Chronic Kidney Disease Pathway Document Description Presented ...

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(Where stage 4 = 0.7%, and stage 5 = 0.2%) Screening of patients with hypertension, diabetes and > 55 would yield approx. 93% of the CKD register, with this approach being the most effective strategy to detect patients with CKD 2 . Based on an expected prevalence of 4.9%: • For a practice population of 2000: The approx. number of patients with CKD = 94 (4 pts. at stage 4 and 4 pts. at stage 5) • For a practice population of 5000 The approx. number of patients with CKD = 245 (10 pts. at stage 4 and 10 pts. at stage 5 • For a practice population of 10 000 The approx. number of patients with CKD = 490 (20 pts. at stage 4 and 20 pts. at stage 5) For guidance on building and validating a practice CKD register see practice action plan - compiling a chronic kidney disease register. References 1. de Lusignan S, Chan T, Stevens P, O'Donoghue D, Hague N, Dzregah B, Van Vlymen J, Walker M and Hilton S. Identifying patients with chronic kidney disease from general practice computer records. Family Practice 2005; 22: 234–241 http://fampra.oxfordjournals.org/cgi/content/full/22/3/234 2. Hallan S et al. Screening strategies for chronic kidney disease in the general population: follow-up of cross sectional health survey BMJ 2006;333(7577):1047. http://www.bmj.com/cgi/con Return to overview 20
Practice Action Plan Compiling a Chronic Kidney Disease Register Name of Practice ………………………………………………………………………………………………………………………… Aim: To build a register of patients with Chronic Kidney Disease to meet the requirements of the Quality and Outcomes Framework of the GMS contract: CKD1 This action plan sets out the method and rationale behind each action in a step wise approach, assigning responsibility to each part of the task. Practice expected prevalence should be calculated, allowing for assessment of the completeness of the final register. Support for completing these actions is available from the Cardiovascular and Renal Disease Lead Nurse, (address below) Shelagh.cleary@dudley.nhs.uk Tel. 01384 362754 Please sign below and send a copy of this front sheet to: Cardiovascular and Renal Disease Lead Nurse Service Development Dept. 5 th Floor, Falcon House, The Minories, Dudley. DY2 8PG. Courier no. 114, Fax 01384 366460 Signed ………………………………………………. Position ………………………………………... Print …………………………………………………. Date …………………………………………… 21
Page 1 and 2: Chronic Kidney Disease Pathway Docu
Page 3 and 4: Pathway for the Identification and
Page 5 and 6: Contents Introduction …………
Page 7 and 8: Introduction Chronic kidney disease
Page 9 and 10: CKD Pathway D I A G N O S I S Ensur
Page 11 and 12: Kidney function deteriorates natura
Page 13 and 14: Joint Speciality Committee - Royal
Page 15 and 16: Acute Renal Failure Acute Renal Fai
Page 17 and 18: Next Steps Any patient suspected to
Page 19: Return to overview CKD Stages CKD S
Page 23 and 24: Action Rationale Responsible Run a
Page 25 and 26: eGFR
Page 27 and 28: CKD Stages CKD Stage Description Re
Page 29 and 30: References Joint Speciality Committ
Page 31 and 32: Cardiovascular Risk All patients wi
Page 33 and 34: Hypertension Blood pressure should
Page 35 and 36: Further information on the pharmaco
Page 37 and 38: Irbesartan* Valsartan Losartan* *Sp
Page 39 and 40: • Diuretics • Lithium carbonate
Page 41 and 42: Recommendation: Therefore consider
Page 43 and 44: Lower levels of proteinuria should
Page 45 and 46: Glycaemic Control CKD and Diabetes
Page 47 and 48: References Audit Commission (2002)
Page 49 and 50: Influenza and Pneumococcal Vaccine
Page 51 and 52: Stage 3 Management at stage 3 shoul
Page 53 and 54: If all other causes for the anaemia
Page 55 and 56: Clinic inclusion criteria: Patients
Page 57 and 58: Where vitamin D supplementation is
Page 59 and 60: Stage 5 Patients identified at CKD
Page 61 and 62: Information to include with referra
Page 63 and 64: Appendix 1 The Dudley Group of Hosp

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