Researchers cast doubt on Gordon Brown's universal kidney screening plan

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

Gordon Brown
Gordon Brown

Study findings have shown little benefit in screening the whole population for CKD, as recommended by prime minister Gordon Brown earlier this month.

The latest 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 of these patients also had CKD related anaemia.

The researchers then 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).

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

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

Since 2006, GPs on the GMS contract have produced a register of CKD patients. GPs are also rewarded three points for measuring eGFR or serum creatinine levels in diabetics, who are considered at high risk of developing CKD.

Dr Paul Giles, a consultant pathologist at Walsall Hospitals NHS Trust, said: ‘Screening for CKD with eGFR would be a very bad idea.

‘It works quite well to stratify people with known CKD but it is very bad at separating people with early CKD from normal people because it has a high false positive rate, the impact of which gets worse the less selective the testing,' he added.

sanjay.tanday@haymarket.com

QJM: International Journal of Medicine

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