Nephrology

Chronic Kidney Disease

Q: SGLT2 benefit in CKD?

30-40% reduction in kidney disease progression (DAPA-CKD, EMPA-KIDNEY).

Q: When to refer nephrology?

eGFR <30, rapidly declining GFR, unclear cause, or heavy albuminuria.

Q: What is finerenone?

Non-steroidal MRA reducing kidney and CV events in T2D CKD.

Sustained decline in kidney function (eGFR <60 mL/min/1.73 m2) or kidney damage for >=3 months; leading causes are diabetes and hypertension.

Last reviewed 29 May 2026 - MedicoMedics editorial team

Pathophysiology

Nephron loss triggers glomerular hyperfiltration and progressive fibrosis. Uraemic toxins, mineral-bone disorder and cardiovascular risk accumulate.

Sources: KDIGO CKD 2024; EMPA-KIDNEY (NEJM 2023;388:117)

Presentation

Often asymptomatic; hypertension, oedema, fatigue, pruritus, restless legs, uraemic frost late-stage. Anaemia and CKD-MBD common.

Diagnosis

eGFR (CKD-EPI 2021), urine albumin-creatinine ratio, urinalysis, kidney ultrasound. KDIGO staging by GFR and albuminuria (G1-5, A1-3).

Management

BP <130/80 with ACE inhibitor/ARB, SGLT2 inhibitor (dapagliflozin, empagliflozin) even without diabetes, finerenone if T2D with albuminuria. Manage anaemia (ESAs, iron), phosphate, PTH; prepare for RRT at eGFR <20.

Sample USMLE-style MCQs

Try 5 questions on this topic. Practice hundreds more free with a trial.

Question 1

A 62-year-old with T2D, HbA1c 7.5%, eGFR 42, UACR 850 mg/g. Which adds greatest kidney protection?

Question 2

Best BP target in albuminuric CKD?

Question 3

Which agent slows non-diabetic CKD progression?

Question 4

What defines CKD stage G4?

Question 5

Which is the primary cause of death in CKD patients?

References

Primary guidelines and peer-reviewed sources used for this entry. Reviewed 29 May 2026 by MedicoMedics editorial team.

Frequently asked

SGLT2 benefit in CKD?

30-40% reduction in kidney disease progression (DAPA-CKD, EMPA-KIDNEY).

When to refer nephrology?

eGFR <30, rapidly declining GFR, unclear cause, or heavy albuminuria.

What is finerenone?

Non-steroidal MRA reducing kidney and CV events in T2D CKD.

Related conditions

High-yield topics students commonly study alongside Chronic Kidney Disease.

Ready to master this topic?

Get the full lecture, 500+ MCQs, and AI explanations with a 7-day free trial.

Start free trial Back to library