Chronic kidney disease

Early detection and intervention are crucial for managing CKD and mitigating its complications. Liz Stallworthy discusses screening at-risk individuals, the use of appropriate tests and ongoing monitoring of CKD in the NZ context.

Topics

Intro
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Defining Chronic kidney disease (CKD)
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Explaining the criteria of KDIGO
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The rising prevalence of CKD in New Zealand
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Variation in rates of CKD between ethnicities.
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Applying the CARI guidelines.
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Other at risk groups.
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Screening for CKD in the general population.
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Tests for screening.
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Frequency of repeat testing.
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Additional investigations to identify the underlying cause.
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Interventions to prevent or delay the progression of CKD
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When to refer to a nephrologist.
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Ongoing monitoring of eGFR and ACR
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Take-home messages
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Take home messages

Chronic kidney disease is common, affecting more than 1 in 10 adults in NZ.
The vast majority of chronic kidney disease is asymptomatic so we have to be proactive to identify it.
CKD is associated with significant morbidity and mortality from vascular disease as well as kidney failure itself.
We can prevent or delay the vascular disease and the kidney disease with medical management to improve health outcomes for our patients.
Patients will need education and support to understand what kidney disease is, why it is a problem and what the benefit of treatment is in order to motivate them to take treatment.
Doing better at identifying and treating CKD early has the potential to address some of the inequity in health outcomes between ethnic groups in New Zealand.

Resources

KDIGO 2024 Clinical Practice Guideline Kidney International
Chronic Kidney Disease (A4 poster) KidneyHealthNZ
Chronic kidney disease: the canary in the coal mine bpac nz
Chronic kidney disease (CKD): B-QuiCK bpac nz
CARI guidelines Māori in Aotearoa New Zealand CKD Guidelines

Presenter

Elizabeth Stallworthy

Nephrologist

MBChB, MRCP(UK), FRACP, ClinPallMedDip.

Liz is a nephrologist at Auckland City Hospital. Her interests include kidney supportive care and conservative management of chronic kidney disease, metabolic management of kidney stones, haemodialysis and teaching communication skills to healthcare professionals.