"Chronic" is not wicked or awful, as your teenager might tell you!

The Rest is Kidneys podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)

In this episode of the North West London Kidney Care Podcast, Consultant Nephrologists Andrew Frankel and Jeremy Levy from Imperial College Healthcare NHS Trust discuss the diagnosis and management of chronic kidney disease (CKD) in primary care. They focus on interpreting blood test results, such as low GFR and high creatinine, and emphasise the importance of distinguishing between chronic kidney disease and acute kidney injury. 

The conversation also highlights the role of past blood results, urine dipstick tests, and further investigations like ACR and tests for underlying causes such as diabetes or myeloma. This episode provides practical insights for healthcare professionals managing CKD in primary care.

Key Takeaways:

1. Always distinguish between chronic kidney disease (CKD) and acute kidney injury by reviewing previous blood results and assessing the patient's overall health status.
2. Don't rely solely on abnormal GFR or creatinine levels; investigate the underlying cause of CKD and consider further tests, such as urine dipstick tests and ACR, especially in patients with diabetes or hypertension.
3. The presence of both blood and protein in the urine may indicate more serious conditions, such as glomerulonephritis, and should prompt further investigation or referral to secondary care.

Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE

Northwest London CKD guidelines for primary care Chronic kidney disease (nwlondonicb.nhs.uk)

The purpose of this podcast is to inform and educate health care professionals working in the primary care and community setting. The content is evidence based and consistent with NICE guidelines and North West Guidelines available at the time of publication.

The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement.

Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

Chapters

• 1:15 Does a creatinine level of 130 mcmol/l and an eGFR of 48 ml/min in a 65-year-old patient confirm chronic kidney disease (CKD)?
• 4:36 When a low eGFR is found, should we check previous results to rule out acute kidney injury and reassess within 1-2 days if the patient is unwell?
• 6:16 When monitoring long-term conditions like diabetes or hypertension in primary care, if blood tests show reduced eGFR, does the patient have CKD?
• 8:53 For a patient with eGFR of 48, previously 52, what other diagnoses should be considered, and what tests should be done in primary care?
• 12:00 What are the key takeaways for abnormal eGFR?