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CKD Monitoring Referral Guidance NICE — ESENeph MCQ

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EasyChronic Kidney DiseaseCKD Monitoring Referral Guidance NICEESENeph

A 45-year-old man with CKD G3b from IgA nephropathy has stable eGFR 35 and proteinuria 0.3 g/day on maximal supportive care. He asks how often he needs to see his nephrologist. According to NICE CG182, what is the recommended referral and monitoring guidance for CKD G3b?

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Correct answer: B — CKD G3bA2 warrants nephrology referral consideration; monitoring at least 2-3 times per year with eGFR and uACR; NICE CG182 recommends referral for accelerating decline, ACR ≥70, or complications

NICE CG182 provides specific referral and monitoring guidance based on CKD stage and risk category. CKD G3b warrants at least 2-3 eGFR and uACR measurements per year. Referral to nephrology is recommended for: eGFR <30 (G4-5), ACR ≥70 mg/mmol, accelerating eGFR decline (>5 mL/min/year or >25% decline in 12 months), uncontrolled hypertension despite ≥4 agents, suspected rare/genetic cause, or complications requiring specialist input. This patient with G3bA1 from known IgAN who is stable may be managed with shared care between nephrology and primary care.

Reference: NICE CG182 2014 (updated 2023) – CKD