Chronic Kidney Disease (CKD) - a primary health care checklist

Adults suffering from any of the following problems have a higher risk of developing CKD:
a) Diabetes
b) High blood pressure
c) Cardiovascular disease – coronary heart disease, chronic heart failure, peripheral vascular disease or cerebrovascular disease

Conditions which affect or damage the kidneys might also increase the risk of developing CKD eg kidney stones, an enlarged prostate.

Some medicines might also have side effects which increase the risk of developing CKD – eg cyclosporin, tacrolimus, lithium and non-steroidal anti-inflammatory drugs (NSAIDs).

The two tests which are used to diagnose and monitor CKD in the community are
a) a blood test that estimates glomerular filtration rate (eGFR)
b) a urine test to detect any protein in the urine (ACR)

Different people will need these tests done at different intervals. The more advanced the condition is, the more frequent the tests will be. Commonly, adults with a mild form of CKD will have their eGFR checked at least once per year.

Blood pressure monitoring is important for people living with CKD because they have an increased risk of developing high blood pressure. Treating high blood pressure can also help to prevent CKD from progressing and reduce the risk of any related complications.

Experts advise that adults with CKD can often benefit from taking a statin medication. This is because people with CKD have a higher risk of developing cardiovascular disease (CVD) and statins can help to prevent CVD whilst reducing the risk of its complications like heart attacks or strokes.The dose or type of statin varies between individuals.

The mainstream media often publish worrying stories about statins and their side effects so many people have concerns about taking them.

This controversy is promoting ongoing research into the benefits and risks of statins. In January 2020, the Royal College of General Practitioners (RCGP) reviewed the latest research and concluded that the evidence continues to show that statins are safe and effective when prescribed appropriately.

Like any medicine, prescriptions for statins should be reviewed at regular intervals to enable all the right checks and safeguards to be applied.

People with CKD – should be offered:
a) Annual influenza flu vaccine (new injection every year usually autumn)
b) Pneumococcal vaccine (once only injection at any time of year)
c) COVID vaccine at intervals determined by evolving national policies

CKD is recognised to increase the risk of developing pneumococcal infections and complications of influenza such as pneumonia or bronchitis.