Published 1 October 2008, doi:10.1136/bmj.a1618
Cite this as: BMJ 2008;337:a1618

Analysis

Early detection of chronic kidney disease

J Feehally, consultant nephrologist1, K E Griffith, general practitioner2, E J Lamb, consultant clinical scientist3, D J O’Donoghue, national clinical director for kidney care for England4,5, C R V Tomson, consultant nephrologist6

1 University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, 2 Wenlock Terrace Surgery, York, 3 East Kent Hospitals NHS Trust, Canterbury, 4 Department of Health, London, 5 Salford Royal Hospitals Foundation Trust, Salford, 6 North Bristol Hospitals NHS Trust, Bristol

Correspondence to: J Feehally jf27@le.ac.uk

J Feehally and colleagues explain the value of reporting estimated glomerular filtration rate

as part of a comprehensive management

programme for chronic kidney disease

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

The number of patients receiving long term renal replacement therapy in the United Kingdom is growing inexorably and treatment already consumes more than 2% of the total NHS budget. The cost of managing patients who present late in the course of progressive chronic kidney disease, the evidence that progression can be slowed or halted, and evidence that chronic kidney disease is associated with increased risk of cardiovascular disease have focused attention on how to optimise the management of early disease in primary care. Policies and guidelines have been designed to improve the recognition, management, and referral of patients with chronic kidney disease by non-specialists. However, the routine laboratory estimation of glomerular filtration rate (GFR) using the simplified modification of diet in renal disease (MDRD) equation has proved controversial.1 Here we describe the UK policies on identifying and managing chronic kidney disease and address some of the concerns about estimating GFR.

. . . [Full text of this article]


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