Chronic Kidney Disease Management: BC Guidelines

Primary care management of CKD

The global unit selector only affects unanswered questions
1.Sex?
2.Age?
3.eGFR?
4.Urine Albumin to Creatinine Ratio?
5.Patient Location?
6.Diabetes?
Created by

1. Sex?

Created by
0/6 completed

About this Calculator

This tool is intended to simplify, not replace, use of the BC Chronic Kidney Disease guidelines. By providing outputs based on patient-specific factors, we hope to provide an educational tool that makes the guidelines simpler to apply at the point of care.

Please note, blood pressure targets are presented based on the BC Chronic Kidney Disease guidelines as well as other guidelines such as those developed by CHEP and KDIGO.

For patients at high risk of atherosclerotic events, the 2013 KDIGO guidelines recommend lifestyle changes and cholesterol-lowering treatment with low dose statin therapy, without target levels of LDL. Reduction of LDL from baseline irrespective of the value is the goal. Note: see KDIGO Lipid Management guideline for caveats at kdigo.org/home/guidelines/lipids/

The tool provides guidance on need for referral to a specialist based on GFR and proteinuria, but here is a more detailed set of clinical parameters that could prompt referral:

  1. Presence of active urine sediments (red blood cell casts or cellular casts), constitutional symptoms, or unexplained severity of kidney dysfunction
  2. AKI or abrupt sustained fall in eGFR
  3. GFR <30 mL/min
  4. Persistent finding of ACR >30 mg/mmol
  5. Rapid and sustained deterioration in kidney function (a decline of eGFR >10-15% within 12 month period) warrants urgent referral to a nephrologist or internist, irrespective of eGFR values.
  6. Progressive CKD
  7. CKD and hypertension refractory to treatment
  8. Persistent elevation of potassium
  9. Hereditary kidney disease
  10. No obvious etiology for kidney disease and knowing etiology may impact care plan.

References

Chronic Kidney Disease - Identification, Evaluation and Management of Adult Patients.

Effective Date: October 30th, 2019 <br /> <br /> This tool was sponsored by the Shared Care Committee of British Columbia, a partnership between Doctors of BC and the Ministry of Health.

Contributed By:
  • Dr. Mohamud Karim
  • Dr. Sanjay Khandelwal
  • Dr. Daniel Schwartz
  • Dr. Monica Beaulieu
  • Dr. John Pawlovich
  • Project Manager: Edoye Porbeni
Legal Notices and Disclaimer

© 2020 QxMD Software Inc., all rights reserved. No part of this service may be reproduced in any way without express written consent of QxMD. This information should not be used for the diagnosis or treatment of any health problem or disease. This information is not intended to replace clinical judgment or guide individual patient care in any manner. Click here for full notice and disclaimer.