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Feature Article

Chronic kidney disease: the six red flags

Mark Thomas
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Abstract

Treating chronic kidney disease (CKD) is an increasing part of chronic disease management in general practice. Yet many patients remain undiagnosed. Regular monitoring of glomerular filtration rates is important not only to help diagnose patients with CKD, but also to alert GPs to major complications associated with disease.

Key Points

  • About one in nine adult Australians have chronic kidney disease (CKD) but many patients with the condition are undiagnosed.
  • All adults with one or more risk factor for CKD should be screened annually for the disease.
  • The severity of CKD is determined by glomerular filtration rate (GFR) and/or the presence of structural kidney disease or urine sediment abnormalities.
  • Reduced GFR is a red flag for six major complications in patients with CKD: acute kidney injury risk, resistant hypertension, metabolic abnormalities, adverse drug reactions, accelerated cardiovascular disease and progression to end-stage kidney disease.
  • CKD can mostly be managed in general practice if blood pressure, weight, electrolyte levels and diabetes are controlled.
  • Referral is indicated if the patient’s GFR is less than 30mL/min or if GFR falls rapidly at any stage.

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