Renal in GP

What's in a Referral

100

This test is the gold standard, and requires early morning sample and may be elevated in non-CKD related illness

Urine ACR

200

This test is only calibrated for albumin detection, it is the gold standard for haematuria detection

Urine dipstick

300

although while not apart of the CDM programme, patients with these medical conditions should be screen for CKD (must name 2)

Patients with Diabetes, CVD, and HTN

400

This test is indicated in a sudden drop of renal function, ongoing heavy proteinuria, if there is concerns of obstructive uropathy, or if there is a family history of PCKD

Renal Ultrasound

500

This set of tests are the basis and required for referral to a renal consultant, and is called _____

Kidney Health Check, it includes eGFR, HbAC1, lipids, Urine dip, ACR, BP, BMI, and smoking history

Causes of CKD

100

These two disease account for over 65% of all renal disease

Diabetes and HTN

200

The thrid most common cause of CKD, patients often present with larger albumin or protein leaks such as persistent ACRs over 70mg/mmol.  A red flag for this condition is associated microscopic non-urological haematuria

Glomerulonephritis

300

These medications increase the risk of renal outflow obstruction and can produce damage within the tubulointerstitial components of the kidneys (must name 2 classes)

PPI, lithium, NSAIDS, and some antibiotics

400

Patients with this condition often present with a family history and often have high blood pressure, back pain, haematuria, and headaches

Polycycstic kidney disease

500

This disease can affect the glomerulus, tubules, and interstitial component of the kidney, and often on bloods have a raised calcium with bony pain

myeloma

Screening

100

This scoring system is often used in assessing AKI and classify the AKI

KDIGO

200

This risk assessment is done by estimating the need for renal replacement therapies at 2 and 5 years

ESFR (Estimation of End Stage Renal Failure)

300

This risk equation, while not validated within the Irish population, is often used to generate a kidney failure risk score

Kidney Failure Risk Equation (KFRE)

400

True or false Patients with CKD should avoid becoming pregnant as it is unlikely that they will have positive outcomes

False, many women with ckd with proper prenatal planning and monitoring can have successful and healthy pregnancies

500

This many people with T2DM are approximately affected with CKD

about 1 in 3

Safe Prescribing

100

This acronym is used to remember what medications should be held during an AKI (double points if you can list each category)

SADMANS 

200

This combo of medications is often held in an AKI, but are often first line treatment in CKD as they help to reduce the progression to ESKD of patients with albuminuria

ACE/ARBS

300

This class of medications is commonly used in T2DM and CVD, and also second line agents for CKD and RAAS inhibitors.

SGLT2

400

This reference guide published in 1999 and updated every 5 years, is free to use and available online for medication dosing with various stages of renal dysfunction

Renal Drug Handbook

500

This is the acceptable % decline in eGFR when using ACE/ARBS

up to 25%