Exclusive: More CKD quality markers

Testing for proteinuria and albuminuria could be added to a future cardiovascular risk programme, says DoH renal czar Dr Donal O'Donoghue.

The best way of guaranteeing these checks are done is by making them the responsibility of GPs and adding them to the quality framework, he told GP.

'The data would seem to suggest that albuminuria and proteinuria are good risk factors for cardiovascular disease,' explained Dr O'Donoghue.

'It may be that some time in the future proteinuria is added to cardiovascular screening. It should be done in those aged 45 or older.'

There are currently four of a total of 27 chronic kidney disease (CKD) quality points for prescribing angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.

But there are concerns about side-effects of the drugs in patients with controlled BP who have low risk of renal failure.

'The solution might be to block the angiotensin-renin system if patients have proteinuria,' said Dr O'Donoghue.

'That would be good practice but there would be problems getting that to be universal.'

Inclusion in the quality framework could only happen when all GPs had easy access to these services, he said.

In the latest review of the quality framework for 2008/9, the Renal Association and Royal College of Physicians (RCP) put forward proposals for a proteinuria dipstick test to be added to the quality framework.


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