Diabetes mellitus

High blood sugar levels can damage the glomerulus, resulting in increased glomerular pressure which can damage the filtration barrier and cause protein to leak into the urine. Patients with diabetes should be checked for signs of microalbuminuria, encouraged to have good glycaemic control and prescribed ACE inhibitors or angiotensin II receptor blockers if microalbuminuria is detected. 

Hypertension

High blood pressure is a leading cause of CKD and kidney disease can also cause hypertension. Good blood pressure control can help to reduce the risk of developing CKD, as well as slow its progression. All patients with CKD should have their blood pressure monitored regularly. Patients treated for hypertension should have their kidney function monitored and urine checked for protein to look for kidney damage.

Inherited

Polycystic kidney disease is an inherited condition that causes cysts to develop in the kidney. The rate of kidney function decline is variable, with some patients having little reduction in kidney function and others progressing to end-stage renal failure requiring renal replacement therapy or a kidney transplant. Patients are encouraged to adopt a healthy lifestyle and carefully control their blood pressure. Tolvaptan is used in selected patients to slow the rate of cyst growth and decline in renal function.

Ethnicity

NICE guidance does not recommend using ethnicity as a marker to test for CKD. However, African, African Caribbean or Asian family origin are risk factors for the condition. As with all populations, exercise, maintaining a healthy weight, stopping smoking and maintaining a healthy blood pressure can help to reduce the risk the risk of developing CKD and slow the rate of kidney function decline.