Renal Disease: Chronic Kidney Disease

sec_arr Chronic Kidney Disease (CKD) Fitness for Duty Criteria
SECTIONS

Chronic kidney disease (CKD) fitness for duty criteria

Stages 1 and 2 (defined as eGFR>60 ml/min)

  • With albuminuria < 30 mg albumin/g creatinine 
    • No restrictions needed
  • With albuminuria > 30 mg albumin/g creatinine
    • Restrictions are dependent on the results of the tests listed below
    • Annual report from nephrologist with GFR, CBC, comprehensive metabolic panel (CMP), parathyroid hormone (PTH), vitamin D, phosphate
    • Imaging stress test (nuclear or stress echocardiogram) to at least 12 METs every 2 years (this is a consensus of the Public Safety Medicine Task Group)
    • Cognitive testing (see Appendix B) every 2 years or if there is a significant change in GFR

Stage 3

  • Stage 3a (eGFR 46-59 cc/min)
    • Restrictions are dependent on the results of the tests listed below
    • Annual report from nephrologist with GFR, CBC, comprehensive metabolic panel (CMP), PTH, vitamin D, phosphate
    • Imaging stress test (nuclear or stress echocardiogram) to at least 12 METs every 2 years (this is a consensus of the Public Safety Medicine Task Group)
    • Cognitive testing (see Appendix B) every 2 years or if there is a significant change in GFR
  • Stage 3b (eGFR 31-45 cc/min)
    • Restrictions are dependent on the results of the tests listed below. Impaired physical status is likely
    • Annual report from nephrologist with GFR, CBC, comprehensive metabolic panel (CMP), PTH, vitamin D, phosphate
    • Imaging stress test (nuclear or stress echocardiogram) to at least 12 METs every 2 years (this is a consensus of the Public Safety Medicine Task Group)
    • Cognitive testing (see Appendix B) every 2 years or if there is a significant change in GFR

Stage 4 (eGFR 15-29 cc/min)

  • The law enforcement officer (LEO) will require restrictions due to the risk of sudden incapacitation, cognitive impairment, and impaired physical status (see Appendix C).

Stage 5 (eGFR<15 cc/min)

  • The law enforcement officer (LEO) will require restrictions due to the risk of sudden incapacitation, cognitive impairment, and impaired physical status (see Appendix C).