Almost half of over-60s with chronic kidney disease may be undiagnosed, according to new research.
In response to the findings, a lead author suggested there ‘could be value’ in checking kidney function in patients with conditions such as hypertension or diabetes.
Primary care researchers in Oxford have found that the prevalence of CKD in people aged over 60 is around 18% and that almost half of these patients would be undiagnosed without screening.
The study, published in the British Journal of General Practice, recruited a total of 3,207 patients aged 60 or above from primary care. Patients were either classified as already having a CKD diagnosis or they underwent a screening assessment to determine their eGFR and ACR results.
They found that just over 300 patients already had a diagnosis, and just under 250 received a diagnosis via the screening assessment, corresponding to 10% and 8% of the whole cohort respectively.
This put the prevalence of CKD within the study population at 18%, with 44% of diagnoses occurring as a result of screening. The researchers suggested that without screening, almost half of the patients would not otherwise have known about their condition.
They said in the paper: ‘This suggests that the early stages of CKD (stages 1–3b) may be under-reported in the literature as many people are unaware that they have the condition. In the UK, some of these people will be picked up in the NHS Health Check Programme.
‘However, only 43% of those invited for an NHS Health Check are reported to attend, and it is likely that many non-attenders will be those most at risk.’
Dr Jennifer Hirst, primary care researcher at the University of Oxford, commented: ‘Although widespread screening of all patients is unlikely to be cost effective, there may be value in checking kidney function in people living with other health conditions such as hypertension or diabetes. This will be established through long-term follow-up of this cohort.
‘Missed diagnoses may, over the long term, lead to an undetected decline in kidney function or untreated hypertension, potentially leading to an increase in GP consultations and referrals, if patients develop end-stage kidney disease or other health problems.’