Chronic kidney disease (CKD) is a worldwidepublic health problem affecting more than 50million people, and more than 1 million of themare receiving kidney replacement therapy.1,2 TheNational Kidney Foundation-Kidney DiseaseOutcomes Quality Initiative? (NKF-KDOQI?)Clinical Practice Guidelines (CPGs) and ClinicalPractice Recommendations (CPRs) on CKD estimatesthat CKD affects 11% of the US population,3 and those affected are at increased risk ofcardiovascular disease (CVD) and kidney failure.Kidney failure represents about 1% of theprevalent cases of CKD in the United States,3and the prevalence of kidney failure treated bydialysis or transplantation is projected to increasefrom 453,000 in 2003 to 651,000 in2010.3,4

     

     Management of CKD is costly. The MedicareCKD stage 5 population nearly doubled in thelast 10 years, and the CKD population expanded,as well. Together, they account for 16.5% ofMedicare expenditures, nearly double that of 10years ago, and the total costs for kidney diseasenow approach 24% of Medicare expenditures.4A growing body of evidence suggests that someof the adverse outcomes of CKD can be preventedor delayed by preventive measures, earlydetection, and treatment.

     

     NKF-KDOQI? CPGs presently offer strategiesto manage hypertension,5 dyslipidemia,6bone disease,7 anemia,8 nutrition,9 and CVD10 inpatients with CKD. The present Guidelines extendthe scope of the NKF-KDOQI? CPGs andCPRs by offering strategies to diagnose andmanage patients with diabetes and CKD.