CLINICAL FEATURES OF CKD PROGRESSION, INVESTIGATIONS:
CLINICAL FEATURES OF CKD PROGRESSION:
- Uraemic odour (advanced indicator)
- Pallor (renal anaemia)
- Cachexia, cognitive impairment
- Increased respiratory rate (Overload, renal anaemia, co-morbs)
- Hypertension (Primary/Secondary to CKD)
- Distended bladder (Obstruction)
- Peripheral oedema ( Renal Na retention, reduced albumin)
- Frothy urine (Protein).
INVESTIGATIONS:
- Urine Sediment Analysis:
- RBCs → glomerular disease
- WBCs → pyelonephritis
- Casts → interstitial nephritis
- Renal tubular epithelia → parenchymal disease
- Other Investigations
– Renal ultrasound
CLASSIFICATION:
- eGFR Stages: – G1: >90
- G2: 60-89
- G3A: 45-59
- G3B: 30-44
- G4: 15-29
- G5: <15
- ACR Categories:
- A1: <3
- A2: 3-30
- A3: >30
REFERRAL CRITERIA:
- 5-year risk of end-stage renal disease >5% – Accelerated progression:
- eGFR drop >25% or >15ml within 12 months
- Change in eGFR category within 12 months
- ACR >70 without diabetes
- ACR >30 + Persistent haematuria post UTI exclusion
- Uncontrolled hypertension
- Suspected renal stenosis
- Suspected CKD complications
- eGFR <30