Renal & Nephrology Pathways

KDIGO-based AKI assessment, staging, and management including nephrotoxin review and RRT indications

CKD staging, cardiovascular and renal risk reduction, anaemia, and referral thresholds

Diagnosis and management of nephrotic syndrome including biopsy indication and complication management

Indications for renal replacement therapy and modality choice in AKI and CKD

Acute Pyelonephritis clinical pathway.

KDIGO 2021 — recognise nephritic syndrome, RPGN red flags, immunology screen, biopsy indications, treatment of pauci-immune / anti-GBM / lupus / IgA / post-infectious.

Long-term management in CKD/HF — dietary, drugs, potassium binders to enable RAAS continuation.

European guidelines — assess severity + symptoms, classify by volume status + urine osmolality + sodium, avoid rapid correction (osmotic demyelination).

Differentiate parathyroid vs malignancy, IV fluids + bisphosphonates, denosumab, treat cause.

KDIGO 2017 — assess Ca, phosphate, PTH, vitamin D, vascular calcification; phosphate binders, vitamin D analogues, calcimimetic, parathyroidectomy.

Recognise acute rejection — biopsy diagnosis (cellular vs antibody-mediated), treatment, infection prophylaxis.

Class III/IV (proliferative) and class V (membranous) — induction with MMF or cyclophosphamide, maintenance, hydroxychloroquine, belimumab/voclosporin.

Annual albuminuria screen, RAAS blockade, SGLT2i + finerenone, glycaemic + BP optimisation, plan for renal replacement.

Diagnosis (Pei-Ravine criteria), risk stratification (Mayo class), tolvaptan, cardiovascular & extra-renal complications.

Recognise FMD vs atherosclerotic, role of revascularisation (CORAL trial), medical therapy.

Anti-PLA2R, primary vs secondary, KDIGO risk-based therapy (rituximab/cyclophosphamide+steroid/calcineurin inhibitor).