Summary of CKD Guideline Recommendations for Primary Care (Updated)

Summary of CKD guideline recommendations for primary care (updated) eGFR < 60 eGFR < 45 eGFR < 30 Documentation: CKD on problem list Documentation: CKD on problem list Documentation: CKD on problem list 585.3 585.3 585.4 Lab tests: annual Lab tests: annual Lab tests: annual • Urinalysis • Urinalysis • Urinalysis • Urine microalbumin • Urine microalbumin • Urine microalbumin • A1c (6 months) • A1c (6 months) • A1c (6 months) • Lipid panel • Lipid panel • Lipid panel • Calcium, phosphorus • Calcium, phosphorus • PTH (intact molecule)* • PTH (intact molecule)* • 25-hydroxy vitamin D • 25-hydroxy vitamin D • CBC • CBC • Iron/TIBC (if Hb <12.0) • Iron/TIBC (if Hb < 12.0) Current meds: Current meds: Current Meds: • NSAIDs (D/C) • NSAIDs (D/C) • NSAIDs (D/C) • Bisphosphonates • Bisphosphonates • Bisphosphonates (D/C) • Allopurinol (reduce dose) • Allopurinol (reduce dose) • Allopurinol (reduce dose) • IV contrast (caution) • IV contrast (caution) • IV contrast (caution) • Metformin (Caution) • Metformin (caution) • Metformin (caution) New meds: New meds: New meds: • ACEI or ARB • ACEI or ARB • ACEI or ARB • ASA 81 mg (consider) • ASA 81 mg (consider) • ASA 81 mg (consider) • Vit. D3, 2,000 IU QD (consider) • Vit. D3, 2,000 IU QD (consider) • Vit. D3, 2,000 IU QD (consider) Risk factor management: Risk factor management: Risk factor management: • BP <140/80 • BP <140/80 • BP <140/80 • A1c <7 (if diabetic) • A1c <7 (if diabetic) • A1c <7 (if diabetic) LDL < 1007 • LDL <100 • LDL <100 • Calcium >8.5 • Calcium >8.5 • PO4 < 4.6 • PO4 < 4.6 • PTH <100 • PTH <100 • 25-OH Vit D >30 • 25-OH Vit D >30 • Hemoglobin >10 and <12 • Hemoglobin >10 and <12 Vein preservation: Vein preservation: • Blood draws from one arm • Blood draws from one arm • No PICC Lines or place in neck • No PICC Lines or place in neck Referral: N/A Referral: N/A Referral: Nephrologist Other: Other: Other: • Flu vaccine (yearly) • Flu vaccine • Flu vaccine • Pneumococcal vaccine • Pneumococcal vaccine • Pneumococcal vaccine • Smoking cessation counseling • Smoking cessation counseling • Hepatitis B vaccination • Patient education form • Patient education form • Smoking cessation counseling • Patient education form

* Correction of vitamin D may correct PTH.