Feature Article

Managing chronic kidney disease

Feature Article

Managing chronic kidney disease

David W Johnson, Timothy Mathew

Abstract

Chronic kidney disease is a major public health issue affecting one in seven Australians. GPs play a vital role in the identification and early management of renal disease and their interventions can prevent affects patients from progressing to kidney failure and dying from cardiovascular disease.

Key Points

  • Over two million Australians have chronic kidney disease (CKD).
  • The major risk factors for CKD are diabetes, hypertension, smoking, obesity, age over 50 years, a family history of CKD, and Aboriginal and Torres Strait Islander origin.
  • ‘Kidney checks’, which include measurement of blood pressure, serum creatinine and estimated glomerular filtration rate and urine dipstick testing for protein, should be carried out annually for patients with one or more CKD risk factors.
  • Patients with CKD are at increased risk of developing cardiovascular disease and more likely to die from this than end up on dialysis.
  • Lifestyle modification, treatment of blood pressure to target and the reduction of proteinuria are the key tasks for managing CKD.
  • Only a small proportion of patients with CKD require referral to a nephrologist.