Chronic Kidney Disease

Definition CKD stages 1 and 2

CKD Stage 1 eGFR > 90 mls/min AND other markers of renal damage (proteinuria, abnormal imaging)

CKD Stage 2 eGFR 60-90 mls/min AND other markers of renal damage (proteinuria, abnormal imaging)

Initial investigations

Dipstick urine (if not performed recently)

Send urine for Protein/Creatinine ratio if dipstick positive for protein

Consider renal ultrasound if urological symptoms, or high risk of renal artery stenosis

Consider diagnosis

Monitoring

Annual eGFR and urine dipstick (1-2 yearly if high risk or proteinuria on original test, 3-5 yearly if low risk and no protein on original test)

Treatment

Treat underlying condition

Modify lifestyle

Treat hypertension

Educate patient

Referral guidelines

Refer if diagnosis unclear

Refer if significant proteinuria or underlying systemic disease

Refer if progressive decline in eGFR >5% annually