Nr | Definition and classification |
---|---|
1a | Percentage of patients with a GFR <60 ml/min/1.73 m2 for 3 months, diagnosed with CKD (= diagnosis of CKD present in the problem list of the EMR) |
1b | Percentage of patients with a GFR < 60 ml/min/1.73 m2, in whom no other measurement was found, who were tested within 3 months |
 | Screening and diagnosis |
2 | Percentage of patients with hypertension, diabetes mellitus, chronic NSAID use or a history of heart- and blood vessel disease, in whom eGFR and albuminuria is determined once a year |
 | Management: Follow-up |
3 | Percentage of patients with CKD with a GFR ≥ 60 ml/min/1.73 m2 , whose eGFR is tested annually |
4 | Percentage of patients with CKD with a GFR between 30-59 ml/min/1.73 m2, who are tested every six months |
5 | Percentage of patients with CKD with a GFR between 15-29 ml/min/1.73 m2,who are tested every three months |
6 | Percentage of patients with CKD, in whom the GFR, albuminuria and total protein is determined at least once a year |
7a | Percentage of patients with CKD with: - macroalbuminuria or - microalbuminuria in combination with an eGFR <60 or - eGFR < 45 ml/min/1.73 m2 in whom serum potassium (on a fresh blood sample), calcium, phosphate, PTH and bicarbonate levels, and Hb is measured at least once a year. |
7b | Percentage of patients with CKD with macroalbuminuria or microalbuminuria and eGFR <60 or eGFR < 45 ml/min/1.73 m2 and an increased PTH, in whom vitamin D is measured at least once a year. |
7c | Percentage of patients with CKD with macroalbuminuria or microalbuminuria and eGFR <60 or eGFR < 45 ml/min/1.73 m2 and a reduced Hb, in whom ferritin and transferrin saturation is measured at least once a year. |
 | Management: Vaccination |
8 | Percentage of patients with CKD who are vaccinated with an influenza vaccine annually |
9 | Percentage of patients with CKD who are vaccinated with a pneumococcal vaccine |
10 | Percentage of patients with CKD with progressive disease (= increasing proteinuria and/or decreasing eGFR) who are vaccinated with a hepatitis B vaccine |
 | Treatment CKD |
11 | Percentage of patients with CKD , who are encouraged to undertake physical activity compatible with cardiovascular health and tolerance (aiming for at least 30 minutes 5 times per week), to stop smoking and obtain or maintain a healthy weight (BMI 20 to 25; waist circumference ≤ 94 cm in men or ≤ 80 cm in women) and to limit alcohol intake |
12 | Percentage of patients with CKD with a normal albuminuria (<30mg/g or <30 mg/24hours) and an office blood pressure consistently >140 mm Hg systolic or >90 mm Hg diastolic, who are treated with blood pressure-lowering drugs to maintain a blood pressure that is consistently ≤140 mm Hg systolic and ≤90 mm Hg diastolic |
13 | Percentage of patients with CKD with a strongly increased albuminuria (> 300 mg/g or > 300 mg/24 hours) or moderately increased albuminuria (30-300 mg /g or 30-300 mg / 24 hours), who are treated with an ARB or an ACE inhibitor |
14 | Percentage of patients with CKD with an albuminuria ≥300 mg/g creatinine (or ≥300 mg/24 hours or proteinuria ≥0.5 g/24 hours), who are treated by increasing ACE inhibitor or ARB dosage if the maximum dose has not yet been reached. |
15 | Percentage of patients with CKD in whom a one-time lipid profile (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides) is determined |
16 | Percentage of patients with CKD with - proteinuria ≥1 g/day or - diabetes mellitus or - strongly increased albuminuria (ACR >300 mg/g creatinine or >300 mg/24 hours) or - ACR ≥700 mg/g in whom the target BP of < 130/80 mmHg (SBP range 120 - 129 mmHg) is achieved by using the first choice antihypertensive drugs (ACE inhibitors or ARBs) |
17 | Percentage of patients with CKD with a reduced serum bicarbonate (<20 mmol / L), who are treated with oral bicarbonate to keep the serum bicarbonate level within the normal range |
18 | Percentage of patients with CKD with a vitamin D deficiency (<15 ng/ml), who are substituted with vitamin D |
 | Medication and safety of the patient |
19 | Percentage of patients with CKD with a RAAS blocker or spironolactone treatment, in whom potassium level and GFR are measured before initiating this therapy and controlled within 1 week after initiation and after each dose increase |
20 | Percentage of patients with CKD who need an examination with contrast medium and of whom no recent value (last 12 months) of eGFR is known, in whom eGFR is determined |
21 | Percentage of patients with CKD with a GFR < 30 ml/min./1.73m2, in whom metformin is avoided/ is not prescribed |
22 | Percentage of patients with CKD with a GFR < 30 ml/min/1.73 m2, in whom bisphosphonate treatment is avoided/ is not prescribed |
23 | Percentage of patients with CKD with a GFR < 60 ml/min/1.73 m2, in whom oral phosphate-containing bowel preparations are avoided/ are not prescribed |
24 | Percentage of patients with CKD who are referred to a specialist, and for whom the referral letter includes active diagnosis of CKD and renal function |
 | Referral to a specialist |
25 | Percentage of patients with a GFR <30 ml/min/1,73 m2 , who are referred to a specialist |
26 | Percentage of patients with CKD with hypertension who do not respond to medical treatment with 4 or more antihypertensive drugs, who are referred to a specialist |
27 | Percentage of patients with CKD who are pregnant or are planning pregnancy, who were referred to a specialist |
28 | Percentage of patients with CKD with: - a chronic eGFR <30 ml/min./1,73 m2 - an eGFR between 30-45 ml/min./1,73 m2 and ACR >200 mg/g for men or 300 mg/g for women , and/or proteinuria >1000 mg/24h or a protein-creatininratio (PCR) > 1 000 mg/g who are referred to a specialist for inclusion in a care program |
29 | Percentage of patients with a confirmed significant albuminuria (ACR ≥300 mg/g or AER ≥ 300 mg/ 24 hours), who are referred to a specialist |
30 | Percentage of patients with hematuria in combination with proteinuria (urine protein ≥0.5 g/day or PCR ≥500mg/g or ACR ≥ 300 mg/g creatinin), who are referred to a specialist |
31 | Percentage of patients with progression of CKD (confirmed decline in GFR category accompanied by a 25% or greater drop in eGFR from baseline or a sustained decline in eGFR of more than 5 ml/min/1.73 m2 /year), who are referred to a specialist |
32 | Percentage of patients with persistent microscopic hematuria of unknown origin, who are referred to a specialist |
33 | Percentage of patients with persistent serum potassium abnormalities (potassium <4.0 mmol / l or potassium >5.5 mmol / l ), who are referred to a specialist |
34 | Percentage of patients with recurrent or extensive nephrolithiasis, who are referred to a specialist |
35 | Percentage of patients with hereditary kidney disease, who are referred to a specialist |
36 | Percentage of patients with an arteria renalis stenosis, who are referred to a specialist |