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Management of Stage 3 CKD eGFR 30 - 59

Some of these patients may be under long-term renal outpatient follow up and the guidelines apply to both primary and secondary care. Routine follow up options would include blood test for Renal profile and FBC every 6 to 12 months 

Routine management for Stage 2 CKD

The major areas of importance are:

  • eGFR change - check eGFR every 6-12 months if falls by > 5ml/yr or any unexplained fall then routine referral
  • blood pressure control

At least annual check of Hb in stage 3B CKD - if <11 g/dl  EPO may be indicated - check haematinics and if normal consider referral

If BP goals not achieved then consider routine referral
Any new lower urinary tract symptoms consider renal tract ultrasound
Abnormalities of calcium or phosphate metabolism consider referral
Routine immunisation against influenza and pneumococcus
Regular medication review to avoid nephrotoxic drugs if possible

If in doubt then consider  e-Advice

Download Management Guidelines CKD Stage 3