{"id":5038,"date":"2023-06-01T12:07:02","date_gmt":"2023-06-01T11:07:02","guid":{"rendered":"https:\/\/cdrc.nhs.uk\/?page_id=5038"},"modified":"2024-04-26T12:43:22","modified_gmt":"2024-04-26T11:43:22","slug":"chronic-kidney-disease-ckd","status":"publish","type":"page","link":"https:\/\/cdrc.nhs.uk\/resources\/systmone-resource-centre\/specialties\/systmone-renal-urology-overview\/chronic-kidney-disease-ckd\/","title":{"rendered":"Chronic Kidney Disease (CKD)"},"content":{"rendered":"\n

CDRC has resources available to support the identification and management of patients with Chronic Kidney Disease (CKD). <\/p>\n\n\n\n

Accessing CDRC resources on SystmOne<\/h4>\n\n\n\n

To access the below resources you will need to be a member of the DCS group on SystmOne. To do this, please follow the instructions on the <\/strong>CDRC SystmOne Access<\/strong><\/a> webpage.<\/p>\n\n\n\n

Reports<\/h2>\n\n\n\n

CDRC’s AKI & CKD Reports (Searches) support the identification of patients at high risk of an AKI on specific medications & patients with un\/miscoded CKD and the prioritisation of patients for intervention. <\/p>\n\n\n\n

These reports are found in the CDRC Quality > Renal<\/em><\/strong> folder.<\/p>\n\n\n\n

AKI Prevention<\/summary>
\n
Report Name<\/strong><\/td>Patient’s<\/strong> Returned<\/strong><\/td><\/tr>
? AKI Prevention – Meds 01.1 PPIs in high risk patients <\/td>Patients at high risk of an AKI or coded with an AKI in the last 3 years and prescribed PPIs on repeat. <\/td><\/tr>
? AKI Prevention – Meds 04.1 Gabapentinoids in high risk patients<\/td>Patients at high risk of an AKI or coded with an AKI in the last 3 years and prescribed Gabapentinoids on repeat. <\/td><\/tr>
? AKI Prevention – Meds 04.2 Lithium in high risk patients <\/td>Patients at high risk of an AKI or coded with an AKI in the last 3 years and prescribed Lithium on repeat. <\/td><\/tr>
? AKI Prevention – Meds 04.3 Opioids in high risk patients<\/td>Patients at high risk of an AKI or coded with an AKI in the last 3 years and prescribed Opioids on repeat. <\/td><\/tr>
? AKI Prevention – Meds 06.1 Long acting sulfonylurea in high risk patients <\/td>Patients at high risk of an AKI or coded with an AKI in the last 3 years and prescribed Long acting sulfonylurea on repeat. <\/td><\/tr>
? AKI Prevention – Meds 10.1 NSAIDs in high risk patients<\/td>Patients at high risk of an AKI or coded with an AKI in the last 3 years and prescribed NSAIDs on repeat. <\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div><\/details><\/div>\n\n\n\n
CKD Casefinding<\/summary>
\n
Report Name<\/strong><\/td>Returns<\/strong><\/td><\/tr>
? CKD 2.0 Casefinding – All patients with potentially uncoded CKD #<\/td>Patients not coded with CKD, with diabetic kidney disease OR<\/strong> two ACR >=3 OR<\/strong> two eGFR <60.
<\/td><\/tr>
? CKD 2.01 Casefinding – eGFR <60 twice, 3 months apart but not coded with CKD 3-5 #<\/td>Patients with last two eGFR <60 at least 3 months apart but not code for CKD 3-5.<\/td><\/tr>
? CKD 2.02 Casefinding – Repeated ACR>=3 but not coded with CKD #<\/td>Patient with last two ACR readings >=3 without a CKD 1-5 code.<\/td><\/tr>
? CKD 2.021 Casefinding – Repeated ACR>=3 but not coded with CKD (excluding diabetic kidney disease) #<\/td>As above, excluding patients with diabetic kidney disease. <\/td><\/tr>
? CKD 2.03 Casefinding – Diabetic kidney disease but not coded with CKD #<\/td>Patients with diabetic kidney disease patients without a CKD 1-5 diagnosis.<\/td><\/tr>
? CKD 2.1 Casefinding – All patients with possible CKD – need repeat eGFR or ACR # <\/td>Patients not coded with CKD with an isolated eGFR <60 or an isolated ACR >=3.<\/td><\/tr>
? CKD 2.11 Casefinding – eGFR<60 (isolated) over 4 months ago but not coded with CKD 3-5 – Repeat U+E #<\/td>Patients not coded with CKD 3-5 but who’s last eGFR was <60 (at least 4 months ago).<\/td><\/tr>
? CKD 2.111 Casefinding – eGFR<50 (isolated) over 4 months ago but not coded with CKD 3-5 – Repeat U+E #<\/td>As above but eGFR <50.<\/td><\/tr>
? CKD 2..4 Casefinding – Isolated ACR>=3 not coded with CKD – Repeat ACR<\/td>Patients not coded with CKD but who’s last ACR was >=3.<\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div><\/details><\/div>\n\n\n\n
CKD Management<\/summary>
\n
Report Name<\/strong><\/td>Returns<\/strong><\/td><\/tr>
? CKD 3.0 Coding – All Coding Issues<\/td>Patients identified in searches ? CKD 3.01, 3.02, 3.021, 3.03 and 3.04.<\/td><\/tr>
? CKD 3.01 Coding – Current CKD G code not in keeping with recent eGFRs <\/td>CKD diagnosed, last two eGFR results not in keeping with current CKD coding.<\/td><\/tr>
? CKD 3.011 Coding – Current CKD G code not in keeping with recent 2 eGFRs<\/td>CKD diagnosed, last two eGFR 60-89 but not CKD 2-5 coded.<\/td><\/tr>
? CKD 3.012 Coding – Current CKD G code not in keeping with recent 3A eGFRs<\/td>CKD diagnosed, last two eGFR 45-59 but not CKD 3A-5 coded.<\/td><\/tr>
? CKD 3.013 Coding – Current CKD G code not in keeping with recent 3B eGFRs<\/td>CKD diagnosed, last two eGFR 30-44 but not CKD 3B-5 coded.<\/td><\/tr>
? CKD 3.014 Coding – Current CKD G code not in keeping with recent 4 eGFRs<\/td>CKD diagnosed, last two eGFR 15-29 but not CKD 4-5 coded.<\/td><\/tr>
? CKD 3.015 Coding – Current CKD G code not in keeping with recent 5 eGFRs<\/td>CKD diagnosed, last two eGFR 0-14 but not CKD 5 coded.<\/td><\/tr>
? CKD 3.02 Coding – Current CKD A code not in keeping with recent ACRs<\/td>CKD diagnosed, last two ACR results not in keeping with current CKD A coding. <\/td><\/tr>
? CKD 3.021 Coding – Current CKD A code not in keeping with recent A1 ACRs<\/td>CKD diagnosed, last two ACR <3 but not coded CKD A1, A2 or A3.<\/td><\/tr>
? CKD 3.022 Coding – Current CKD A code not in keeping with recent A2 ACRs<\/td>CKD diagnosed, last two ACR 3-30 but not coded CKD A2 or A3.<\/td><\/tr>
? CKD 3.023 Coding – Current CKD A code not in keeping with recent A3 ACRs<\/td>CKD diagnosed, last two ACR >30 but not coded CKD A3.<\/td><\/tr>
? CKD 3.03 Coding – Repeat ACR to confirm different CKD A code<\/td>CKD diagnosed, latest ACR result 3-29.9 and not coded with CKD A2 or A3 OR<\/strong> >30 and not coded with CKD A3.<\/td><\/tr>
? CKD 3.04 Coding – CKD A code not stated<\/td>CKD diagnosed, no CKD A1, A2 or A3 code.<\/td><\/tr>
? CKD 3.11 – BP Management – BP measurement overdue<\/td>CKD diagnosed, no BP reading in the last 15 months.<\/td><\/tr>
? CKD 3.12 – BP Management – BP not controlled<\/td>CKD diagnosed, personal or NICE BP target not achieved.<\/td><\/tr>
? CKD 3.21 – ACR Monitoring – ACR measurement overdue<\/td>CKD diagnosed, no ACR\/PCR in the last 15 months.<\/td><\/tr>
? CKD 3.22 – eGFR Monitoring – eGFR measurement overdue<\/td>CKD diagnosed, no Renal test in the last 9 months or 15 months depending on CKD stage.<\/td><\/tr>
? CKD 3.31 – Lipids Monitoring – Consider lipid intervention<\/td>CKD diagnosed, consider lipid intervention.<\/td><\/tr>
? CKD 3.32 – ACEi\/A2RB – Consider ACEi\/A2RB intervention<\/td>CKD diagnosed, consider ACEi\/A2RB intervention.<\/td><\/tr>
? CKD 3.33 – SGLT2i – Consider SGLT2i intervention<\/td>CKD diagnosed, consider SGLT2i intervention.<\/td><\/tr>
? CKD 3.34 – Finerenone – Consider finerenone intervention<\/td>CKD diagnosed, consider finerenone intervention.<\/td><\/tr>
? CKD 3.41 – KFRE – Higher Risk CKD without KFRE in the last 12 months<\/td>Higher risk CKD patients that have not had a Kidney Failure Risk Equation 5 year risk score in the last 12 months.<\/td><\/tr>
? CKD 3.42 – KFRE >=5% but no renal team involvement<\/td>Patients that have a KFRE of >=5% but have no renal team involvement<\/td><\/tr>
? CKD 3.43 – CKD and Renal Team involvement without discharge – not seen L3Y<\/td>CKD diagnosed, renal team involvement or referral, without a discharge, not seen in the last 3 years.<\/td><\/tr>
? CKD 3.51 ACR \/ BP \/ U+E Monitoring – 2 \/ 3 overdue<\/td>CKD patients that have two out of three:
– ACR overdue
– BP overdue
– U+E overdue<\/td><\/tr>
? CKD 3.52 ACR \/ BP \/ U+E Monitoring – 3 \/ 3 overdue<\/td>CKD patients that have three out of three:
– ACR overdue
– BP overdue
– U+E overdue<\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div><\/details><\/div>\n\n\n\n
CKD Intervention Prioritisation <\/summary>
\n
Report Name<\/strong><\/td>Returns<\/strong><\/td><\/tr>
? CKD 4.1 – CKD Intervention Prioritisation – Highest priority<\/td>Priority Group 1<\/td><\/tr>
? CKD 4.2 – CKD Intervention Prioritisation – High priority<\/td>Priority Group 2<\/td><\/tr>
? CKD 4.3 – CKD Intervention Prioritisation – Lower priority<\/td>Priority Group 3<\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div><\/details><\/div>\n\n\n\n
\n\n\n\n

Visualisations<\/h2>\n\n\n\n
Enabling Visualisations<\/summary>
\n

TPP SystmOne have released a new functionality called Visualisations.<\/p>\n\n\n\n

Visualisations are customisable dashboards that can display key patient information, practice information and\/ or organisational details on one screen, allowing for easy data checking and data entry. This dashboard can link to other SystmOne resources and functionalities such as Reports, Data Entry Templates and Questionnaires, allowing you to perform multiple actions from one screen.<\/p>\n\n\n\n

Visualisations have two main functions:<\/p>\n\n\n\n