Anaemia guidance is ‘missing patients'

NICE guidance on detecting anaemia in chronic kidney disease (CKD) could miss significant numbers of cases, say UK researchers.

The NICE guideline, published in October 2006, advises screening for CKD-linked anaemia only in patients with an eGFR below 60ml/min/1.73m2.

But data from the Teesside Anaemia Study suggests that almost one patient in 10 with an eGFR above 60ml/min/1.73m2 has anaemia.

The study focused on 234 patients, aged an average of 62 years, selected from the district register who completed a questionnaire and gave a blood sample for anaemia testing.

Overall, 14.5 per cent of patients had a haemoglobin level below 12g/dl, indicative of anaemia. Of these, 41 per cent had a previous diagnosis of anaemia.

But while anaemia affected 25 per cent of patients with an eGFR below 60ml/min/1.73m2, indicating CKD stages three to five, it was also diagnosed in 9.5 per cent of those with better renal function.

Presenting the findings at the Diabetes UK annual professional conference in Glasgow last week, lead researcher Dr Steve Jones, an expert in diabetic nephropathy at the James Cook University Hospital in Durham, said: ‘60 per cent of people on a district register have an eGFR of 60–90.’

But among this patient group anaemia ‘would not be detected under current screening strategies,’ he added.

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