Person—end-stage renal disease status (diabetes complication), code N

DSS specific information:

To determine chronic renal impairment: -

Glomerular filtration rate (GFR)
GFR > 90 ml/min normal
GFR > 60 - 90 ml/min: mild renal impairment
GFR > 30 - 60 ml/min: moderate renal impairment
GFR 0- 30 ml/min: severe renal impairment
For greater than 3 months.

In general, patients with GFR < 30 ml/min/1.73 m2 are at high risk of progressive deterioration in renal function and should be referred to a nephrology service for specialist management of renal failure.
Patients should be assessed for the complications of chronic renal impairment including anaemia, hyperparathyroidism and be referred for specialist management if required.

Patients with rapidly declining renal function or clinical features to suggest that residual renal function may decline rapidly (i.e. hypertensive, proteinuric (>1 g/24 hours), significant co-morbid illness) should be considered for referral to a nephrologist well before function declines to less than 30 ml/min. (Draft CARI Guidelines 2002. Australian Kidney Foundation).
Patients in whom the cause of renal impairment is uncertain should be referred to a nephrologist for assessment.

End-stage renal disease is a recognised complication of Type 1 and Type 2 diabetes mellitus. Diabetes is the commonest cause for renal dialysis in Australia.

The term end-stage renal disease has become synonymous with the late stages of chronic renal failure. Diabetic nephropathy may be effectively prevented and treated by controlling glycemia and administering angiotensin-converting enzyme (ACE) inhibitors. J Am Soc Nephrol 2002 Jun; 13(6): 1615-1625].

DSS specific information:

To determine chronic renal impairment: -

Glomerular filtration rate (GFR)
GFR > 90 ml/min normal
GFR > 60 - 90 ml/min: mild renal impairment
GFR > 30 - 60 ml/min: moderate renal impairment
GFR 0- 30 ml/min: severe renal impairment
For greater than 3 months.

In general, patients with GFR < 30 ml/min/1.73 m2 are at high risk of progressive deterioration in renal function and should be referred to a nephrology service for specialist management of renal failure.
Patients should be assessed for the complications of chronic renal impairment including anaemia, hyperparathyroidism and be referred for specialist management if required.

Patients with rapidly declining renal function or clinical features to suggest that residual renal function may decline rapidly (i.e. hypertensive, proteinuric (>1 g/24 hours), significant co-morbid illness) should be considered for referral to a nephrologist well before function declines to less than 30 ml/min. (Draft CARI Guidelines 2002. Australian Kidney Foundation).
Patients in whom the cause of renal impairment is uncertain should be referred to a nephrologist for assessment.

End-stage renal disease is a recognised complication of Type 1 and Type 2 diabetes mellitus. Diabetes is the commonest cause for renal dialysis in Australia.

The term end-stage renal disease has become synonymous with the late stages of chronic renal failure. Diabetic nephropathy may be effectively prevented and treated by controlling glycemia and administering angiotensin-converting enzyme (ACE) inhibitors. J Am Soc Nephrol 2002 Jun; 13(6): 1615-1625].

DSS specific information:

To determine chronic renal impairment: -

Glomerular filtration rate (GFR)
GFR > 90 ml/min normal
GFR > 60 - 90 ml/min: mild renal impairment
GFR > 30 - 60 ml/min: moderate renal impairment
GFR 0- 30 ml/min: severe renal impairment
For greater than 3 months.

In general, patients with GFR < 30 ml/min/1.73 m2 are at high risk of progressive deterioration in renal function and should be referred to a nephrology service for specialist management of renal failure.
Patients should be assessed for the complications of chronic renal impairment including anaemia, hyperparathyroidism and be referred for specialist management if required.

Patients with rapidly declining renal function or clinical features to suggest that residual renal function may decline rapidly (that is, hypertensive, proteinuric (>1 g/24 hours), significant co-morbid illness) should be considered for referral to a nephrologist well before function declines to less than 30 ml/min. (Draft CARI Guidelines 2002. Australian Kidney Foundation).
Patients in whom the cause of renal impairment is uncertain should be referred to a nephrologist for assessment.

End-stage renal disease is a recognised complication of type 1 and type 2 diabetes mellitus. Diabetes is the commonest cause for renal dialysis in Australia.

The term end-stage renal disease has become synonymous with the late stages of chronic renal failure. Diabetic nephropathy may be effectively prevented and treated by controlling glycemia and administering angiotensin-converting enzyme (ACE) inhibitors.

References:

Draft CARI Guidelines 2002. Australian Kidney Foundation

J Am Soc Nephrol 2002 Jun; 13(6): 1615-1625].