A working party report by the Royal College of Physicians and the Renal Association says that, although GPs should be actively involved in CKD management, new roles such as renal GPSIs or consultant community nephrologists are not warranted.
Professor John Feehally, consultant nephrologist at the University Hospitals of Leicester and president of the Renal Association, said: ‘CKD needs champions in primary care, but I don’t think we need to call for GPSIs.’
This is because management of early CKD in primary care largely concerns vascular risk management rather than kidney failure.
Because GP practices are already set up to focus on vascular risk, CKD can be managed alongside diabetes, hypertension and cardiovascular disease, he explained.
But Dr Ian Wilkinson, said: ‘There is a role for having GP champions working at the strategic level but, in terms of service delivery, there is a role for clinicians with a special interest who are based in the community.
‘We know how highly successful that model has been in diabetes.’
Although GPs will be looking at the vascular aspects of CKD, there will also be a need for knowledge of CKD complications in primary care, said Dr Wilkinson.
‘There may be a role around renal anaemia management in primary care,’ he added.
However, the working group report said it should be for consultant renal physicians to provide education and mentoring to primary care teams to help them develop care pathways for CKD patients.