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GPs handed extra CKD work and new proteinuria test

By Nigel Praities

GPs are to be expected to manage increasing numbers of patients with chronic kidney disease in their surgeries and start using a new test for proteinuria.

Final NICE guidance on CKD tightens up referral criteria in a move set to significantly increase GP workload. The guidelines also recommend GPs measure proteinuria in all patients with CKD using the albumin-creatinine ratio, which involves sending samples off for testing.

Dr Steven Kane-Toddhall, a GP and PEC chair of Redcar and Cleveland PCT, said practices would have to get used to ACR testing. ‘This is completely different from what we had to do before, as the receptionist could just take the sample and put it into the analyser – we didn't even have to involve the nurse.

‘People will be sending bottles off for the wrong thing or just being dipstick-tested instead. It is going to be difficult.'

Dr Lawrence Goldberg, nephrology consultant and member of the guideline development group, said the referrals guidance should ‘reassure' GPs about who they should be

managing, but admitted it would increase their workload.

‘A lot of people will not meet these criteria so it will facilitate management by GPs,' he said.

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