renal function and increased cardiovascular risk. In primary care, early detection through assessment of estimated glomerular filtration rate (eGFR) and albuminuria is essential for staging and risk stratification. Management encompasses blood pressure and glycaemic control, judicious use of renin–angiotensin system inhibitors, and more recently the incorporation of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists to slow progression. Primary care providers coordinate multidisciplinary care, engage in patient education to encourage self-management and lifestyle modification, and collaborate with nephrology services via e-consults. Electronic health record (EHR) tools, registries and incentive frameworks support guideline-concordant practice, while telemonitoring and population health strategies extend reach. Nonetheless, gaps in coding accuracy, barriers to guideline uptake and resource constraints persist. Emerging approaches aim to integrate risk-based care pathways, digital health applications and enhanced collaboration to improve outcomes at both individual and population levels.

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Chronic Kidney Disease Management in Primary Care publication trend

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Technical terms

Chronic Kidney Disease (CKD): A progressive reduction in renal function over at least three months, classified by eGFR and albuminuria stages.

Estimated Glomerular Filtration Rate (eGFR): A calculated index of kidney filtration capacity based on serum creatinine, age, sex and ethnicity.

Albuminuria: The abnormal presence of albumin in urine, indicating glomerular damage and used for CKD staging and prognostication.

Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i): A class of medications that reduce renal glucose reabsorption and confer renal and cardiovascular protection in CKD.

Glucagon-Like Peptide-1 Receptor Agonist (GLP-1RA): An injectable agent that improves glycaemic control and may slow CKD progression through metabolic and haemodynamic effects.

Electronic Health Record (EHR): A digital system for recording patient health data, facilitating coding, decision support and population health management in primary care.

References

1. Population Health Management and Guideline-Concordant Care in CKD. Journal of the American Society of Nephrology (2024).
2. Chronic kidney disease: detect, diagnose, disclose—a UK primary care perspective of barriers and enablers to effective kidney care. BMC Medicine (2024).
3. Barriers and Facilitators in Implementing a Telemonitoring Application for Patients With Chronic Kidney Disease and Health Professionals: Ancillary Implementation Study of the NeLLY (New Health e-Link in the Lyon Region) Stepped-Wedge Randomized Controlled Trial. JMIR mHealth and uHealth (2025).