Chronic Kidney 
        Disease (CKD) 
        Management in 
        Primary Care 
        Guidance and clinical tips 
        to help detect, manage 
        and refer patients in your 
        practice with CKD
        4th Edition 2020
       The Chronic Kidney Disease (CKD) Management in Primary Care  
       (4th edition) handbook has been officially recognised as an Accepted 
       Clinical Resource by The Royal Australian College of General Practitioners 
       (RACGP), and endorsed by the Australian Primary Health Care Nurses 
       Association (APNA), and the Australian and New Zealand Society of 
       Nephrologists (ANZSN).
       Supporting the work of Kidney Health Australia
       © Kidney Health Australia
       This report is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be 
       reproduced without written permission from Kidney Health Australia. Requests and enquiries concerning 
       reproduction and rights should be directed to Kidney Health Australia, PO Box 9993, Melbourne VIC 3001. 
       info@kidney.org.au.
       ISBN:  978-0-6485845-4-4 (print)   
         978-0-6485845-5-1 (web)
       Citation: Chronic Kidney Disease (CKD) Management in Primary Care (4th edition).   
       Kidney Health Australia, Melbourne, 2020.
       A digital version of this handbook is available at www.kidney.org.au
       Please refer to the digital version of the handbook for any relevant updates.
                Why use this handbook?
                Chronic Kidney Disease (CKD) Management in Primary Care  
                (4th edition) provides best practice recommendations for detecting  
                and managing CKD in primary care:
                •  Easy to use and interactive.
                •  Quick reference guide containing all the essential information  
                   on detecting and managing CKD.
                •  Colour coded CKD staging table.
                •  Colour coded clinical action plans outlining goals of management,  
                   key management tasks and frequency of assessment required by CKD stage.
                •  Medication advice and treatment targets.
                •  Management framework for common CKD complications.
                •  Nephrology referral guidelines.
                •  Links to fact sheets, websites, and additional resources.
                The CKD Management in Primary Care handbook is available in both hard copy  
                and electronic soft copy (free download from www.kidney.org.au).  
                It is also available in app format via the app CKD Go! (free download on your app store).
                      What’s new in the 4th edition? 
                      •  New treatment targets for the                          •  New section on the management  
                         management of hypertension in                             of kidney cysts.
                         people with CKD (maintain blood                        •  New information on the 
                         pressure below 130/80mmHg for                             management of oedema and 
                         anyone with CKD).                                         cognitive decline in CKD.
                      •  New quick reference guide.                             •  Expanded information on ‘whole  
                      •  Kidney disease hotspots                                   of practice approach’ to CKD care.
                         – are you in one?                                      •  Expanded information on  
                      •	 New	algorithms,	flow	charts	                              self-management and behavioural 
                         and action charts.                                        change in CKD.
                      •  New sick day plan for management                       •  Integrated resources and 
                         of acute kidney injury.                                   handouts.
                      •  New information on managing  
                         CKD in the presence of diabetes 
                         and cardiovascular disease.
                                                                                                       Kidney Health Australia          1   
             Foreword
             Welcome to the 4th edition of the Chronic  
             Kidney Disease (CKD) Management in Primary 
             Care handbook. With this new edition, comes 
             an updated title that reflects the important 
             contribution of all health professionals engaged  
             in primary care and their role in the delivery of  
             best-practice care for patients at risk of and living 
             with chronic kidney disease (CKD).
             CKD remains an under-recognised                   organ ‘silos’ but recognise that addressing 
             condition in Australia, due to the                multi-morbidity through patient-centred 
             asymptomatic nature of the disease                cohesive care is the most clinically 
             and low awareness among Australians               effective	and	cost-effective	approach.	
             regarding risk factors for kidney disease.        Primary care is the central setting where 
             Further compounding this problem is               patient engagement in self-management, 
             the issue of limited access and utilisation       support for shared decision making, 
             of health care services amongst those             and multidisciplinary team care can 
             most at risk of CKD. This includes                be delivered to change the course of 
             the geographically isolated, socially             potentially devastating illnesses such as 
             disadvantaged as well as Aboriginal               CKD. 
             peoples and Torres Strait Islanders.              This handbook continues to be an 
             Therefore, while we increasingly                  extensively utilised resource in primary 
             focus on policy and whole of society              care. It is both practical and accessible, 
             approaches, including chronic disease             and	is	used	widely	out	in	the	field,	
             care frameworks, proactive health checks          especially when making key clinical 
             and lifestyle and social determinants of          decisions, due to its easy-to-use style 
             chronic disease, there is much that can be        and hard copy and digital formats. Many 
             done in primary care at an individual level       health professionals also utilise the highly 
             to detect and slow progression of CKD.            regarded CKD Go! digital application, 
             This 4th edition handbook emphasises              which has accompanied the handbook 
             the relationship between CKD,                     since 2016. Positive feedback from the 
             cardiovascular disease and diabetes.              clinical community strengthens our 
             Given the potential for new therapeutics          commitment to this handbook, and we 
             that may address all three conditions,            are	confident	the	changes	within	this	
             it is particularly pertinent that we no           new edition will enhance its utility for all 
             longer view the patient in disease or             primary care professionals. 
             2       Kidney Health Australia