Few people are taking a test that can identify those most at risk for serious complications from chronic kidney disease, according to new research.
Chronic kidney disease is a long-term condition where the kidneys don’t work as well as they should and affects 10% to 15% of the general population.
Only a very small number of people (1% to 4%) with chronic kidney disease will progress to kidney failure that requires treatment – dialysis or a kidney transplant.
However, scientists say that using a series of simple blood and urine tests, general practitioners can help identify more people at high risk and refer them to the hospital before they progress to this late stage.
New research led by the University of Glasgow found that few people with chronic kidney disease routinely received this recommended assessment, despite it being recommended by the National Institute for Health and Care Excellence (Nice) in 2021.
The researchers said that many patients and general practitioners remain unaware of the testing’s potential and patients may be missing out on the best treatment.
University of Glasgow researcher and NHS kidney specialist Jennifer Lees said: “Kidney disease is common among adults, but only a small number of people need to see kidney specialists.
“It’s important that all people with kidney disease get the right treatments at the right time, and these blood and urine tests are an easy way to ensure that happens.
“Our research shows that currently few people with kidney disease have their urine tested and therefore may be missing out on the best treatments.”
In 2021, Nice recommended using the Kidney Failure Risk Equation (KFRE), which includes measurement of protein in the urine (albuminuria).
KFRE allows clinicians to define an individual’s risk of kidney failure, allowing those at greatest risk to be referred to specialist care in a timely manner.
The KFRE test is currently available to anyone with stage three chronic kidney disease or worse. However, in this study, the researchers found that the KFRE test is likely only performed on a small minority of those eligible, largely due to a lack of awareness of it.
Researchers estimate that about 75% to 80% of people with chronic kidney disease do not routinely have urine tests for albuminuria and therefore may be missing out on early preventive treatments to reduce their risk of kidney failure, heart disease and death.
For this study, researchers studied over 1.8 million patients at the Secure Anonymised Information Linkage Databank (SAIL), an electronic repository of health records primarily on the population of Wales and around 465,000 UK Biobank participants. .
The Doctor. Michael Sullivan, from the University of Glasgow School of Cardiovascular and Metabolic Health, said: “General practitioners need to identify which patients will benefit most from referral to hospital clinics.
“KFRE is effective in helping general practitioners identify and refer these patients early, before their kidney disease becomes more advanced.
“More kidney disease patients need access to this new tool.
“Our research shows that for this to be possible, more patients need to bring urine samples to their family doctor.”
The article, Potential impact of the Nice guidelines on primary care referrals for nephrology, was published in the British Journal of General Practice.
The work was funded by the Medical Research Council.