National service framework for Renal

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National service framework for Renal Services
Part one and two
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Serum creatinine 120 GFR 30 mls/minute
Serum creatinine 120 GFR 150 mls/minute
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ESTIMATING GFReGFR (mL/min/1.73m2)
Cockcroft-Gault equation (140-age) x weight x
1.23 x (0.85 if female)
Creat umol/l
MDRD Formula       186 x Creat(umol/L) x
0.0113-1.154 x Age-0.203 (x 0.742 if female)
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Patients Sarge!........... ..Thousands of em!
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Population prevalence of CKD stages (NEOERICA
study 2005)

1. 0.7
2. 2.3
3. 4.7
4. 0.19
5. 0.04

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Patients with stages of CKD in a GP practice of
10,000
Stage 5 CKD
6
Stage 4 CKD
60
Stage 3 CKD
380
Stage 1-2 CKD
460
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(No Transcript)
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Cardiovascular Mortality Rates are Higher among
Dialysis Patients
100
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1
Dialysis male
Dialysis female
0.1
General population male
0.01
General population female
0.001
Adapted from Levey AS et al. Am J Kidney Dis
1998 32 853-906.
DOD/0401-04
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• CKD stages
• Stage GFR (mls/min/1.73m2) Action Required
• gt90
  Diagnosis/Treatment
• 
  Slowing Progression
• 
  CVD risk reduction
• 60-89
  Estimate Progression
• 30-59
  Evaluate/treat complications
• 15-29
  Preparation for RRT
• lt15
  RRT / Conservative
• 
  management
• 
  

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CKD Stage 1, 2,3 EducationBlood
pressureSmoking cessationLipid
control Medicines managementDiet
adviceExercisePsychosocial support
DM
CHD
CKD Stage 4 AnaemiaAcidosisBone
diseasePreparation/choice
CKD Stage 5 RRTPDHPTp
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Renal.org

• Identification, management and referral of adults
  with chronic kidney disease
• eGFR calculator