A practical guide to diagnosis and assessment of chronic kidney disease for the non-nephrologist

Chronic kidney disease (CKD) is common. People with CKD have a wide range of comorbidities and, therefore, the majority of non-nephrologists will care for people with CKD. This paper aims to provide a brief overview of the diagnosis and management of CKD for the non-nephrologist. Identifying those with CKD and optimising treatment is essential as CKD has a direct association with adverse patient outcomes. There are modifiable factors where interventions may delay progression of CKD, including: smoking cessation, dietary advice, hypertension management, renin-angiotensin system blockade, glycaemic control and relieving urinary outflow obstruction. Complications, such as renal anaemia, metabolic acidosis, CKD-related mineral bone disease, hyperkalaemia and gout, are best managed in conjunction with nephrology input. The progression of CKD is often variable and nonlinear, but person-centred intervention can delay progression of CKD, reduce morbidity and mortality, and allow time for preparation for renal replacement therapy, ultimately providing the best possible personalised care.