[Conservative therapy Guidelines for chronic renal failure].

In recent years, many national and international organizations have developed clinical practice guidelines for the most important areas of nephrology. In 1999, the Italian Society of Nephrology (SIN) was one of the first scientific societies to publish (in Giornale Italiano di Nefrologia) the Guidelines for the Treatment of Chronic Renal Failure. Since then, new evidence has accumulated on several aspects of the conservative treatment of chronic kidney disease (CKD). These new data have been included in the present version of the guidelines. The first section of the new guidelines underline the importance of the early detection of CKD and early referral to a nephrologist. The second and third sections are dedicated to the dietetic treatment of chronic renal failure, even when associated with nephrotic syndrome. The fourth section analyzes the anti-hypertensive treatment of renal failure, focusing on the choice of anti-hypertensive drugs to retard the progression of renal failure and reduce cardiovascular mortality. This section highlights the reno-protective role of ACE inhibitors and of AII receptor antagonists in diabetic and nondiabetic nephropathies. The Appendix describes methods for the evaluation of the patient's nutritional status and for protein intake in chronic renal failure.