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GP's warning over CKD misdiagnosis

Use of estimated glomerular filtration rates can misdiagnose patients with chronic kidney disease even after repeat testing, GPs are being warned.

A GP in Portsmouth raised the alarm after finding one of his patients had been twice wrongly identified as having CKD stages 3-5.

Dr Bernard Klemenz became suspicious after an apparently healthy 54-year-old woman had eGFRs measured at 43 and 49ml/min respectively in two separate tests.

Dr Klemenz ran a full 24-hour glomerular filtration rate, which recorded a rate of 88ml/min – well within the normal range.

He said: 'It's quite worrying really. People of 80 or 90 years old obviously have reduced renal function, but someone who's 50?

'We want to know what's going on – do we need to look at all these people?'

Dr Klemenz's finding reflects growing unease in primary care with eGFR and its inclusion last year in the quality and outcomes framework.

As well as the frequent need for retesting, reports have suggested simple factors such as

diet and fluid intake can artificially suppress eGFR.

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