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Chronic kidney disease

BMJ 2007; 334 doi: 10.1136/bmj.39196.714491.94 (Published 14 June 2007)
Cite this as: BMJ 2007;334:1273

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  1. Prabir Kumar Mitra, GP registrar1,
  2. Peter R W Tasker, general practitioner2,
  3. M S Ell, consultant physician1
  1. 1Queen Elizabeth Hospital, King's Lynn, Norfolk PE30 4ET
  2. 2St James' Medical Practice, King's Lynn
  1. Correspondence to:P K Mitra mitra_prabir{at}yahoo.co.uk

    A 68 year old man sees you after you sent him a letter saying that the results of blood tests done over the past year to monitor hypertension show that he has chronic kidney disease (CKD). He is worried, as he thought that high blood pressure was his only medical problem.

    Useful resources

    • Department of Health. The national service framework for renal services. Part two: chronic kidney disease, acute renal failure and end of life care. www.dh.gov.uk/publications

    • Joint Specialty Committee on Renal Medicine of the Royal College of Physicians of London and the Renal Association. Chronic kidney disease in adults: UK guidelines for identification, management and referral. www.renal.org/CKDguide/full/CKDprintedfullguide.pdf

    • Renal Association's eGFR calculator. www.renal.org/eGFRcalc/GFR.pl

    What issues you should cover

    • Explain the terms CKD and estimated glomerular filtration rate (eGFR). To most patients “kidney disease” means dialysis and shortened life expectancy. Explain that CKD is a spectrum of disease, with mild renal impairment at one end and established renal failure at the other (table⇓), and that eGFR, a number that is …

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