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End-stage renal disease is associated with considerable morbidity and a high mortality (UK Renal Registry 2009), as well as affecting quality of life Furthermore, the costs of ESRD are considerable.
In the United Kingdom, the absolute cost per patient is around £30,000 - £35,000 per year for haemodialysis patients, and around £20,000 - £25,000 per year for peritoneal dialysis patients In order to help in the early identification of patients, and enable stratification of risk and management, CKD has been categorised into stages dependent on the e GFR, whether other evidence of kidney damage is present and whether or not there is proteinuria.
Microscopic haematuria is now more aptly termed non-visible haematuria (NVH).
This can be subdivided into symptomatic NVH with the presence of lower urinary tract symptoms, or asymptomatic NVH When screening for haematuria, urinary reagent strips should be used rather than urine microscopy.
A positive HIV test may suggest underlying HIV-associated nephropathy (HIVAN), which may present with renal impairment and proteinuria - and almost exclusively occurs in black people • Renal biopsy.