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Letters

How to measure renal function in clinical practice: Estimated glomerular filtration rate in general practice

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7574.918-a (Published 26 October 2006) Cite this as: BMJ 2006;333:918
  1. Jo Richardson, general practitioner (jo.richardson{at}GP-F84710.nhs.uk)
  1. London E14 3BQ

    EDITOR—The introduction of routine reporting of estimated glomerular filtration rate with every serum creatinine requested seems to have led to three outcomes in general practice: worried patients, increased workload, and confused clinicians.1

    Although the national service framework for renal services does not say that estimated glomerular filtration rate should be used as a screening tool for renal disease among unselected patients, but rather should be used to give further information about patients already known to be at risk of renal disease, this is effectively what has happened. In common with other doctors, general practitioners request baseline biochemistry in situations ranging from investigation of symptoms, to “work-up” of known disease, to monitoring of long term illness, and so on. Of the 30 estimated glomerular filtration rates in my practice lablinks inbox recently that originated from unselected patients of varying health, social class, and ethnic origin, 18 were less than 90 (and in only two of these cases was the creatinine outside the normal range) and required further followup. The high risk patients will mostly have had their urine tested already—perhaps we should routinely dip test urine of everyone having blood taken for serum creatinine to avoid the worry of recall.

    Estimated glomerular filtration rate is not a population screening test; no screening test would ever have been introduced without extensive data relating to the performance of the test in the population concerned, and without much clearer information to clinicians.

    Footnotes

    • Competing interests None declared.

    References

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