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Independents' Day

CKD burden to rise

GPs will be expected to take on a large part of the burden of managing anaemia in chronic kidney disease under new NICE guidance.

The guidance, which is strongly targeted at primary care, comes after Pulse revealed experts were advocating an anaemia target for future versions of the QOF.

Dr Paul Stevens, a consultant nephrologist and clinical adviser to the guideline development group, said: 'Part two of the renal national service framework will see the balance of care for patients with chronic kidney disease predominantly in primary care settings.

'The guideline will help GPs understand what's required to provide the best possible services for people with anaemia of chronic kidney disease.'

The guidance says management of anaemia should be considered in CKD stages 3, 4 and 5 with haemoglobin levels of 11g/dl or less. Treatment should aim to keep haemoglobin between 10.5 and 12.5g/dl.

Erythropoiesis-stimulating agents should be offered to people 'who are likely to benefit in terms of quality of life and physical function'.

But GPs are concerned about taking on more specialist work.

Dr Grant Ingrams, a GP in Coventry, said: 'If someone's kidneys are not producing

erythropoietin, you're talking about specialist care.'

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