Management of Patients with Non-Dialysis Dependent Chronic Kidney Disease (ND-CKD)

Chronic kidney disease (CKD) is defined as the presence of kidney damage, mainly albuminuria, and/or decreased kidney function (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73m2) for at least 3 months. It has been widely shown that the presence of CKD is associated with an increased cardiovascular (CV) and renal risks. Increase in CV risk means that each patient with one or more signs of kidney damage or renal dysfunction is exposed to the risk of developing a CV event over time, such as myocardial infarction, stroke, peripheral vascular disease, arrhythmias and heart failure. Similarly, patients with CKD from any cause are more likely to experience a steeper decline of eGFR over time and a greater risk of developing End-Stage-Kidney-Disease (ESKD), which is considered a hard endpoint of CKD patients, as it leads to a major change in quality of life and prognosis. What is known is that both CV and renal risks depend on a variety of co-morbidities and clinical features that, taken together, can determine the future outcome of CKD patients. Indeed, as eGFR decreases <60 mL/min/1.73m2 the prevalence of metabolic complications (hyperparathyroidism, anaemia, metabolic acidosis, hyperkalemia and hyperphosphatemia), progressively increases. Moreover, the presence of diabetes, albuminuria, hypertension, abnormal sodium/protein dietary intake is associated with an even worse prognosis in these patients. In the past several years, great attention has been spent to the development of prevention strategies with the aim of ensuring a better control of complications and prognosis of CKD patients, such as increase of follow-up visits' number/frequency and monitoring of laboratory assessments. Similarly, a large number of clinical trials, testing the effect of many different drugs, have been carried-out with the aim of obtaining a significant risk reduction in CKD patients.

This Research Topic aims to assemble the updated evidence around the management of non-dialysis CKD patients followed by nephrologists. Articles focusing on epidemiology, pathophysiology, clinical aspects, prognosis and treatment are welcome. New insights, such as predictive and prognostic biomarkers evaluation, Genome-Wide Association Studies (GWAS), machine learning approaches are adequate as well.

CKD patients are exposed to a very high risk of harmful clinical outcomes. Although in the past years an increase of treatments' options has been obtained, the residual risk for these patients is still enormous. Moreover, on the global scale CKD is still growing - almost doubled both in prevalence and incidence, mostly over the past two decades. Potential contributors may explore the new therapeutic strategies that may help nephrologists to ameliorate prognosis of patients followed in renal clinics. New evidence on risk factors and prognosis are similarly important for clinicians and patients management.

We would suggest Investigators to submit Intervention studies, Observational studies, Meta-analyses, Systematic or Narrative Reviews.
Specific themes could be:

• Anaemia in CKD patients;
• Blood Pressure and cardiorenal risk in CKD patients;
• Lowering albuminuria and the assessment of future CV and renal outcomes in CKD;
• Risk factors for eGFR decline in CKD patients;
• Mineral-bone-disease in CKD, electrolyte disorders in CKD;
• CKD: improving diet to improving prognosis;