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Chronic kidney disease

A detailed Australian summary of chronic kidney disease, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Classify chronic kidney disease using both estimated GFR and urine albumin-to-creatinine ratio, confirming chronicity for at least three months when appropriate. Investigate reversible causes and review diabetes, blood pressure, cardiovascular risk, obstruction, nephrotoxic exposure and family or systemic disease. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:KHA CKD handbook

The Bottom Line

  • Classify chronic kidney disease using both estimated GFR and urine albumin-to-creatinine ratio, confirming chronicity for at least three months when appropriate.
  • Investigate reversible causes and review diabetes, blood pressure, cardiovascular risk, obstruction, nephrotoxic exposure and family or systemic disease.
  • Persistent haematuria with albuminuria or casts raises glomerular disease and should not be managed as uncomplicated age-related eGFR decline.
  • Reduce progression and cardiovascular risk with smoking cessation, appropriate blood-pressure and renin鈥揳ngiotensin management, and indicated cardiorenal therapy.
sources for this section:KHA CKD handbook

Practical clinical workflow

1

Topic-specific assessment action

Classify chronic kidney disease using both estimated GFR and urine albumin-to-creatinine ratio, confirming chronicity for at least three months when appropriate.
2

Topic-specific diagnostic action

Reduce progression and cardiovascular risk with smoking cessation, appropriate blood-pressure and renin鈥揳ngiotensin management, and indicated cardiorenal therapy.
3

Topic-specific management action

Monitor kidney function, albuminuria, potassium, haemoglobin, mineral-bone parameters and medicine doses at a frequency matched to stage and trajectory.
4

Topic-specific follow-through

Avoid dual ACE-inhibitor and ARB therapy and review NSAIDs, contrast and over-the-counter products at every kidney review.
sources for this section:KHA CKD handbook

Safety boundaries and escalation

  • Seek nephrology advice for rapid decline, heavy albuminuria, resistant hypertension, suspected glomerulonephritis, advanced disease or unexplained electrolyte complications.
  • Give a written acute-illness medicine plan that specifies which medicines to pause, when to seek testing and how to restart.
sources for this section:KHA CKD handbook

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:KHA CKD handbook

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:KHA CKD handbook

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Kidney Health AustraliaChronic Kidney Disease Management in Primary Care5th edition, 2024 路 accessed 2026-08-20
    view source
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