chronic kidney disease guidelines

Question 1

Chronic kidney disease

- criteria to diagnose (5)

Answer 1

any of these for 3 months
* eGFR < 60, persistent for 3 months
* albuminuria
* haematuria (after urological causes excluded)
or 
* structural abnormalities on ultrasound
* pathological abnormalities on biopsy

Question 2

Chronic kidney disease - risk factors that warrant ‘kidney health check’
- PMHx (3)
- Personal (4)
which warrant biannual screening vs annual screening

Answer 2

PMHx

• diabetes (annual)
• hypertension (annual)
• established cardiovascular disease

Personal

• ATSI >30
• family history of kidney disease
• obesity
• smoking

Question 3

Chronic kidney disease - criteria for macroalbuminuria

Answer 3

UACR >25 (male) or >35 (female)

Question 4

Chronic kidney disease management

- indications for nephrologist referral (5)

Answer 4

• eGFR < 30
• sustained eGFR drop by 15mL/min per year
• eGFR drop of 25%, sustained within 12 months
• persistent significant albuminuria, UACR > 30
• CKD + hypertensive on 3 meds

Question 5

Chronic kidney disease diagnosis

- initial work-up for all CKD people (9)

Answer 5

FBC
UEC
ESR
CRP
UACR
urine microscopy for red cell casts, crystals or dysmorphic red cells
fasting lipids
fasting BSL
renal tract ultrasound