Using estimated glomerular filtration rate (eGFR) to help manage patients with chronic kidney disease

Chronic kidney disease (CKD) has been considered an uncommon condition requiring specialist management. The traditional view of CKD has been of patients with end-stage renal disease (ESRD) requiring dialysis or a kidney transplant as forms of renal replacement therapy (RRT). However the prevalence of CKD is much higher than previously appreciated and this has provided a stimulus to the integration of primary and secondary care to optimise the health of persons with CKD. In particular up to 40% of ESRD patients had been referred to specialists shortly before they needed dialysis. Such late referral often results in increased morbidity and mortality for patients and poor acceptance and planning for RRT.