GPs could face greater CKD management role

GPs across the UK may have to take on a bigger role in management of chronic kidney disease (CKD), say experts.

The quality framework currently rewards GPs with up to 27 points for identifying and treating patients with CKD stages 3–5.

But experts at a two-day consensus meeting hosted by the Royal College of Physicians of Edinburgh (RCPE) this week discussed current guidelines and whether GPs needed to do more for patients with CKD stages 1–3.

Specifically, they considered whether these patients should be given treatments to reduce their known vascular risk.

As an estimated 10 per cent of the UK population has early CKD, this could result in an increase in the number of scrips for antihypertensives and statins which, the RCPE says, may ‘place greater pressure’ on GPs.

Dr Stuart Rodger, a consultant nephrologist in Glasgow and lead organiser of the RCPE conference, said: ‘Obviously, if you apply that to 10 per cent of the population, there’ll be huge cost implications.’

Outcomes from the conference are likely to influence the current UK CKD guidelines by the Renal Association, and the group developing CKD guidelines for NICE will be paying ‘considerable attention’, he said.

‘There’s a strong feeling that the [current] guidelines are not right,’ he said. ‘The UK CKD guidelines that are out are going to change.’

The conference will also consider whether patients with early CKD should be treated to prevent severe renal failure developing.

Dr Ian Wilkinson, GPSI in renal medicine in Oldham, Lancashire, said: ‘The general feeling is that, for CKD stages 1, 2 and 3, we should be looking at it as a cardiovascular risk factor.’

CKD treatment

  • GPs may have to treat patients with CKD stages 1–3.
  • Treatment to reduce vascular risk may need to be given.
  • Prevention of progression to renal failure may be needed.
  • The quality framework includes management of CKD stages 3–5.

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