Tel. 01845 577297 * Fax. 01845 577128
| Topcliffe Surgery, Topcliffe, Thirsk, YO7 3RP
Tel. 01845 577297 * Fax. 01845 577128 |
CHRONIC KIDNEY DISEASE is a condition that GPs are diagnosing more frequently as part of a national campaign. There is a new test to make the diagnosis and new expert guidance on how best to manage CKD to minimise the risks.
Although CKD can occur sporadically it is usually a complication of other conditions. The conditions are:
If you have one of these conditions please make sure that we are doing the test to see whether you have chronic kidney disease.
For further information on chronic kidney disease and why it is important, please see the information below.
This is a condition where the kidneys do not function as well as they should. This in itself is not usually a great problem. CKD is not a new condition but is now being diagnosed by GPs as a result of a national campaign.
Information is now available about how to treat CKD to reduce the risks of the condition, which include a susceptibility to cardiovascular disease.
Chronic kidney disease is classified into five stages, where Stage 1 actually represents normal kidney function! Stage 2 CKD is only slightly impaired kidney function and is of no major significance. The three stages that doctors are concerned about are Stages 3, 4 and 5. They are classified according to how well your kidneys deal with waste products. This in turn is expressed as the Glomerular Filtration Rate or GFR. The five stages are as follows:
Stage 1 GFR 90 ml/min or more (normal) but with other evidence of kidney disease
Stage 2 GFR 60-90 ml/min
Stage 3 GFR 30-60 ml/min
Stage 4 GFR 15-30 ml/min
Stage 5 GFR <15 ml/min (these patients may need kidney dialysis)
No, this is unlikely. Patients with CKD Stage 3 have less than a 5% chance of needing dialysis.
Although your actual kidney function is not likely to be a problem, patients with CKD Stage 3 do have a 25% chance of developing cardiovascular disease (CVD) – a heart problem or stroke. This risk can be reduced by appropriate treatment.
You will need the same treatment as other patients with a significantly increased risk of cardiovascular disease:
Some patients with chronic kidney disease develop hyperparathyroidism. This means that there is too much parathyroid hormone in the system. Parathyroid hormone affects the calcium in the body. Too much parathyroid hormone causes calcium to be lost from the bone and usually gives rise to too much calcium (and too little phosphate) in the blood. Specialist treatment may be required for hyperparathyroidism. Some patients with chronic kidney disease develop anaemia. This may require specialist treatment with a drug called erythropoetin.
Your GP will want to monitor your blood pressure and your kidney function on a regular basis, usually every 6 months. In addition your GP will want to check your urine for protein. Kidney function is assessed in the blood by the level of creatinine and by the glomerular filtration rate, calculated by a means known as the “estimated GFR abbreviated MDRD”.
Annually you will need a blood test for cholesterol and, if you are on a statin to lower cholesterol, a blood test for liver function. From time to time you will also need checks of your blood for anaemia and for calcium and phosphate. Specialist blood tests for parathyroid hormone levels and vitamin D levels may also be needed.
At Topcliffe Surgery we are delighted when patients want to be involved in the care of their own condition. If you would like to be, please ask for a copy of our Chronic Kidney Disease Record Card to keep your own record.