Shaping better health
REMEDY : BNSSG referral pathways

Chronic Kidney Disease

Checked: 08-05-2017 by Rob.Adams Next Review: 08-05-2018

Clinical Guidance

Chronic kidney disease (CKD) is an abnormality of kidney function or structure that is present for more than 3 months, with implications for health.

Complications of CKD include

  • Worsening renal disease that progresses to renal replacement therapy

  • Cardiovascular disease

  • Renal anaemia

  • Renal bone disease

  • Malnutrition

  • Neuropathy

  • Lipid abnormalities

People with CKD are twenty times more likely to die of cardiovascular disease than end-stage renal disease.  The aim of early identification and treatment of CKD is to decrease the risk of cardiovascular disease and progression to end-stage renal disease.

Principles of Management

Clinical Knowledge Summaries has useful guidelines on the diagnosis and management of CKD and when to refer.


Referral Guidance

Referrals to nephrology for patients with CKD should be made via e-referral and include the following information and preferably include the renal medicine assessment form:

  • Reason for referral.

  • Past medical history.

  • Current medications.

  • Result of urine dipstick and urine ACR.

  • Recent blood pressure reading.

  • All available previous serum creatinine and electrolytes measured over the last 2 years.

  • Renal USS if performed (please provide report)

  • Blood test results to include - FBC, UE, Ca, Phosphate, lipids, HbA1c

NBT has a webpage Renal (Kidney) with the following information:

How to make a referral 

Renal Medicine Assessment Form - Stage 3 CKD

Renal Medicine Referral Form - Stage 4&5 CKD

Red Flags

If Acute Renal Failure is suspected then refer to AKI guidelines

If potassium is > 7 then contact on call renal registrar at Southmead Hospital (0117 9505050).

Rapid access advice is also available from the SpR bleep (9578) via Southmead switchboard.