CKD care

Prevention of CKD progression

The management of progression of CKD is aimed at addressing a multiplicity of factors known to be associated with progression. NephroCare supports and encourages utilising a common strategy adopting the best medical practices included in the KDIGO Guideline for the Evaluation and Management of CKD. Based on this, NephroCare recommends for example general lifestyle measures which improve cardiovascular health, blood pressure control, interruption of the renin-angiotensin-aldosterone system (RAAS) and medical intervention.

Referral to specialist services

The nephrological community recommends referral to specialist kidney care services for people with CKD in the following circumstances:

  • AKI or abrupt sustained fall in GFR;
  • GFR <30 ml/min/1.73 m2 (GFR categories G4-G5);
  • a consistent finding of significant albuminuria (ACR ≥300 mg/g [≥30 mg/mmol] or AER ≥300 mg/24 hours, approximately equivalent to PCR ≥500 mg/g [≥50 mg/mmol] or PER ≥500 mg/24 hours);
  • urinary red cell casts, RBC 420 per high power field sustained and not readily explained;
  • CKD and hypertension refractory to treatment with 4 or more antihypertensive agents;
  • persistent abnormalities of serum potassium;
  • recurrent or extensive nephrolithiasis;
  • hereditary kidney disease.1