U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Tuesday, October 21, 2014

Division of Diabetes Treatment and Prevention - Leading the effort to treat and prevent diabetes in American Indians and Alaska Natives


Quick Guide Cards

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  • Algorithm Cards (1 of 2)
  • [PDF - 45KB / PDF - 229KB]

Why is this important?

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NOTE: Access to this information is not restricted; however, the information found here is intended for use by medical providers. Some videos contain graphic images. Patients should talk with their medical providers about any specific concerns.

 

Important Resources

  • Quick Reference on UACR and eGFR Exit Disclaimer: You Are Leaving www.ihs.gov – Describes the two key markers for kidney disease, urine albumin and estimated glomerular filtration rate (eGFR).
  • Patient Education Videos Exit Disclaimer: You Are Leaving www.ihs.gov – Short videos demonstrating patient-provider interactions around common CKD questions. Topics include CKD and risk, treatment, testing and diagnosis, and dialysis and transplantation.
  • Early CKD detection/treatment decreases development of kidney failure 30-70%.
  • Screen, diagnose, monitor and treat CKD complications.
  • Early preparation for kidney replacement therapy (transplant, dialysis) improves outcomes.

Quick Facts

  • Screen all patients with type 2 diabetes yearly:
    • Creatinine/eGFR (estimated Glomerular Filtration Rate).
    • UACR (Urine Albumin to Creatinine Ratio).
  • Dx CKD: ≥3 mos duration of either:
    • decreased function - eGFR <60 mL/min/1.73 m2 or
    • evidence of damage - UACR ≥30 mg/g or other.
  • BG and BP control (ACE inhibitor/ARB) decreases CKD progression.
  • R/O potential causes of CKD not related to type 2 diabetes.
  • eGFR <60 mL/min/1.73 m2: monitor/treat CKD complications:
    • Acidosis
    • Anemia
    • CVD
    • Edema/fluid overload
    • Metabolic bone disease
    • Uremia
  • Monitor patients more closely if:
    • Amount of albuminuria is high (e.g., UACR >1000 mg/g) or
    • Rate of albuminuria increases rapidly.
    • Nephrology referral:
      • If unsure of cause of CKD (e.g., renal biopsy needed).
      • Difficulty controlling complications of CKD.
      • Usually once eGFR <30 mL/min/1.73 m2.
      • Rapid progression of CKD.
Overview How To Other Resources

Division of Diabetes Treatment and Prevention | Phone: (505) 248-4182 | Fax: (505) 248-4188 | diabetesprogram@ihs.gov