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Paper of the day - most in care homes have undiagnosed CKD

Over 80% of people in UK care homes have CKD of at least stage 3, although only five per cent have been diagnosed with kidney disease, suggests a study carried out last year.

Researchers studied 250 residents selected randomly from 155 residential care homes in east Kent from March to November 2006. Using the Modification of Diet in Renal Disease (MDRD) equation, 18% had stage 4A CKD, 34% stage 3B and 10% stage 4. Only 5% were previously known to have kidney disease.
The authors say that many of these patients will be very frail, with multiple medical problems and often cognitively impairmed. Reducing their CV risk by using antihypertensives and statins could do more harm than good.
But - as a minimum - attention should be paid to the risks of prescribing renally excreted or nephrotoxic drugs in these patients, they conclude.

Nephrology Dialysis and Transplantation 2007 19 November early online publication

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