The Chronic Kidney Disease: Identification, Evaluation, and Management of Adult Patients guideline provides recommendations for investigating, evaluating, and managing adults aged 19 years or older who are at risk of or with known chronic kidney disease, including care objectives and patient self-management. Specialized management of established chronic kidney disease (e.g., erythropoietic agents for anemia; renal replacement therapy; and treatment of calcium, phosphate, or parathyroid hormone abnormalities) is beyond the scope of this guideline. 

Key recommendations
•    Identify high-risk patient groups for evaluation of chronic kidney disease.
•    Measure both estimated glomerular filtration rate and urine albumin/creatinine ratio for evaluation and prognosis purposes.
•    Determine cause of kidney disease where possible. The three dimensions of cause, estimated glomerular filtration rate, and albuminuria are all important in developing a management plan (new in the 2014 guideline).
•    The word “microalbumin” has been previously used to describe small amounts of protein in urine; however, recent guidelines and consensus recommend abandoning the term and using the albumin/creatinine ratio value instead.
•    In consultation with the patient and family/caregivers, develop an individualized management plan.
•    Ensure timely referral to specialists and health care teams as appropriate.

For the complete listing of BC guidelines, visit www.bcguidelines.ca [9].

Physicians interested in participating in the development of future guidelines and protocols are encouraged to e-mail hlth.guidelines@gov.bc.ca [10]. Physician participation in guidelines and protocols development is compensated at the Doctors of BC sessional rate.