Chronic Kidney Disease (CKD) Algorithm - NHS Cumbria

More documents

Recommendations

Info

ReferralBox 15Referral to a kidney specialist Routine Information required• Take into account theindividual’s wishes andco morbidities whenconsidering referral• People with CKD in thefollowing groups shouldnormally be referred forspecialist assessment:Urgent- Suspected Acute KidneyInjury- Newly detected eGFR < 15ml/min with symptoms- Nephrotic Syndrome- Accelerated Hypertension- Severe hyperkalaemia(MAU)• Stage 4 and 5 CKD (with or withoutdiabetes)• Proteinuria (ACR > 70 mg/mmol) unlessknown to have diabetes and alreadyappropriately treated with ACE Inhibitor orARB Box 14• Proteinuria (ACR > 30 mg/mmol) togetherwith haematuria• Declining eGFR (> 5 ml/min in 1 year, or > 10ml/min within 5 years)• Poorly controlled hypertension despite fourantihypertensive drugs at therapeutic doses• Suspected rare or genetic causes of CKD• Suspected renal artery stenosis• Urologically unexplained visible haematuria• Suspected renal anaemia Box 11• Symptoms and Reasonfor referral• Relevant medical andsocial history• Key examinationsfindings includingblood pressure• Serial creatinine / eGFRand urinary albuminresults• Renal ultrasound orother relevant testresultChronic Kidney Disease (CKD) Algorithm | Page 13
Key MessagesAll patients with CKD have an increased risk of developing heart diseaseand other diseases of blood vessels, including stroke. For many, this ismore important than the risk of developing more serious kidney disease.Knowing that you have CKD can help reduce your risk of heart attack byprompting discussion about lifestyle issues and treatment of high bloodpressure and high cholesterol.Patients with advanced, progressive or proteinuric CKD require promptspecialist referral.Strict blood pressure control is fundamental in the management of CKD.Kidney failure accounts for 21% and 11% of deaths in type 1 and 2diabetes respectively.Chronic Kidney Disease (CKD) Algorithm | Page 14
Page 1 and 2: Chronic Kidney Disease(CKD) Algorit
Page 3 and 4: How should it be done?Measure eGFR
Page 5 and 6: ManagementStages 1 & 2Stages 3A & 3
Page 7 and 8: Box 3 -Optimise bloodpressure contr
Page 9 and 10: Evaluate albuminuria and haematuria
Page 11 and 12: Box 9 - Renal Ultrasound(NCG 73 p12
Page 13: Box 13 - Manage bone conditions(NCG

Chronic Kidney Disease (CKD) Algorithm - NHS Cumbria

Create successful ePaper yourself

Delete template?

Save as template?