Time to move forward

doi:10.1136/bmj.39273.574479.BE

BMJ 2007;335:111 (21 July), doi:10.1136/bmj.39273.574479.BE

Letters

eGFR and chronic kidney disease

Time to move forward

The first 150 words of the full text of this article appear below.

Giles and Fitzmaurice's arguments are designed to persuade BMJreaders that reporting estimated glomerular filtration rate(eGFR) has introduced a screening programme by the back door,will pressurise specialist services, and cause unnecessary anxietyand harm to patients in terms of getting life insurance andreceiving inappropriate treatment.¹

The marked increase in referrals of patients with newly diagnosedchronic kidney disease is likely to be temporary due to referralof patients with prevalent disease. UK guidelines ensure thatonly patients who will receive added value from a specialistopinion are referred²: most can safely and more efficientlybe managed in primary care.³ Most patients diagnosed as havingchronic kidney disease as a result of eGFR reporting are older,few of whom will take out new life insurance. Angiotensin convertingenzyme inhibitors are indicated only in the presence of hypertension(in the quality and outcomes framework (QOF)), in keeping with. . . [Full text of this article]

C R V Tomson, past chair, Joint Specialty Committee on Renal Medicine of the Renal Association and the Royal College of Physicians¹, E J Lamb, consultant clinical scientist², K Griffith, general practitioner³, D O'Donoghue, national clinical director of kidney care⁴, J Feehally, immediate past president, Renal Association⁵

¹ Renal Medicine, Southmead Hospital, Bristol BS10 5NB, ² Clinical Biochemistry, East Kent Hospitals NHS Trust, Kent and Canterbury Hospital, Canterbury CT1 3NG, ³ University Health Centre, York University, York YO10 5DD, ⁴ Department of Nephrology, Salford Royal Hospital NHS Trust, Hope Hospital, Salford M6 8HD, ⁵ John Walls Renal Unit, Leicester General Hospital, Leicester LE5 4 PW

edmund.lamb@ekht.nhs.uk

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Formula estimation of glomerular filtration rate: have we gone wrong?: Paul D Giles and David A Fitzmaurice
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