African Americans have disproportionately high rates of chronic and end-stage renal disease. The key factor in slowing the progression of renal failure is blood pressure reduction. Angiotensin-converting enzyme inhibitors are more effective at preserving kidney function than other classes of antihypertensive agents-although higher doses may be needed in African Americans than in other patients. Tight glycemic control is most important in early renal disease; once overt diabetic nephropathy is established, glucose control has little effect on the decline in the glomerular filtration rate (GFR). Regularly measure GFR in patients at risk for chronic kidney disease by using an estimation equation, such as the Cockcroft-Gault equation. Refer patients to a nephrologist when the GFR falls below 30 mL/min/1.73 m 2 or when a treatable cause is likely, chronic renal insufficiency is rapidly progressive, or therapeutic goals cannot be achieved.
|Original language||English (US)|
|Number of pages||12|
|State||Published - Nov 1 2003|
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