From the Guidelines
Chandra's Grade 2-3 chronic kidney disease (CKD) should be managed according to the standards of medical care in diabetes, which defines stages 3-5 CKD based on evidence of kidney damage with eGFR <60 mL/min/1.73 m² 1.
Key Considerations
- The management of CKD involves a comprehensive approach, including lifestyle modifications, medication adherence, and regular monitoring of kidney function and other cardiovascular risk factors.
- The classification system developed by Kidney Disease Improving Global Outcomes (KDIGO) is used to identify typical risk strata of adults with CKD, from low to very high risk of CKD progression and related complications 1.
- For patients with CKD, particularly those with stages 3-5, it is essential to consider the potential risks and benefits of various medications and interventions, including the use of sodium-glucose cotransporter-2 (SGLT-2) inhibitors, which have been shown to have beneficial effects on kidney outcomes in adults with CKD 1.
Management Strategies
- According to the 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction, an invasive strategy is reasonable in patients with mild (stage 2) and moderate (stage 3) CKD, but the benefits and risks of such an approach must be carefully weighed 1.
- The identification of CKD is crucial in patients with cardiovascular disease, as it represents a subgroup with a more adverse prognosis, and interventions may have less certain benefits 1.
- The use of isosmolar contrast agents and careful monitoring of kidney function are essential in patients with CKD undergoing coronary arteriography to minimize the risk of contrast-induced nephropathy 1.
Monitoring and Follow-up
- Regular monitoring of kidney function, including estimation of glomerular filtration rate and testing for microalbuminuria, is essential in patients with CKD 1.
- The albumin-to-creatinine ratio should be used to screen for the presence of kidney damage in adult patients with CKD, with values greater than 30 mg of albumin per 1 g of creatinine regarded as abnormal 1.
From the Research
Grade 2-3 Chandra’s
- There are no direct research papers to assist in answering this question, as the provided studies do not mention "Grade 2-3 Chandra’s" specifically.
- However, some studies discuss the treatment of infections and the use of antibiotics such as amoxicillin/clavulanic acid 2, 3, 4.
- The treatment of infections is often based on the severity of the infection and the type of pathogen involved 5.
- Severity grades are used to characterize histopathologic changes in nonclinical toxicity studies, but this may not be directly related to "Grade 2-3 Chandra’s" 6.
- Further research would be needed to determine the relevance of these studies to "Grade 2-3 Chandra’s".