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About KidneyWise

The KidneyWise Toolkit 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 that can be used at the point of care
  • An evidence summary with more details on the clinical algorithm
  • An outpatient nephrology referral form outlining clinical scenarios that may require primary care providers to request consultation with a nephrologist

Acknowledgements

KidneyWise has been vetted and endorsed by nephrologists and primary care providers within Ontario and across Canada. The tool will be reviewed and updated every 2 years, as needed.

Development was led by these provincial medical leads at the Ontario Renal Network:

  • Dr. Allan Grill, MD, CCFP, MPH, Provincial Primary Care Lead
  • Dr. Scott Brimble, MD, MSc, FRCPC, Provincial Lead for Early Detection & Prevention of Progression

Guidelines Referenced to Develop KidneyWise

Levin A, Hemmelgarn B, Culleton B, Tobe S, McFarlane P, Ruzicka M, et al. Guidelines for the Management of Chronic Kidney Disease. CMAJ [Internet].2008 Nov [cited 2018 May 10]; 179(11): 1154-1162.

Collins AJ, Vassalotti JA, Wang C, Li S, Gilbertson DT, Liu J, Foley RN, Chen SC, Arneson TJ. Who Should Be Targeted for CKD Screening? Impact of Diabetes, Hypertension, and Cardiovascular Disease. Am J Kidney Dis 2009 Mar 53(S3): S71-S77.

Kidney Disease Improving Global Outcomes [Internet]. CKD Guidelines; 2012. [Cited 2018 May 11].

Tangri B, Stevens L, Griffith J et al. A Predictive Model for Progression of Chronic Kidney Disease to Kidney Failure. JAMA [Internet]. 2011 Apr 11. [Cited 2018 May 10]. 305(15): 1553-9.

Acedillo RR, Tangri N, Garg AX. The kidney failure risk equation: on the road to being clinically useful? Nephrology Dialysis Transplantation [Internet]. 2013 July [cited 2018 May 10]; 28(7): 1623-4.

Kidney Disease Improving Global Outcomes [Internet]. Clinical Practice Guideline for Lipid Management in CKD; 2013. [Cited 2018 May 11].

Nerenberg KA, Zarnke KB, Leung AA, Dasgupta K, Butalia S, McBrien K et al. Hypertension Canada's 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children. Canadian Journal of Cardiology. [Internet]. 2018 May [cited 2018 May 10]; 34 (5):506-525.

Canadian Diabetes Association [Internet]. Clinical Practice Guidelines; 2018. [Cited 2018 May 11].

A Randomized Trial of Intensive versus Standard Blood-Pressure Control. The SPRINT Research Group. N Engl J Med. 2015 Nov 373: 2103-2116.

Zia A, Kamaruzzaman SB, & Tan MP. Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk. Postgrad Med 2014 Dec 127(3): 330-7.

Ruzicka M, Edwards C, McCormick B, Hiremath S. Thus Far and No Further: Should Diastolic Hypotension Limit Intensive Blood Pressure Lowering? Curr Treat Options Cardio Med 2017 Sep 19 (10):80.

Public Health Agency of Canada [Internet]. Toronto: For Health Professional Flu (Influenza) [cited 2018 May 15].