Making Best Practice, Every Day Practice
Heart failure (HF) is a devastating clinical syndrome characterised by a constellation of symptoms and signs in the presence of reduced cardiac function. Comorbidity is almost inherent as HF is often the culmination of chronic disease processes such as ischaemic heart disease, hypertension and valve disease and its treatment may precipitate comorbidities such as gout, erectile dysfunction (ED) and acute kidney injury (AKI).
This article seeks to demonstrate the close relationship between cardiovascular disease and chronic kidney disease (CKD). It also highlights the importance of identifying people with CKD as a means of recognising people at high risk of both cardiovascular events and unplanned admissions.
Ischaemic or coronary heart disease is the single leading cause of death in any Western population but more critically is one of the leading causes of premature deaths (i.e. deaths 75 years) in both men and women. There are numerous risk factors for ischaemic heart disease and understanding these and other comorbidities is critical to achieving optimal outcomes.
This month’s Back to Basics feature is a useful wallchart showing the five key functions of the kidney which include making balancing salt and water levels, making strong bones, boosting the production of red blood cells, controlling blood pressure and excreting waste from the blood.
Chronic kidney disease (CKD) is the term used to describe long-lasting abnormal kidney function and/or structure. It is common and often exists together with other conditions like cardiovascular disease (CVD) and diabetes. CKD is an essential diagnosis because treatment can reduce the risk of CVD and prevent or slow progression to kidney failure. This is your briefing on important NICE guideline changes that will help us to better identify at-risk patients while making over-diagnosis less likely.
Since the publication in 2008 of the first NICE guideline on the diagnosis and management of chronic kidney disease (CKD), there has been concern that creatinine-based estimated glomerular filtration rate (eGFR) may not accurately identify people at increased risk–particularly in elderly populations. The updated NICE guideline, issued in July 2014, includes some important changes that take into account recent research into the prognosis of CKD. Of particular relevance for GPs are changes to the diagnostic criteria and classification of CKD, which are described in this article.
This article describes the interrelationship between chronic kidney disease (CKD) and cardiovascular disease and defines the basis for the various interventions which have been recommended in national guidelines. It also provides a critique of currently available guidelines and suggests where changes may be desirable in future.
Chronic kidney disease (CKD) is increasing worldwide. The aim of this study was to identify factors related to progression of chronic kidney disease in a primary care service. Risk factors for progression of CKD were: diabetes, hypertension, uncontrolled systolic pressure and basal creatinine.
Richard Bright was ahead of his time in recognising the importance of being able to diagnose renal disease. Chronic kidney disease (CKD) patients can be at similar levels of cardiovascular risk to those patients who have previously had a heart attack.
In March 2012, the Department of Health created the first National Clinical Director post dedicated to stroke care. Whilst the post is an interim one, pending final decisions about the nature of clinical input to the NHS Commissioning Board from 1st April 2013, its creation emphasises the commitment of the government to continue the implementation of the National Stroke Strategy, in the context of a major emphasis on joining up cardiovascular care.
Chronic kidney disease (CKD) is a multifaceted disease that has several associated complications. Anaemia is one of the most common complications that can develop early in the course of the disease process. It is associated with increased mortality,increased hospitalisation rates, and reduced quality of life. Lower levels of kidney function are associated with lower haemoglobin (Hb) levels and a higher prevalence and severity of anaemia.
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