Patient with persistant elevated Cr or proteinuria [A]
Obtain history, physical examination and laboratory tests [ B ]
Emergent, Urgent condition? [C] Refer / stabilize as indicated
Assess kidney function [D]
Perform diagnostic workup [E]
Acute exacerbation of established renal disease? [ F ] Treat as indicated or consult
Is SCr > 4 or eGFR < 25 or symptoms of chronic kidney failure? [G]
Consult/confer with nephrologist [I]
Discuss future need for KRT[J]
Is SCr > 2 or GFR < 50 or nephrotic range proteinuria or questionable etiology ? [H]
Consult/confer with nephrologist [I]
Discuss future need for KRT[J]
Manage primary etiology : HTN, DM, GN, UTO,PCKD, HIV,HCV,RVD,MM [K]
Initiate strategies to slow the progression of the disease [L]
Prevent and treate symptoms and complications [M]
Prevent and treat cardiovascular disease [N]
Provide patient education [ O ]
Follow-up [P]