Optimizing Care of Patients with CKD

Friday, March 12 at 2:05 pm

NEW ORLEANS—Chronic kidney disease (CKD) is known to increase the risk of cardiovascular events and mortality. However, Dr. James Matera is set to explain how physicians can manage CKD to optimize patient care in a presentation on Friday.

James J. Matera, DO, FACOI, is a Physician at Nephrology Hypertension Associates of Central NJ and Co-Director of Physician Integration at CentraState Medical Center in Freehold, NJ.

In his session, “Cardiovascular Risk Factors Associated with CKD and ESRD,” Matera will define and classify chronic kidney disease (CKD) as it relates to testing- and age-related factors estimated glomerular filtration in the patient population; discuss the CKD population by identifying, modifying, and reducing the potential risks that lead to increased morbidity and mortality; analyze the risk factors for cardiovascular disease in CKD, as well as specific factors seen in the CKD and end-stage renal disease (ESRD) patient; and develop methods for risk reduction and improving outcomes by working with nephrologists in tandem.

According to Matera, 15 to 20 million American adults have CKD, who have an increased risk of ESRD and cardiovascular events and increased morbidity, mortality, and hospitalization rates. To lessen these risks, physicians can recommend therapeutic strategies—such as aggressive blood pressure control, statins, and angiotensin-converting enzyme inhibitor (ACEIs) or angiotensin II receptor blockers (ARBs).

Matera will also discuss studies regarding the impact of different medications, the albuminuria effect, low-density lipoprotein (LDL) cholesterol management, hypertension and cardiovascular risk, and when to prescribe medication. For example, adults with dialysis-dependent CKD should not be prescribed statins or a statin/ezetimibe combination. However, if patients taking statins or a statin/ezetimibe combination start dialysis, medication should continue.

In addition, Matera will explain how to reduce complications in CKD, including nutritional, lifestyle, and medical interventions. For instance, nutritional interventions include limiting sodium intake to control blood pressure and maintaining a protein intake of 0.8 g/kg body weight per day; lifestyle interventions include smoking cessation, weight loss, and increased physical activity; and medical interventions include managing diabetes, hypertension, lipids, and mineral metabolism.

“Cardiovascular risk is a major component of CKD patients and directly impacts outcomes,” Matera concludes. “Specific considerations for this population include looking at hypertension, mineral metabolism, albuminuria, and lipid disorders. Addressing these issues as they arise can help to improve these outcomes, improve patient satisfaction, and reduce costs.”

—Amanda Balbi