Prime minister's blanket CKD test may offer little benefit

GPs should only check at-risk patients for chronic kidney disease (CKD), say UK researchers.

A study has shown little benefit in screening the whole population for CKD, as promised by prime minister Gordon Brown.

The research involved 6,072 patients, admitted to St George's Hospital in London for cardiovascular problems.

All had estimated glomerular filtration rate (eGFR) measured, showing that 17 per cent had CKD between stages 3 and 5. Nine per cent had CKD-related anaemia.

The researchers compared the prevalence of CKD in the at-risk group with the prevalence recorded in studies on general population CKD screening from the US (4.7 per cent), Norway (4.4 per cent) and China (5.2 per cent).

They concluded that screening at-risk patients 'presents an opportunity for identifying new patients with renal dysfunction'.

But they warned against whole-population screening as 'the practicalities and cost-effectiveness remain unclear'.

Since 2006, the GMS quality framework has included a register of CKD patients. GPs earn quality points for measuring eGFR or serum creatinine levels in diabetics, who are considered at high risk of developing CKD.

'Screening for CKD with eGFR would be a bad idea,' said consultant pathologist at Walsall Hospitals NHS Trust Dr Paul Giles said. 'It is bad at separating people with early CKD from normal people because it has a high false-positive rate, the impact of which worsens the less selective the testing.'

sanjay.tanday@haymarket.com

- QJM Online 2008, live links at healthcarerepublic.com

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