Chronische Nierenerkrankungen – was der Praktiker wissen sollte

Abstract

Chronic kidney disease (CKD) affects between 3 and 17 % of the population in Europe, especially elderly persons. CKD is a clinical syndrome which may develop in patients with e. g. diabetes mellitus, arterial hypertension or autoimmune diseases. A poorer renal function – especially in old age – is to be considered irrespective of the medication. Many antibiotics and painkillers require dose adjustments. Therapy should be done in a manner which is suitable for indication. Polypharmacy should be avoided as far as possible. Diuretics and RAAS inhibitors are useful drugs in therapy of CKD. Changes of lifestyle are important, so as weight reduction, restriction of salt and fructose, sufficient drinking, strict control of blood glucose, blood pressure and hypercholesterolaemia. Additional acute lesions have to be avoided ("acute-on-chronic renal failure").

Was früher als chronische Niereninsuffizienz bezeichnet wurde, heißt heute chronische Nierenerkrankung – in Anlehnung an den international üblichen Begriff „Chronic Kidney Disease“ (CKD). Häufig sind alte Menschen betroffen, häufig sind Komorbiditäten vorhanden: CKD als klinisches Syndrom ist eine Herausforderung. Dieser Beitrag bietet viele praktische Hinweise für den Primärbehandler hinsichtlich Prävention, Früherkennung und Behandlung.

Schlüsselwörter

Chronische Nierenerkrankung - Diuretika - RAAS-Blockade - Schmerzmittel - Lebensstiländerungen

Key words

chronic kidney disease - diuretics - RAAS inhibition - pain killers - changes of lifestyle

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