Table 1. Operating procedures.
| Team member | Intervention |
|---|---|
| Nurse (30 min) | Retrieval of the patient from waiting area |
| Documentation of patient demographic information | |
| Etiology of CKD | |
| Identification of risk factors for CKD progression | |
| Calculation of patient eGFR | |
| Estimation of start RRT and review modality plan if eGFR <20 ml/min per 1.73 m2 | |
| Measurement of vital signs, blood pressure, height and weight | |
| Review of symptoms (uremic, cardiac, respiratory) | |
| List antihypertensive treatment, dosage and frequency | |
| Fluids: evaluation of volemic status | |
| Glycemic control: review ambulatory glycemic record, medications and hypo-hyperglycemic episodes | |
| Anemia: review of symptoms related to anemia; implementation of anemia protocol if necessary | |
| Review of medication, dosage, frequency, interactions | |
| Record blood and urine tests | |
| Review of all recommendations regarding CKD progression, RRT modality plan, treatment goals, blood pressure control, anemia, mineral metabolism | |
| Instructions for routine blood and urine tests, future appointments | |
| Dietician (30 min) | Review of clinic blood work for K+, Ca, PO4, albumin, hemoglobin, uric acid, hemoglobin, cholesterol, triglycerides, HgbA1c targets |
| Anthropometric evaluation; weight changes | |
| Review of dietary habits | |
| Discussion of dietary changes with emphasis on protein, K+, sodium, carbohydrates, PO4, and lipids intake; use of PO4 binders, Vitamin D, and iron supplements | |
| Physician (30 min) | Review of clinic blood work for K+, Ca, PO4, albumin, hemoglobin, uric acid, hemoglobin, cholesterol, triglycerides, HgbA1c targets |
| Evaluation of hypertension, anemia, Ca+, PO4, lipids therapy in an algorithmic fashion | |
| Anemia management recommendations | |
| Assessment of medication adherence and barriers to compliance | |
| Review of all recommendations regarding CKD progression | |
| Review of RRT modality and treatment plan | |
| Request (based on modality plan) vascular access consults, peritoneal dialysis suitability, transplant assessments | |
| Social worker (30 min) | Evaluation of social and economic factors; employment; family support |
| Review of charitable and welfare organizations that provide services to CKD patients |
Abbreviations: CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; RRT, renal replacement therapy.