CKD patients at risk in eGFR test shortfall

Thousands of patients may have been put at risk, and payments to practices skewed, because of patchy availability of the chronic kidney disease (CKD) test used in the quality framework.

The eGFR test to determine the severity of a patient's CKD was added to the quality framework in 2006/7. The test boosts detection and treatment of patients at an early stage of CKD, and can pinpoint late-stage CKD patients who need dialysis, helping to cut emergency admissions.

But many laboratories had not adopted the test in time for 2006/7. GP leaders believe regional variations in availability of the test are to blame for low prevalence across the UK.

Scotland's prevalence as reported in quality data for 2006/7 is 1.8 per cent, compared with 2.2 in England and 2.3 in Northern Ireland.

GP leaders say the lower figure for Scotland is unrealistic, and reflects the slower roll-out of eGFR testing facilities compared with the rest of the UK.

National clinical director for kidney services Dr Donal O'Donogue said: 'The delay in implementing eGFR tests could explain low prevalence.'

Clinical data from other sources indicated actual prevalence of 5-7 per cent, he said.

Early detection of CKD improves outcomes for patients, Dr O'Donogue said. Patients in areas where eGFR arrived late may have been denied optimum treatment.

A lack of test facilities also affects practices' quality pay. The 27 CKD points are worth £3,500 to an average practice, but high or low prevalence could significantly alter the value of these points.

Lanarkshire LMC agreed compensation for practices because eGFR tests were not available in the region until the fourth quarter of 2006/7.

GPC chairman Dr Laurence Buckman called for similar actions by primary care organisations where eGFR tests were not available.

Comment below and tell us what you think

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in