CKD Virtual Clinic
The clinic has three key elements
- e-clinic where specialists assess and provide information and advice based on shared-viewing agreements;
- community CKD active patient link tool (RENAL APL TOOL) and prevalence searches identifying patients at risk of ESKD to alert practices to patients who may benefit from addition to CKD practice register, coding with CKD and treatment based on London Kidney Network guidelines here
- education for GPs and community allied health professionals for CKD coding, diagnosis and treatment.. Patient resources available through the London Kidney Network as above.
Eligibility
Inclusion
- a 5-year risk of needing renal replacement therapy of greater than 5% (measured using the 4-variable Kidney Failure Risk Equation)
- ACR of 70 mg/mmol or more, unless known to be caused by diabetes and already appropriately treated (see recommendations 1.6.6. and 1.6.7)
- an ACR of more than 30 mg/mmol (ACR category A3), together with haematuria
- a sustained decrease in eGFR of 25% or more and a change in eGFR category within 12 months
- a sustained decrease in eGFR of 15 ml/min/1.73 m2 or more per year
- hypertension that remains poorly controlled (above the person's individual target) despite the use of at least 4 antihypertensive medicines doses (see also NICE's guidelines on hypertension in adults) here
- known or suspected rare or genetic causes of CKD
- suspected renal artery stenosis.
How to refer
Who can refer: GP
EMIS referral
Send by: e referral — <p><span style="font-size:11pt"><span style="font-size:13.5pt"><span style="color:#031835">Refer via eRS - Search under 'Community Kidney E-Clinic.'</span></span></span></p> <p><span style="font-size:11pt"><span style="font-size:13.5pt"><span style="color:#031835">You will need to do the following before referring:</span></span></span></p> <ul> <li><span style="font-size:11pt"><span style="font-size:13.5pt"><span style="color:#031835">ask for consent to view the medical record and tick 'share consent'</span></span></span></li> <li><span style="font-size:11pt"><span style="font-size:13.5pt"><span style="color:#031835">review patient data in the updated CKD template and decide if further tests are needed </span></span></span></li> <li><span style="font-size:11pt"><span style="font-size:13.5pt"><span style="color:#031835">write what you want from the renal consultant in the consultation field </span></span></span></li> </ul>