Chronic Kidney Disease Pathway Document Description Presented ...

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• Persistent haematuria (after exclusion of other causes) • Structural abnormalities seen on X-ray (e.g. polycystic kidney disease) • Biopsy proven chronic glomerulonephritis Patients found to have an eGFR of 60-89 mls/min without one of the markers above should not be considered to have CKD and should not be subject to further investigation unless there are additional reasons to do so, e.g. belonging to a high risk group. References 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 Return to overview 28
References Joint Speciality Committee - Royal College of Physicians, The Renal Association (2006) Chronic Kidney Disease in Adults, UK guidelines for Identification, Management and Referral. http://www.renal.org/CKDguide/full/CKDprintedfullguide.pdf Department of Health (2005) The National Service Framework for Renal Services: Part Two: Chronic Kidney Disease, Acute Renal Failure and End of Life Care. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicy AndGuidance/DH_4101902 University Hospital Leicester (2005) Renal Guidelines – Adults with Chronic Kidney Disease http://www.britishrenal.org/Other/RenalGuideline.pdf British Medical Association (2007) Chronic Kidney Disease Frequently Asked Questions. NHS Employers http://www.primarycarecontracting.nhs.uk/uploads/QOF/june_07/qof__faq_in_chr onic_kidney_disease.pdf Return to overview 29
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 and 20: Return to overview CKD Stages CKD S
Page 21 and 22: Practice Action Plan Compiling a Ch
Page 23 and 24: Action Rationale Responsible Run a
Page 25 and 26: eGFR
Page 27: CKD Stages CKD Stage Description Re
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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