Chronic kidney disease
Chronic kidney disease (CKD) affects around 1 in 10 adults in the UK and is a major contributor to cardiovascular disease, kidney failure, and other serious health conditions. Early detection and regular monitoring are essential to slow the progression of CKD and prevent complications. Patients with CKD or those at risk should have at least an annual review to assess kidney function and manage associated health risks. Regular reviews help identify changes in kidney function early, allowing for timely adjustments in treatment and management to preserve kidney health and improve overall outcomes.
Annual care needs:
Blood pressure
Rationale:
NICE guideline 203 on CKD recommends patients with CKD stages 1-4 have regular BP monitoring ensure hypertension is controlled, as it is a major risk factor for CKD progression.
Guideline:
NICE Guideline 203: Chronic kidney disease assessment and management
U&Es
Rationale:
Regular assessment of kidney function is essential for detecting changes and managing CKD effectively. This includes measuring serum creatinine and estimated glomerular filtration rate (eGFR). Please note, patients with more advanced CKD and/or associated risk factors will need more frequent monitoring which should be arranged on an individual patient basis.
Guideline:
NICE Guideline 203: Chronic kidney disease assessment and management
uACR
Rationale:
NICE Guideline 203 emphasises the importance of individualised monitoring of uACR in patients with CKD, with the frequency of testing based on the severity of CKD, the level of proteinuria, and the patient's overall risk profile. Regular uACR testing is essential for early detection of kidney damage and to guide appropriate management.
Guideline:
NICE Guideline 203: Chronic kidney disease assessment and management
Annual CKD review
Rationale:
CKD is a progressive condition that significantly increases the risk of cardiovascular disease, kidney failure, and mortality. Regular monitoring in primary care allows for early detection of disease progression, optimisation of treatment and prevention of complications, to preserve kidney function and improve patient outcomes. Annual reviews also help manage co-morbid conditions like hypertension and diabetes, which are major contributors to CKD progression.
Guideline:
NICE Guideline 203: Chronic kidney disease assessment and management
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