Chronic Kidney Disease Model of Care, Algorithm and Referral Form
The Renal Health Network has developed a Model of Care for Chronic Kidney Disease. The Model of Care describes the continuous care pathway from prevention and early detection at a primary care level, specialist referral and management of the established condition, through to the final or “end-stage” requiring dialysis, transplant or supportive care. Primary prevention is being addressed in conjunction with other Networks.
An algorithm for Chronic Kidney Disease has been developed for patients with kidney disease to be seen at public hospital renal specialist services. The development of the algorithm was based on current evidence and recommendations found in the document Kidney Health Australia (2007: “Chronic Kidney Disease Management in General Practice”) which, after discussion with local specialists and GPs have been adopted for local use.
As with all guidelines these are general recommendations, and assessment of the suitability of the recommended actions ultimately lies with the clinician. For example renal dysfunction associated with the treatment of patients with severe heart failure may be an acceptable consequence of necessary treatment, and may warrant different management of their renal impairment as outlined
- It has been estimated that the prevalence rate of Chronic Kidney Disease in WA is 83,000 patients with moderate kidney damage (stage 3) and 2,265 patients with severe to end stage kidney disease (stage 4 to 5).
- The incidence rate of end stage kidney disease in WA has grown by 139 % from 1990 to 2005 (from 49 patients per million population in 1990 to 117 patients per million population in 2005).
- In December 2006 there were 860 patients on dialysis in WA.
- In 2005 to 2006 metropolitan dialysis activity in WA accounted for 82,076 public hospital admissions. This is expected to increase to approximately 115,891 by 2013/2014. This represents a conservative growth estimate of 41.2% over a 7-year period (5.9% per annum).