Clinical Audit Activity - CKD - Case study

This case study provides feedback on the effectiveness of the access, use and best practice guidelines contained in the CKD Health Pathways.

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Pathway: Chronic Kidney Disease Case Study 1

Mary (aged 63 years) has been your patient for 2 years; she is an ex-smoker and has hypertension, which is managed well with Amlodipine that she takes regularly. She also has a history of recurrent UTI and strong FH of Diabetes. She attends to get scripts for her medication.

Case Study 1 continued

Mary returns after a week to discuss her results, which shows eGFR 55ml/min/1.73m2 and normal albuminuria. Her BP is 120/75mm of hg. You advise her that she needs to have her tests repeated in 3 months. At her next review, her results show eGFR 52ml/min/1.73m2 and normal albuminuria.

Case Study 2

Robert (aged 52 years) is a truck driver, who is diabetic and currently on metformin 1gm/day. His BMI is 46.0 and he often misses his chronic disease review appointments due to his work schedule. He is attending today for a flu jab and you notice his last bloods that were done 3 months ago, show HbA1c- 8.5 and his eGFR 42ml/min/1.73m2 (dropped from 44ml/min/1.73m2 6 months ago) and no urine albumin results are available for last 12 months. You impress upon Robert that it is important that the tests are repeated and additional ones performed. At his review in a week his eGFR I 40ml/min/1.73m2 and he has microalbuminuria present, his HbA1c is now 8.8.

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