[SEMERGEN position paper on chronic kidney disease].

In Spain, it is estimated that the prevalence of chronic kidney disease (CKD) is 7-30%. CKD is associated with a significant risk of kidney disease progression, as well as cardiovascular complications and death. CKD is currently underdiagnosed, which implies the need for greater screening in the population at risk (arterial hypertension, diabetes), through the determination of estimated glomerular filtration rate and albuminuria. On the other hand, evidence from clinical trials has demonstrated the benefits of four pharmacological groups in patients with diabetic CKD, including renin-angiotensin system inhibitors, SGLT2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists (currently finerenone) and GLP1 receptor agonists, in particular subcutaneous semaglutide. Consequently, comprehensive treatment should be promoted through the early use of the combination of these pharmacological groups. In patients with non-diabetic CKD, renin-angiotensin system inhibitors and SGLT2 inhibitors would be indicated as the treatment of choice. Primary care is the optimal setting for screening, initial diagnosis and follow-up of patients with CKD, as well as the initiation and optimization of medical treatment for these patients. However, there is considerable room for improvement between what the guidelines indicate and clinical practice. The objective of this SEMERGEN position paper is to facilitate and improve care for patients with CKD in primary care.