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Chronic Kidney Disease (CKD) Clinical Pathway

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Background

Background

Chronic kidney disease (CKD) is common, affecting 9% of adults in Canada. However, management of CKD is complex and often suboptimal – in part because many providers are unaware of best practices.

Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the evaluation and management of CKD was released in 2012 and defines CKD based on eGFR (estimate glomerular filtration rate) and albuminuria levels. Primary care physicians and allied health care professionals (e.g. pharmacists, nurses) play a key role in identification, medical management and referral of adult patients with CKD and thus are an important target population to disseminate the CKD guidelines to.

Accessing the pathway

Clinical pathways are an effective tool to translate the guidelines into practice in order to optimize care for patients with CKD. The CKD clinical pathway is an effective, interactive, online tool that is credible, evidence-based and easy to navigate. Currently, primary care providers can access the CKD Pathway via webpage: www.ckdpathway.ca

In 2015, clinicians will be able to access the CKD Pathway via an embedded URL link in a patients eGFR & urine lab test results.

The CKD Pathway assist you in the following ways:

  1. Diagnosis of CKD (who to test and how to test)
  2. Medical management of CKD (lifestyle and drug therapy)
  3. Referral of patients with CKD to a nephrologist

We want to test patients at risk for CKD, namely those who have

  • Hypertension
  • Diabetes Mellitus
  • Family history of CKD or hereditary kidney disease
  • Vascular disease
  • Multisystem disease (e.g. SLE)

The tests recommended are:

  • eGFR
  • Urine Albumin Creatinine ratio (ACR)
  • Urinalysis

Related KT activities

The following KT resources are available for health care providers:

1 Page Handout

1phandout

Information Brochure

brochure

Patient Handout

handout

Development of the CKD pathway

Development of the CKD pathway

CKD Pathway Podcast

podcast poster

CKD Medication Podcast

medication podcast

Community pharmacists targeted
CKD screening

CPA ICDC2

Publications

  1. Community pharmacist targeted screening for chronic kidney disease. To view the Canadian Pharmacists Association video media release "pharmacists key to detecting CKD in at-risk patients" (January 18, 2016) click here.
  2. Online clinical pathway for managing adults with chronic kidney disease 
  3. Development and implementation of an online clinical pathway for adult chronic kidney disease in primary care: a mixed methods study.

Contact Us

CKD Pathway preliminary evaluation (user satisfaction and experience) - view the infographic.

Partners in the development of the Online CKD Pathway:

The CKD Clinical Pathway was developed by the Interdisciplinary Chronic Disease Collaboration in partnership with primary care physicians, nurses, allied health care professionals, nephrologists, the Northern and Southern Alberta renal programs and IT.

Evidence-based recommendations have been derived from:

  • Kidney Disease Improving Global Outcomes
  • Canadian Cardiovascular Society
  • Canadian Diabetes Association
  • Canadian Hypertension Education Program
  • Canadian Society of Nephrology