CKD Questionnaire

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Is Kidney Failure in Your Chronic Kidney Disease(CKD) Future?

  • Posted: 1/13/2013
  • By: Expert Zhang Youkang

Make An Estimation of Your Current CKD. This health checker estimates the risk to develop Kidney Failure and provide some guidance for CKD patients and their families, friends and nursing personnel. Do not forget to leave your email address here or we can not send the illness analyses to you! We agree with personal privacy protection and promise not to reveal your info to anybody.

Patient Information

Provided by Expert Zhang Youkang

Patient Information

1. Are you a CKD patient?

Yes, I have.  No, my friend, relative or patient has.
2. Is the patient male or female?

Male Female
3. The age of the patient?

< 18 18~30 30~45 45~60
4. How long since CKD is found?

< 1year 1~5years 5~10 years No idea
5. What's the creatine level?

0.5-1.2mg/dl 1.2-2.0mg/dl 2.0-4.0mg/dl 4.0-5.0mg/dl Above 5.0mg/dl No idea
6. What's the GFR level? (Not clear, test it now)

90 - 120 mL/min/1.73 ㎡ 60 - 90 mL/min/1.73 ㎡ 15 - 60 mL/min/1.73 ㎡ Below 15 mL/min/1.73 ㎡ No idea
7. What is the renal function?

≥90% 60 - 90 % 15 - 60 % Below 15 % No idea
8. What's the urine output in 24 hours?

Above 2500ml 1500-2500ml 1000-1500ml 400-1000ml Below 400ml Do not know
9. What symptoms the patient has? (click all that apply)

Nausea and vomiting flank pain blood in urine protein in urine high blood pressure increased or decreased urine output increased urination at night others
10. What kind of treatments the patient has received? (click all that apply)

no treatment anti-hypertension medicines immunosuppressive therapy dialysis kidney transplant hormone therapy
11. What cause your CKD like high blood pressure, diabetes?

12. Other information you want to be given?


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Unlike any other charity, we can offer a comprehensive menu of outpatient, hospital-based and Web offerings that enable use to provide the ongoing support for children and families--from diagnosis through the entire medical treatment course. We can help them relieve their pain and manage their illness better.

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