Making Best Practice, Every Day Practice
Chronic kidney disease (CKD) affects renal drug elimination and other important processes involved in drug disposition, including absorption, drug distribution and non-renal clearance. As a result, the reduced renal excretion of a drug or its metabolites can cause toxicity and the sensitivity to some drugs is increased even if elimination is unimpaired.
The Quality and Outcomes Framework (QOF) was implemented in 2004 with the aim of ensuring that all patients had access to standardised, evidence-based care for their long-term condition. Points are awarded for meeting certain standards in each of theseconditions and the number of points earned is translated into money that is paid to the practice. Chronic kidney disease (CKD) is one of the long-term conditions with QOF points for registering and monitoring.
What exactly is chronic kidney disease (CKD), what causes it and how is it diagnosed? In this article we get down to the basics of defining what CKD is, and explore the stages of CKD. We review CKD progression and the assessment and management recommendations for each stage of CKD.
The effective management of long-term conditions such as chronic kidney disease (CKD) is probably the single greatest challenge faced by the NHS. The population is growing and people are living longer. Every week, the life expectancy for a newborn baby in the UK increases by more than 24 hours. While this is, in part, testament to the success of our health services, it also places steadily increasing demands upon them. As the population ages, the number of people living with long-term conditions is predicted to triple by 2050.
Chronic kidney disease (CKD) has shot up the primary care agenda over the last few years, and is now well recognised as an independent risk factor for cardiovascular disease (CVD). At the same time, CVD is a risk factor for progression of CKD. The close links between CKD and CVD mean we have to get to grips with assessing patients’ kidney function and ensuring those with CKD receive the treatment needed to prevent progression. This special issue devoted to CKD is full of step-by-step guides and illustrated articles to help you get to grips with this important condition.
What exactly is chronic kidney disease (CKD), what causes it and how is it diagnosed? In this article we get down to the basics of defining what CKD is, and explore the stages of CKD. We review CKD progression and the assessment and management recommendations for each stage of CKD.
People with advanced kidney disease are required to make many choices about their treatment throughout the journey of this disease. Opting not to have dialysis or to withdraw from treatment is a difficult decision and there are many factors that influence patients’ decisions. For those who choose not to have dialysis, the implications need to be understood by the patient, their family and carers and healthcare professionals involved in their care. This article provides an update on this important issue to equip primary care professionals with a clear understanding of end-of-life care for patients with advanced kidney disease.
Chronic kidney disease (CKD) has shot up the primary care agenda over the last few years, and is now well recognised as an independent risk factor for cardiovascular disease (CVD). At the same time, CVD is a risk factor for progression of CKD. The close links between CKD and CVD mean we have to get […]
Chronic kidney disease mineral and bone disorders (CKD-MBD) is a slowly progressive complication of CKD occurring over many years. The kidneys are unable to maintain normal levels of calcium and phosphate and respond to the hormones needed to maintain healthy bones. CKD–MBD is a common problem in people with stage 3 CKD onwards and affects almost all patients receiving dialysis. This article explains why renal bone disease occurs, the problems it can cause for patients affected and provides practical tips on how to identify people at risk and management options.
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