Low Clearance Clinic

Low Clearance Clinic (LCC) is a renal clinic for patients with advanced chronic kidney diseases (CKD). Its emphasis is on a patient centric, multidisciplinary approach in managing the myriad medical issues that the patients may face. The main aims of LCC is to optimize CKD management and prevent CKD progression, and to prepare patients for long term renal care plan in the event of reaching end stage renal disease (ESRD). 

The team consists of

1. Renal physicians

2. Renal advanced nurses (APN)

3. CKD programme manager

4. Renal coordinators

5. Medical social workers

6. Dietitians

7. Pharmacists

8. Transplant coordinators

9. Palliative care team

 

The LCC is supported by 

1. PD nurses

2. Befriender service of National Kidney Foundation (NKF)

3. Vascular surgeons

4. Advanced Care Planning (ACP) coordinators

Prior to the actual patient visit to the clinic, the patient’s medical and social issues will be discussed during a Multidisciplinary Round (MDR). A proposed care plan will be established after the LCC MDR discussion with careful considerations of patient and family previous inputs, patient’s medical conditions and psychosocial situation.

At the LCC session, all patients will be reviewed by either a renal physician or renal advanced practice nurse (APN).

They will review patient CKD progression and address any potential CKD complications. They will also discuss with the patient and family about the different long term renal care plans including renal transplant, peritoneal dialysis, haemodialysis and best renal supportive care. Depending on the proposed care plan, patient will be allocated time to see other team members to address specific issues. This provides convenience for patient who will be able to see the different healthcare groups in a single setting. The patient will continue to be followed up by the LCC team until the discharge criteria is reached.

Patient will be discharged from the LCC programme when patient renal function has stabilized or when patient has reached ESRD and the confirmed renal care plan has been completed.