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Section 5: Configuration of healthcare to manage CKD

This program focuses on patient-centered services, early detection and treatment of CKD, dialysis access surgery, transplantation, and end-of-life care. It emphasizes prevention, minimizing CKD progression, treating complications, and preparing for replacements. The standards include preparation/choice, education, management, and psychosocial support to improve patient outcomes.

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Section 5: Configuration of healthcare to manage CKD

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  1. Section 5: Configuration of healthcare to manage CKD

  2. The Renal NSF: Part 1 • Standard 1: Patient centred service • Standard 2: Preparation and choice • Standard 3: Elective Dialysis access surgery • Standard 4: Dialysis • Standard 5: Transplantation

  3. The Renal NSF: Part 2 • Quality requirement 1: Prevention and early detection of chronic kidney disease (CKD) • Quality requirement 2: Minimising the progression and consequences of CKD • Quality requirement 3: Acute renal failure • Quality requirement 4:End of life care

  4. Management of CKD Think/Report eGFR Early Detection of CKD Early Detection of CKD CKD = chronic kidney disease; RRT = renal replacement therapy

  5. Recorded serum creatinine Stage 3–5 CKD NEOERICA: percentage recording of creatinine and prevalence of Stage 3–5 CKD by age Patients (%) 80 70 60 50 40 30 20 10 0 15–24 25–34 35–44 45–54 55–64 65–74 75–84 85+ Age groups

  6. Source of Late Referrals Lamiere - NDT 1999

  7. SILO MANAGEMENT NEPHROLOGISTS DIABETOLOGISTS GEN. PRACTICE CARDIOLOGISTS GEN. MEDICINE

  8. SILO MANAGEMENT INTEGRATED MANAGEMENT CHRONIC DISEASE MANAGEMENT DIABETOLOGISTS GEN. PRACTICE CARDIOLOGISTS GEN. MEDICINE

  9. CKD: An Overall Health Approach Complications Normal Increasedrisk Damage GFR Kidneyfailure DEATH Screeningfor CKDrisk factors CKD risk factorreduction, screening for CKD Diagnosisand treatment, treatcomorbid conditions,slow progression Estimate progression,treatcomplications, prepare for replacement Replacementby dialysisand transplant

  10. Cardiac Kidney Diabetes Anti coagulationAnti arrhythmicsMedical treatment of CHF CKD Stage 4 AnaemiaAcidosisBone diseasePreparation/choice CKD Stage 1, 2,3 EducationBlood pressureSmoking cessationLipid controlMedicines ManagementDiet adviceExercisePsychosocial support Glycaemic control + DM + CHD Complicationseyesfeetkidney CKD Stage 5 RRTPDHPTp RadiologySurgical interventions

  11. QOF indicators for CKD 2009

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