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Department of Health issues edict on kidney tests

By Nigel Praities

The Department of Health has written to all GPs, PCTs and laboratories to insist the new albumin-creatinine test is used for all patients with chronic kidney disease.

The edict follows a Pulse investigation in January revealing widespread concerns over the introduction of ACR testing, which nephrologists said was being used by only a quarter of GPs.

Some PCTs were continuing to recommend that GPs use the cheaper protein-creatinine test, despite clear guidance from NICE that ACR testing was now the preferred option for measuring levels of proteinuria.

The DH guidance explains the basis for use of ACR ahead of PCR, insisting its sensitivity is greater and that it can be used to standardise results and measure disease progression.

A new QOF indicator for proteinuria is due to come into force next month, but to add to the confusion over CKD testing, this offers the choice of ACR or PCR testing.

The Government's renal tsar, Dr Donal O'Donoghue, said ACR was now the recognised test and that GPs using PCR for patients should change their testing method at the next patient check-up.

‘The evidence from NICE is quite clear about the advantages to using ACR and I think these are due to quality of care, which over time translate into a financial gain.

‘I would be disappointed if PCTs were directing GPs on the basis of cost, which is small in comparison compared with potential costs and impact of CKD,' he said.

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