ESRD

Diagnosis Diagnosis
- When where you diagnosed?
- How many years have you had kidney problem?
- What is the cause of kidney problem?
- Can you tell me how were you diagnosed with CKD? AKI/ pick up on blood test
- What symptoms did you had? Blood in urine/frothy urine, were you not producing any urine or
was it an incidental finding on a blood test?

Possible causes: HTN, DM, GN (SLE, vasculitis), PCKD, Obstruction: Prostate problem/stones
Recent
events
Baseline Urinary symptoms Anaemia
Over the - Frothy urine, oliguria, anuria -fatigue, SOB
years do you Uraemia Fluid overload
develop any - Nausea and vomitting - Leg swelling
symptoms? - Malaise/fatigue - Dyspnoea
- Pruritis - Orthopnea
- PND
Monitoring Clinic
- Who look after your kidney?
- When was your recent clinic day?
- Do you know your baseline creatinine?
- Any protein in the urine when they dip your urine?
- BP reading recently? Measure at home? What is the value?
Treatment & What treatment have you had for your kidney? TRANSPLANT
Complication - How long have you been on dialysis - Are you listed from transplant?
Any plan for transplant in the
HAEMODIALYSIS future?
- How many times per week do they dialyse and how - When was transplant performed?
many hours is each treatment? From live donor or deceased
- What is the patients current access for dialysis (e.g. donor?
an arteriovenous fistula, a PTFE graft, or a - What immunosupression are you
tunnelled dialysis taking?
- catheter)? 1. MMF [mycolat]
- Any issue with the fistula so far? Infection or 2. Tacrolimus (Prograf)
blockage? 3. Prednisolone
- Do you know your BP at the end of session? 4. Septrin/Valganciclovir
BOTH 5. PPI/Ranitine???
How much urine do they pass, if any? - Have you had any rejection
What is their dry (aka flesh, target, post-dialysis) period?
weight? - What mode of dialysis you were
What is their daily fluid allowance? on prior to transplant?
Do they adhere to a renal diet?
Do they receive erythropoietin injections? Who Transplant related
performs these? - Previous skin cancer, blood
Have they always been on the same modality of cancer, cervical cancer
dialysis? - Opportunistic infection: BK
virus, CMV, PCP pneumonia
Are they listed for deceased donor
- Rejection episode?
transplantation?
- hyperPTH
Have they previously received a transplant?
How are they coping with dialysis? ELECTROLYTE ABNORMALITIES
- uric acid: allopurinol
PERITONEAL DIALYSIS
Do you do them overnight or during the day? CARDIOVASCULAR DISEASE
How many exchanges do they perform? - Any heart issue? Chest pain or
How many litres is each exchange? heart attack? pericarditis
Do they need assistance to perform an exchange? - Are you on aspirin or statin
Do they measure their own blood pressure at home? - Fluid overload?
What have the readings been recently?
Is the exit site of their dialysis catheter clean and
dry?
Are the dialysis bags clear or cloudy on drainage?
When was their last episode of peritonitis?
Ever experience any fluid leak?
 RENAL ANAEMIA BONE DISEASE
- EPO injection Bone density affected by your kidney?
- Iron & folic acid Any report of high calcium or low
calcium
- Bone protection: calcium & Vit
D
- Cinacalcet
- Parathyroid sx?
- Phosphate binder [sevelamir]