Chronic kidney disease in the primary care setting: A narrative review

Abstract

Chronic kidney disease (CKD) is a growing public health concern globally, with primary care physicians (PCPs) playing a pivotal role in its early detection and management. This review explores the epidemiology, risk factors, screening strategies, and clinical manifestations of CKD within primary care settings. PCPs are integral in recognizing at-risk populations, initiating timely screening through eGFR and albuminuria tests, and managing modifiable risk factors like hypertension and diabetes. The article discusses current guideline-recommended pharmacologic therapies—including RAAS inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, and non-steroidal MRAs—that slow disease progression. Lifestyle modifications and dietary interventions are emphasized as essential components of care. Additionally, the review outlines key indications for nephrology referral and the management of common CKD complications, such as anemia and mineral-bone disorder. By embracing a proactive and multidisciplinary approach, PCPs can significantly influence CKD outcomes, reduce progression to end-stage renal disease, and improve overall patient prognosis.