I read with interest your article on eGFRs (GP, 26 May).
I agree that excluding patients on the basis of age would be unethical, I also feel that it is unethical to label patients as chronic renal disease and put them on a renal register on the bases of an eGFR.
I can find no evidence that eGFRs have been validated in the elderly.
The renal register states that patient with stage 3 renal disease (GFR <60ml/min) should be on a renal register, but an eGFR is not an accurate way of measuring this.
I discussed this with consultant nephrologist from Norfolk and Norwich Hospital. He suggested that eGFRs should not be done on patients with normal creatinine (124mu mol/l should be put on a renal register. I feel that this as a practical solution, avoiding worrying elderly patients with normal stable creatinines unnecessarily.
I would appreciate Dr Donal O'Donaghue's opinion on this.
Dr Ciara Killeen, GP principal and former specialist registrar in nephrology.