Most chronic kidney disease is found on a blood test, not because someone feels unwell – and most of it is managed in general practice rather than by a kidney unit. Done properly that means the right two tests on schedule, tight blood pressure control, and a medication list reviewed against your kidney function.
What we look after
- Chronic kidney disease at every stage, including working out whether a low eGFR is real, new or long-standing
- The two conditions that cause most of it – diabetes and high blood pressure
- Protein in the urine, and what to do about it
- Medication review against kidney function, including the common over-the-counter tablets that quietly make it worse
- The complications that come with reduced function – anaemia, bone and mineral problems, potassium, acidosis
- Cardiovascular risk, which in kidney disease is the thing most likely to cause harm
- Referral to a kidney specialist at the right point, with the work-up already done
What gets monitored
- eGFR from a blood test and urine albumin-to-creatinine ratio (ACR) – these two together give the stage, and the ACR is the one most often left off the request form. Both are needed.
- Blood pressure – at every visit and at home. This is the single biggest lever on how fast kidney function declines, and 24-hour blood pressure monitoring is available here when the readings do not add up.
- HbA1c where you have diabetes – see diabetes care.
- Electrolytes, particularly potassium and bicarbonate, and a full blood count for anaemia.
- Calcium, phosphate and vitamin D as function falls.
- Cholesterol and overall cardiovascular risk, reassessed regularly.
- Your medicine list, checked against your current eGFR – doses change as function changes, and some things are best stopped.
Pathology is on site, so the bloods and urine can be done at the practice and the results come straight back to your doctor.
Things that quietly make it worse
Anti-inflammatory tablets bought without a prescription are the most common avoidable cause of kidney decline we see. Dehydration during a vomiting or diarrhoea illness is the second, particularly when usual tablets are continued through it. Bring everything you take to your appointment, including anything from a supermarket, a chemist shelf or a health food shop, and ask your doctor what to do with your medicines on a day when you are unwell and not keeping fluids down. That conversation is worth having before you need it.
Your care plan
The way Medicare funds this changed on 1 July 2025. The old GP Management Plan and Team Care Arrangement were replaced by a single GP Chronic Condition Management Plan. If you already had a plan under the old system it still counts; it simply moves across at your next review.
What that means in practice:
- You are eligible if you have at least one condition that has lasted, or is likely to last, six months or more. There is no official list of qualifying conditions – it is your doctor’s clinical judgement.
- One plan now covers both the management plan and the referrals to other health professionals.
- The plan needs to be written or reviewed within the last 18 months for you to keep access to the rebated allied health visits.
- With a current plan you can claim up to five individual allied health visits per calendar year (ten for Aboriginal and Torres Strait Islander patients) – for example a dietitian, podiatrist, diabetes educator, physiotherapist or exercise physiologist.
- You can also have up to five services from a practice nurse on your doctor’s behalf.
- If you are registered with us through MyMedicare, your plan is written here, at the practice you are registered with. If you are not registered, your usual GP can still write it.
Care plans and their reviews are bulk billed at Health Nexus. There is no out-of-pocket cost for writing the plan or for reviewing it.
For kidney disease the allied health visits usually go to a dietitian – potassium, phosphate, salt and protein all matter, and generic healthy-eating advice is not the same thing.
Much of the monitoring and recall work is done by the practice nursing team alongside your doctor. The nurses run the checks that are due, keep the recalls on schedule and prepare the review so that your appointment with the doctor is spent on decisions rather than data entry. It is also why the reviews actually happen – the most common reason chronic disease care fails is that the review is never booked.
What to expect
Book a long appointment. Bring home blood pressure readings if you take them, every medicine and supplement, and any results or letters from elsewhere. If you have had kidney function tested before, even years ago, say so – the trend over time tells your doctor far more than a single number.
The doctors
All of the doctors who work from Health Nexus manage long-term conditions. Several have substantial hospital experience behind them:
- Dr John Esho – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals, including cardiology and nephrology; internal and general medicine
- Dr Arsalan (Sam) Mahmud – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals; general and emergency medicine, and continues to work in acute care
- Dr Asim Razak – chronic disease, cardiovascular and respiratory conditions
- Dr Sai Tip – chronic disease, respiratory medicine
- Dr Miyulasi Attanayake – chronic disease, diabetes, hypertension, asthma and COPD
- Dr Nadia Khan – chronic disease, diabetes and hypertension
- Dr Nalika Hendawitharana – chronic disease, preventive health
Fees and Medicare
Health Nexus Launceston is a mixed-billing practice. Children aged 12 and under are bulk billed whenever the practice is open, including evenings and weekends. Pension card holders over 65 and DVA Gold Card holders are bulk billed on weekdays between 8am and 5pm. Everyone else pays the consultation fee with the Medicare rebate claimed on the spot. The current fees are on the fees and bulk billing page.
The practice is open 8am–8pm Monday to Friday, 8am–5pm Saturday and 9am–5pm Sunday, every day of the year, and on every public holiday at the standard hours for that day.
Common questions
My eGFR came back low. Does that mean kidney failure?
Usually not. A single low reading can be caused by dehydration, an illness or a recent medicine, and eGFR also falls gradually with age. What matters is whether it is confirmed on repeat testing, whether there is protein in the urine, and which way the trend is going. That is what the next appointment is for.
Why do I need a urine test as well as a blood test?
Because they measure different things. The blood test gives filtration rate, the urine albumin-to-creatinine ratio shows whether the kidneys are leaking protein. You can have significant kidney disease with a near-normal eGFR and an abnormal ACR, so leaving the urine test off misses it.
Do I need to see a kidney specialist?
Many people never do. Referral is guided by how low the function is, how fast it is falling, how much protein is in the urine, and whether the cause is unclear. Your doctor will refer you when those thresholds are met, with the work-up already done so the appointment is useful.
Is the care plan bulk billed?
Yes. Care plans and their reviews are bulk billed here, and a current plan gives you Medicare-rebated visits to a dietitian.
Can I still take pain relief?
Some options are fine and some are not, and it depends on your kidney function. Ask your doctor rather than guessing – this is the most common way people damage their kidneys further without realising.
