Table 11.1

Selected complications of chronic kidney disease

ComplicationMedical and laboratory evaluation
Elevated blood pressure >140/90 mmHgBlood pressure, weight
Volume overloadHistory, physical examination, weight
Electrolyte abnormalitiesSerum electrolytes
Metabolic acidosisSerum electrolytes
AnemiaHemoglobin; iron testing if indicated
Metabolic bone diseaseSerum calcium, phosphate, PTH, vitamin 25(OH)D
  • Complications of chronic kidney disease (CKD) generally become prevalent when estimated glomerular filtration rate falls below 60 mL/min/1.73 m2 (stage 3 CKD or greater) and become more common and severe as CKD progresses. Evaluation of elevated blood pressure and volume overload should occur at every clinical contact possible; laboratory evaluations are generally indicated every 6–12 months for stage 3 CKD, every 3–5 months for stage 4 CKD, and every 1–3 months for stage 5 CKD, or as indicated to evaluate symptoms or changes in therapy. PTH, parathyroid hormone; 25(OH)D, 25-hydroxyvitamin D.