There are many causes of CKD, diabetes being the most common cause, followed by hypertension. Chronic glomerulonephritis, post-AKI, amyloidosis, polycystic kidney disease, and transplant rejection are other causes. Regardless of the cause, as the glomerular filtrate rate (GFR) drops, complications of CKD will ensue, such as anemia of CKD, mineral bone disease (also known as renal osteodystrophy), metabolic acidosis. To treat anemia, erythropoietin will be used but will only be effective if iron levels are normal. Mineral bone disease is treated by maintaining normal serum phosphorous levels via diet and phosphate binders and active vitamin D (calcitriol, vitamin D 1,25-OH). Vitamin D25 is also used. Metabolic acidosis can worsen kidney function. It is recommended to treat with bicarbonate, aiming for a serum bicarbonate level of 22.
