NICE guidance issued last week says GPs should consider anaemia in patients with CKD stage 3 to 5 if they had haemoglobin levels of 11g/dl or less. A third of patients with stage 5 CKD have anaemia, as do around 9 per cent with stage 4 disease.
GPs should look for anaemia and refer where appropriate but they will not be expected to initiate treatment to ensure patients have a stable haemoglobin level of 10.5–12.5g/dl.
South London GP Dr Penny Ackland, who helped draw up the guidance, said that it and the CKD quality indicators, would improve diagnosis and management of anaemia in CKD.
Although the guideline would not pose a significant burden for GPs at the moment, primary care is likely to play an increasing role in the diagnosis and management of CKD, said Dr Ackland. She did not think the quality indicators for CKD would need to change.
Oldham GP Dr Ian Wilkin-son, who has an interest in renal disease, said because it is in the quality framework, primary care management of CKD co-morbidities was likely to increase.
‘Once people are involved in CKD management, there is a tendency to move to anaemia and even bone mineral management,’ he said. ‘Even initial case finding can certainly improve the quality of these patients’ lives.’
