Exclusive GPs should hugely increase their testing and diagnosis of patients with early-stage chronic kidney disease, and include even those with stages 1-2 disease on their registers, the Government’s kidney tsar has said.
Dr Donal O’Donoghue, the Department of Heath’s national clinical director for kidney care, called for GPs to test all patients with structural kidney abnormalities and request a proteinuria test for every urine sample taken.
He said the practice would identify patients with either protein in the urine or reduced kidney function who might be at risk of later stage CKD, and tackle the 40% of patients with CKD who were still not on GP registers.
Dr O’Donoghue, consultant nephrologist at the Salford Royal Hospital, said: ‘It’s worthwhile testing for protein in the urine and keeping a register of patients with stage one or two CKD. But the incentives shouldn’t kick in until CKD stages three to five, after which point the GP actually has to do something.’
Professor Mike Kirby, professor of health and human sciences and a GP in Hertfordshire who help draft the original CKD QOF indicators, said: ‘It’s good medical practice but it would push the registers up quite a bit, which would be more work for no more money.’