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Kidney disease in primary care Dr James Tang
Description
Episode Summary: In this episode of the General Practice Clinical Sessions podcast, brought to you by My Health Academy, Dr. James Tang shares his expert insights into the early identification, risk stratification, and contemporary management of chronic kidney disease (CKD) in primary care. This session translates specialist knowledge into practical, evidence-based strategies to help general practitioners optimize patient care and slow disease progression.
Guest: Dr. James Tang is a clinician-researcher, an accredited nephrologist, and a transplant physician based at St. Vincent's Hospital in Sydney.
Key Topics Covered in This Episode:
- Defining and Screening for CKD: CKD affects an estimated 10% of the Australian population. Dr. Tang outlines the high-risk groups that require regular screening, including patients with diabetes, hypertension, cardiovascular disease, a history of acute kidney injury, and First Nations Australians.
- Assessment Tools: A complete kidney health check requires evaluating blood pressure, the estimated glomerular filtration rate (eGFR), and the first morning urine albumin-to-creatinine ratio (UACR), as albuminuria is a critical early indicator of kidney disease.
- The "Four Pillars" of Pharmacological Treatment: Dr. Tang details the newest framework for protecting kidney function and reducing cardiovascular risks, which includes:
- ACE inhibitors and ARBs.
- SGLT2 inhibitors (e.g., dapagliflozin and empagliflozin).
- Non-steroidal Mineralocorticoid Receptor Antagonists (MRAs) (e.g., finerenone) for diabetic CKD.
- GLP-1 receptor agonists.
- When to Refer to a Specialist: Guidelines for knowing when to escalate care to a nephrologist, such as a rapid eGFR decline of greater than 50% over three months, an eGFR of less than 30, persistent UACR greater than 30, or refractory hypertension.
- Late-Stage Management: The importance of multi-disciplinary teams in preparing patients with advanced CKD for renal replacement therapy, dialysis, or preemptive transplants.
Continuing Professional Development (CPD): Australian general practitioners can obtain CPD points for listening to this episode through My Health Academy. Myhealth Academy Link: https://lms-academy.myhealth.net.au/login/index.php?tenant=MHAC01
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