Volume 2, Special Issue 1, April-May-June 2009
POPULAR
TOPICEDITORIALThe urine tells a tale
Professor Mike Kirby EDITORIALCKD as part of integrated management of vascular risk
Donal O’Donoghue POPULAR
TOPICORIGINAL RESEARCHChronic kidney disease management in southeast England: a preliminary crosssectional report from the QICKD – Quality Improvement in Chronic Kidney Disease study
Simon de Lusignan, Tom Chan, Hugh Gallagher, Jeremy van Vlymen, Nicola Thomas, Neerja Jain, Aumran Tahir, Michael Nation, Jo Moore, Fiona Reid, Kevin Harris, Nigel Hague Background: Chronic kidney disease (CKD) is an important cause of mortality and morbidity, especially in people with cardiovascular
disease. Interventions that can be delivered in primary care have the potential to slow the progression of the disease. People with CKD
can be identified readily and reliably from GP computer systems.
Objective: To report the baseline quality of CKD management.
Method: Pseudonymised routinely collected data from a representative sample of 14 practices across Surrey were extracted as part
of a quality improvement study.
Results: The crude and adjusted prevalences of stage 3 to 5 CKD are 6.3% and 5.8%, respectively. More than twice as many females
(8.8%) as males (3.9%) have this condition. Hypertension, diabetes, ischaemic heart disease and other cardiovascular disease and
anaemia are much more common with deteriorating renal function.
Conclusions: The reported prevalence is lower than suggested by previous studies but this may reflect the lower levels of
cardiovascular disease associated with a healthier lifestyle in the Southeast. However, there is scope to further improve the quality of
CKD management in Surrey. Programmes carefully targeted at high-risk groups could slow the progression of CKD and therefore
reduce the need for renal replacement therapy. JOURNAL REVIEWJournal Review
HOT TOPIC REVIEWOptimising the management of chronic kidney disease in clinical practice
Karen Jenkins Chronic kidney disease (CKD) is now
recognised as a significant public
health problem and various
mechanisms have been put in place
to identify people at risk. CKD overlaps with
other chronic diseases, including diabetes and
hypertension, and should not be managed in
isolation. Vascular risk assessments are
coming into place for the general population
and there are strong links with vascular and
kidney disease. CKD is becoming an integral
part of chronic disease management. GUIDELINESThe cardiovascular implications of chronic kidney disease
Ivan Benett Chronic kidney disease (CKD) is a cardiovascular condition, with cardiovascular causes and
consequences. The kidney complications are relatively uncommon. Until recently, many clinicians, let
alone the public, were unaware of the high prevalence of the disease and its accompanying
morbidity. The National Institute for Health and Clinical Excellence (NICE), through the National
Collaborative Centre for Chronic Conditions, recently reviewed the available evidence and published a
guideline to assist early identification and management of CKD. POPULAR
TOPICCLINICAL PRACTICE REVIEWDiagnosing and monitoring CKD in practice
Robert Lewis Diagnosing chronic kidney disease (CKD) and monitoring kidney function are
key steps in improving management. This article reviews the
recommendations on making a diagnosis of CKD, including staging patients,
and the tests available for monitoring kidney function, with explanations of
how to test patients, what the findings mean, and how to act on the findings. POPULAR
TOPICDISEASE REVIEWThe pathophysiology underlying chronic kidney disease
Robert Lewis Chronic kidney disease (CKD) is characterised by irreversible renal scarring. Nephrologists draw the
distinction between primarily glomerular scarring (glomerulosclerosis) and scarring centred on the
kidney tubules (chronic tubulointerstitial nephritis). However, in clinical practice, glomerulosclerosis is
by far the most common pattern in CKD and this article will focus on this type of renal injury. PRACTICE REVIEWManaging a patient with cardiovascular disease: where does chronic kidney disease fit in?
Kathryn E Griffith THERAPEUTICS REVIEWThe key role of renin blockade in chronic kidney disease
Alan Begg POPULAR
TOPICTHERAPEUTICS REVIEWPrescribing for patients with chronic kidney disease
Professor Michael Kirby 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. Q&ATen key questions on chronic kidney disease
Robert Lewis INFO & RESOURCESInformation & Resources
|
