KidneyWise Toolkit

The KidneyWise Clinical Toolkit promotes person-centered and high-quality primary care in chronic kidney disease (CKD) across Ontario. It provides primary care providers with:

• guidance on the identification, detection and management of people with chronic kidney disease in primary care

• guidance on who will likely benefit from a referral to nephrology
• recommendations on identifying people at high risk of developing chronic kidney disease, ordering appropriate tests to confirm diagnosis, and how best to manage the disease to help prevent further progression and reduce cardiovascular risk

What’s in KidneyWise

Clinical Algorithm

• Provides guidance on the identification, detection and management of people with chronic kidney disease
• A print-friendly version that can be used at the point of care

Evidence Summary – Coming soon

• Offers more details and references that were used to develop the toolkit
• Can be used to gain insight on the evidence used for the algorithm

Outpatient Nephrology Referral Form

• Highlights clinical scenarios that may require consultation with a nephrologist
• Can be used as a guide for appropriate referral criteria and applied to your current referral system

Patient Fact Sheets

• Chronic Kidney Disease Fact Sheet to help patients learn more about their kidney health
• Chronic Kidney Disease Fact Sheet for Indigenous Populations and Black People Living in Ontario
• SGLT2i Medications Fact Sheet to provide patients with information on this group of medications

Provider Education – Coming soon

• A set of education slide decks are available for primary care provider education on KidneyWise. A summary deck and a comprehensive deck are available.
• The KidneyWise Medication Access Fact Sheet provides information to primary care clinicians on how to access the medications described in the KidneyWise Toolkit.

What’s New

KidneyWise was updated in 2026 based on new evidence from clinical practice guidelines (e.g., Hypertension Canada, Diabetes Canada, Kidney Disease Improving Global Outcomes) and feedback from clinical providers. The latest version includes the following updates:

• Black people living in Ontario have been identified as a group at high-risk of CKD who should be screened on an annual basis. Other high-risk groups requiring annual screening already identified in previous versions of KidneyWise include people who are First Nations, Inuit, Métis, or Urban Indigenous, and people who have diabetes
• A lower ACR threshold for recommended referral to nephrology has been included for people who do not have diabetes.
• A new section has been included to address incidental CKD detection through common urinalysis tests.
• Recommendations for medications used to manage patients with CKD have been updated. Information on these medications have been added:
  • sodium glucose contransporter-2 inhibitor (SGLT2i)
  • non-steroidal mineralocorticoid receptor antagonists (MRA)
  • glucagon-like peptide-1 receptor agonists (GLP-1 RA)

Additional Resources

• Medication Safety List – Find a list of medications commonly prescribed in primary care that should be avoided or dose-adjusted for people with chronic kidney disease
• eConsult – Do you have questions about your patient that you would like to ask a nephrologist? Sign-up for the Ontario eConsult Program and ask one of the 40+ nephrologists registered. Feedback on the program has been very positive from referring healthcare providers, specialists and patients. Visit econsultontario.ca to learn how to make eConsult a regular part of your practice.

Acknowledgements

KidneyWise has been vetted and endorsed by nephrologists and primary care providers within Ontario and across Canada. The toolkit will be reviewed regularly to ensure that it reflects the latest evidence.