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Organising health care for someone with Chronic Kidney Disease (CKD)

If your parent has chronic kidney disease (CKD), and you are helping to organise their health care, then this checklist summarises some of the issues you might want to discuss with them.

CKD is a common problem, especially in older people and those living with diabetes or circulation problems. Treatment can prevent or delay the progression of CKD and its complications so it’s important to recognise the condition early on and keep it under control.

CKD does not usually cause symptoms, so it can easily go undiagnosed. Fortunately tests for CKD are simple and widely available – usually a simple blood or urine test.

CKD can increase the risk of developing circulatory problems like strokes or heart attacks. In fact, these problems can be more common and serious for many people living with CKD than the actual kidney problem. This means that actions to promote heart health - blood pressure, cholesterol, diabetes, exercise, - are extra specially important for people living with CKD.

The checklist is not a substitute for medical advice – always seek professional help. Remember, healthcare professionals will not share information about a patient unless they have been given permission to do so.

The Carents Room CKD Checklist

Do I have CKD?

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).

Do I need any blood tests?

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.

Do I need my blood pressure checking or treating?

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.

Do I need to take any tablets?

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 most commonly prescribed statin is atorvastatin 20mg.

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.

Do I need any vaccines or immunisations?

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)

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

Want to know more?

Chronic Kidney Disease (CKD) Patient Information Leaflet (Kidney Care UK)

This patient information leaflet has been developed by Kidney Care UK in association with The Renal Association. The Renal Association represents professionals who treat kidney problems.

Kidney Care Uk Website

This charity specialises in helping people living with kidney disease

Improving care for CKD

Results from a national audit of primary care for CKD (in England 2017)

Acute Kidney Injury

NICE Quality Standard QS76

Our Carents Say

“Mum was a bit concerned when the doctor told her she had CKD - it sounded serious - but it was quite mild and it never developed into anything more serious. We found the regular tests were very reassuring."