Chronic Kidney Disease Pathway Document Description Presented ...

More documents

Recommendations

Info

This CKD pathway has been produced by the CKD pathway group, a sub-group of the Dudley Renal LIT. It is intended to be used by practice and community teams, GPs, practice nurses, HCAs and administrative/I.T staff to: • Build and validate accurate CKD registers in line with the Quality and Outcomes Framework of the GMS contract and nationally expected prevalence rates. • Promote an awareness of CKD and the need for reduction of risk, early identification and diagnosis. • Inform the management of people with CKD in line with best practice as demonstrated in local and national guidelines • Support the appropriate referral to acute services and/or promotion of joint working with acute and community services to provide optimum outcomes in terms of management and patient choice. Consultation has included: • Renal LIT • Diabetes DIP • Vascular LIT • Nephrologists at DGoH • Diabetologists at DGoH • Consultant Chemical Pathologist • Dudley Clinical Commissioning Forum (DCF) • Dudley Clinical Executive Team • Community Diabetes Team • Renal Dieticians • Dudley Kidney Patients’ Association This pathway may be used wholly electronically by downloading onto the practice system, or in paper form. Practices may wish to use the pathway in either way, or may wish to download certain sections only. For further information on the development of the CKD pathway please contact: Cardiovascular and Renal Disease Lead Nurse Tel. 01384 366880 Falcon House Fax. 01384 366460 The Minories Mob. 07786 338072 Dudley DY2 8PG Courier 114 4
Contents Introduction ……………………………………………………………………….7 Renal Pathway Overview ……………….……………………………………. ..9 High Risk Groups ……………………………………………………………….10 Read Codes ……………………………………………………………………..12 Identification of CKD in patients not in a High Risk Group …………………14 Acute Renal Failure …………………………………………………………….15 Contact Details ……………………………………………….. ………………. 17 Diagnosis of CKD ……………………………………………………………... 18 CKD Stages ……………………………………………………………………. 19 Prevalence of CKD ……………………………………………………………. 20 Practice Action Plan Template ………………………………………………. .21 Stages 1 and 2 …………………………………………………………………. 30 Patient information ……………………………………………… 30 Cardiovascular risk ……………………………………………… 31 Hypertension …………………………………………………….. 33 Initiating ACE Inhibitor …………………………………………… 36 Salt intake ………………………………………………………… 36 Nephrotoxic drugs ……………………………………………….. 36 Renal Artery Stenosis …………………………………………… 37 Urinalysis …………………………………………………………. 40 Diet ………………………………………………………………... 44 Diabetic Control …………………………………………………. .45 Hepatitis B ……………………………………………………… 48 5
Page 1 and 2: Chronic Kidney Disease Pathway Docu
Page 3: Pathway for the Identification and
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 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
show all

Chronic Kidney Disease Pathway Document Description Presented ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?