• CKD was defined by presence of blood or protein on urinalysis and/or serum creatinine >150
• 8% of the surveyed group had diabetes and half of them were unaware of Dx
• Indigenous populations have much higher rates of end stage kidney disease (ESKD)
• Risk factors for ESKD
– Hypertension – Diabetes – Family history – Ethnicity – Smoking – Obesity
– About 1 in 20 people have abnormalities on urinalysis
– About 8% of the general population have evidence of diabetes mellitus
– About 1 in 10 type 2 diabetics have evidence of diabetic nephropathy
• Further discussion
Take home message
• Single urine dipstick for protein – limitations false positives, false negatives
• Kidney function should be measured at least yearly in those at increased risk CKD
– Those with diabetes are at risk of end stage kidney disease
Case 1 cont.
• Question 1
• In large epidemiological surveys for diabetes and chronic kidney disease, which of the following are correct?
culture
Case 1
• Question 2 • Which of the following is the most
appropriate investigation when screening for CKD?
– 24 hr urinary protein – 24 hr urinary albumin excretion – Urinary prot/creat ratio on a spot urine – Urinary alb/creat ratio on a spot urine – MSU with dipstick, spot ACR, microscopy
and culture
Discussion
• CARI/KCAT reviewed evidence • Combo screening the best –
– U/A – MSU - m,c,s – ACR – BP – Serum creatinine (GFR)
• This should be done Байду номын сангаасearly in high risk groups – eg diabetics, ATSI
– Those with diabetes are at risk of end stage kidney disease
Discussion Case 1
• AusDiab 1 in 7 pts in Australia have diabetes. This can be as high as 1 in 3 in indigenous Australians
• 30% of those surveyed had hypertension with half being unaware of Dx
• 1 in 3 type 2 diabetics will develop nephropathy
Take home message
• Type 2 Diabetes is now worldwide, the most common cause of end stage kidney disease
【高血压英文PPT精品课件】 Progressive Chronic Kidney Disease
Case 1 cont.
• In large epidemiological surveys for diabetes and chronic kidney disease, which of the following are correct?
– About 1 in 20 people have abnormalities on urinalysis
– About 8% of the general population have evidence of diabetes mellitus
– About 1 in 10 type 2 diabetics have evidence of diabetic nephropathy
Case 1
• Question 2 • Which of the following is the most
appropriate investigation when screening for CKD?
– 24 hr urinary protein – 24 hr urinary albumin excretion – Urinary prot/creat ratio on a spot urine – Urinary alb/creat ratio on a spot urine – MSU with dipstick, spot ACR, microscopy and