Renal tract.

Abstract

Chronic kidney disease (CKD) affects 850 million people worldwide1 and an estimated one in 10 adult Australians (2.4 million people).2 At the bottom of the 'CKD iceberg', one in three adult Australians is at risk of CKD.2 At the tip of the iceberg, over 26,000 Australians are currently receiving kidney replacement therapy with dialysis or transplantation.3 The burden of kidney disease is particularly high in Aboriginal and Torres Strait Islander peoples, with critical gaps in access to kidney care, particularly transplantation.4 There is much more to be done to address the burden of CKD in our community, as outlined in a recently published national strategy.5 Thankfully, Australians have been mostly spared the large additional burden of significant kidney failure due to COVID-19 that will have long-term implications for kidney disease care in other countries.6 In April 2021, AJGP focused on chronic kidney disease management. [...]all episodes of AKI, even if renal function is fully recovered, should spark medication review, the development of management plans for future episodes of intercurrent illness and ongoing monitoring for CKD. Thia and Saluja provide a framework for evaluating pain arising from the renal tract and managing kidney stones, which are the most likely culprit.10 Finally, O'Connor et al clarify current approaches to haematuria in general practice, with a focus on identifying those at most risk of malignancy or underlying kidney disease.11 A key practice point is that all these clinical presentations provide an excellent opportunity for the general practitioner to engage with the patient about their kidney health and identify those at risk of CKD.