Chronic Kidney Disease Pathway Document Description Presented ...

Management of a Previously Undiagnosed Patient with eGFR <
60mls/min
Is the YES patient acutely unwell
NO
YES
Manage illness as appropriate.
Repeat eGFR within 1-5 days
(Go to *)
Symptoms of outflow
obstruction**
YES
Palpate for bladder
Urgent renal ultrasound
(Renal ultrasound scan if history
suggestive of urological disease)
NO
* Has a reduced eGFR (< 60mls/min) or
raised creatinine been measured
previously
NO
Repeat eGFR within 5 days
Suspect ARF in the presence of
any of the following:
eGFR < 30 ml/min
eGFR fall of 25%
Creatinine rise of 50%
Blood and Protein in urine
YES
Check previous eGFR results.
Calculate eGFR using the 4-
variable MDRD formula from
previous creatinine results.
Compare results and track rate of
progression chronologically.
Suspect ARF if there is:
• A fall in eGFR of 25%
• A rise in Creatinine of 50%
• eGFR < 30 ml/min
• Blood and Protein in urine
URGENT
ADMISSION
Refer to/
Discuss with
nephrologist.
Contact details
**People with CKD and renal outflow obstruction should normally be referred to urological
services, unless urgent medical intervention is required.
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