This presentation will explore the ways in which Quality Requirements One and Two of the Renal NSF (Part Two) (2005) can be implemented at local level. Quality Requirement One of the Renal NSF Part Two recommends that people at increased risk of CKD or those with undiagnosed CKD are identified, assessed and their condition managed. Quality Requirement Two recommends that people with CKD should receive timely, appropriate and effective investigation, treatment and follow-up to reduce the risk of progression and complications.

The benefits and challenges of managing CKD in the community through collaboration with primary care teams will be presented. The speaker has been working with primary care teams in south-west London since early 2004, and this paper is based on her experiences. Issues to be explored will include:

• Challenges of identifying patients with early diabetic kidney disease
• Managing microalbuminuria in collaboration with practice nurses and general practitioners
• Patient perspectives on diabetic nephropathy
• Introducing eGFR in primary care>
• Developing a strategic approach to working with primary care teams