Mr Graeme Turner, Nurse Practitioner, Northern NSW Local Health District
The link between early changes to renal haemodynamics leading to later kidney damage was established over 40 years ago. By the 1990s studies confirmed the efficacy of angiotensin converting enzyme inhibitors and angiotensin 2 receptor blocker medications in the treatment of diabetic kidney disease. The American National Kidney Foundation published a classification of CKD based on eGFR in 2002, this has been refined to improve precision and is the framework used to classify CKD. The 2005 implementation of automatic reporting of eGFR on pathology requests in Australia lead to an increased awareness of early CKD and an increase in early referrals to nephrology services.
Screening for and management of early CKD principally occurs in general practice in Australia. Kidney Health Australia published the first edition of their guidelines for management of CKD in general practice in 2007, they are now in their 4th edition. They provide GPs guidance on detection, management and referral in early CKD. Despite these guidelines being available for 15 years early CKD remains under recognised and under treated and under referred in Australia. Meanwhile the burden of renal replacement therapies continues to rise.
With new medications being approved for management of early CKD in Australia in the last two years there is renewed interest in the early identification and management of CKD.
This presentation will review current best practice management of stage II and III CKD, look at current resources and programs aimed at management of stage II and III CKD in Australia and consider our role as kidney health professionals in early identification and management of CKD.