Kidney disease in primary care Dr James Tang

Episode Summary: In this episode of the General Practice Clinical Sessions podcast, brought to you by My Health Academy, Dr. James Tang shares his expert insights into the early identification, risk stratification, and contemporary management of chronic kidney disease (CKD) in primary care. This session translates specialist knowledge into practical, evidence-based strategies to help general practitioners optimize patient care and slow disease progression.Guest: Dr. James Tang is a clinician-researcher, an accredited nephrologist, and a transplant physician based at St. Vincent's Hospital in Sydney.Key Topics Covered in This Episode:Defining and Screening for CKD: CKD affects an estimated 10% of the Australian population. Dr. Tang outlines the high-risk groups that require regular screening, including patients with diabetes, hypertension, cardiovascular disease, a history of acute kidney injury, and First Nations Australians.Assessment Tools: A complete kidney health check requires evaluating blood pressure, the estimated glomerular filtration rate (eGFR), and the first morning urine albumin-to-creatinine ratio (UACR), as albuminuria is a critical early indicator of kidney disease.The "Four Pillars" of Pharmacological Treatment: Dr. Tang details the newest framework for protecting kidney function and reducing cardiovascular risks, which includes:ACE inhibitors and ARBs.SGLT2 inhibitors (e.g., dapagliflozin and empagliflozin).Non-steroidal Mineralocorticoid Receptor Antagonists (MRAs) (e.g., finerenone) for diabetic CKD.GLP-1 receptor agonists.When to Refer to a Specialist: Guidelines for knowing when to escalate care to a nephrologist, such as a rapid eGFR decline of greater than 50% over three months, an eGFR of less than 30, persistent UACR greater than 30, or refractory hypertension.Late-Stage Management: The importance of multi-disciplinary teams in preparing patients with advanced CKD for renal replacement therapy, dialysis, or preemptive transplants.Continuing Professional Development (CPD): Australian general practitioners can obtain CPD points for listening to this episode through My Health Academy. Myhealth Academy Link: https://lms-academy.myhealth.net.au/login/index.php?tenant=MHAC01 -------------------------------------------------------------------------------If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.It's the same education, without interrupting your life.GPs can also earn CPD hours.Earn Educational Activity (EA) CPD without sacrificing time with your family.Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).Earn Reviewing Performance (RP) CPD without sacrificing time with your family.After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.Remember to document your learning!Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.To claim MO, you need:A baseline measurementA change in practiceA re-measurementReflection on the outcome1. Identify a measurable change. After the podcast, ask:“What will I do differently on Monday?”Example:Start using a screening toolChange prescribing habitsIncrease documentation of a risk factor2. Measure your baseline (quick audit). Do a small, realistic auditExamples:Review last 10 patients with condition X% who had guideline-based management% with documented counselling3. Implement the change. Apply the idea from the podcast for 2–4 weeksCould be as simple as a checklist, template, or reminder4. Re-measure. Repeat the same audit:Same sample sizeSame criteria5. 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