Try and avoid nephrotoxic agents (NSAIDs, aminoglycoside antibiotics, and
radiocontrast)
Monitor and control blood pressure with a goal of <130/80 mmHg
Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers
(ARBs) may slow progression of CKD, especially in patients with proteinuria
Monitor phosphorous, calcium, and parathyroid hormone levels in all patients with
stage 3 to 4 CKD
Patients with CKD are at higher risk of cardiovascular events and should be on a baby
aspirin, and a lipid lowering agent with goal LDL <100mg/dL (Maybe <70mg/dL for LDL
in patients with CAD and CKD)
Consider referral and co-management with a nephrologist if a patient has CKD
progression, active urine sediment and/or stage 3 CKD
ALL patients with Stage 4 – 5 CKD should be referred to a nephrologist
Pearl # 5: DO NOT Discontinue an ACEI or ARB Because of a Small Increase in Serum