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CKD – Integrating kidney health into patient care

Integrate targeted screening, early detection and diagnosis of chronic kidney disease (CKD) into your clinical practice to slow or prevent deterioration in kidney function and improve cardiovascular outcomes of your patients.

Key Points

  • Targeted screening of people at risk of developing CKD is critical for early detection and timely management of this silent disease.
  • Screening includes a blood test for serum creatinine to calculate estimated glomerular filtration rate (eGFR), a urine albumin- creatinine ratio (ACR) test and blood pressure check. These 3 components complete a Kidney Health Check.
  • A diagnosis of CKD is confirmed if there is a reduction in eGFR (< 60 mL/min/1.73 m2) for ≥ 3 months and/or elevated ACR (males ≥ 2.5 mg/mmol, females ≥ 3.5 mg/mmol) for ≥ 3 months.
  • After confirming a diagnosis of CKD, further investigations may help determine the underlying pathology.
  • Complete documentation of a CKD diagnosis requires recording the stage (based on eGFR result), level of albuminuria (based on ACR) and underlying cause.
  • Timely management reduces both the burden of kidney failure and the associated cardiovascular morbidity and mortality.

One in 10 Australian adults have signs of chronic kidney disease (CKD).1,2 For Aboriginal and Torres Strait Islander peoples, the prevalence is even higher, affecting nearly one in five adults.3 CKD contributes to 11% of all deaths and is associated with 37% of all cardiovascular deaths in Australia.4

However, the asymptomatic nature of CKD means it can be difficult to diagnose unless there is targeted screening for it. Timely management can slow or even prevent the deterioration in kidney function, and improve cardiovascular outcomes.1,5,6

GPs are in a prime position to detect and diagnose CKD early. This involves targeted screening and performing investigations that are mostly already part of regular clinical practice.1

Dr Tim Senior, GP at Tharawal Aboriginal Corporation, clinical senior lecturer at the University of Western Sydney Medical School and CKD expert in general practice

“Rather than seeing the kidneys as a single, separate, complex and difficult organ, it is straightforward to integrate them into the overall care of your patients along with other organ systems.

“You’ll find, for instance, that what’s needed to diagnose CKD is largely already what you’re doing for other conditions like cardiovascular disease and diabetes.

“So when you assess your patients for risk factors and test for cardiovascular disease and diabetes, you should also think of their kidneys.”

 

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