Patients are unaware of CKD in 40% of cases

GPs have been urged to improve communication with patients diagnosed with chronic kidney disease (CKD), after research found that four in 10 patients were unaware they had the condition.

CKD: more communication needed with patients (Photograph: CNRI/SPL)
CKD: more communication needed with patients (Photograph: CNRI/SPL)

Researchers found that GPs were concerned about causing patients anxiety for what is seen as a low-risk condition.

But the DH kidney care czar warned GPs they risk ‘failing our most vulnerable patients’ and breaching moral and legal codes by not telling them about their diagnosis.

Although a register of CKD patients is in the QOF, GPs believe many patients are low-risk and do not require active management, researchers said. This can lead to a lack of communication.

A study led by Dr Maarten Taal of the Royal Derby Hospital examined the management of stage 3 CKD patients in primary care. It found that 41% of 1,741 patients on QOF registers at 32 general practices were unaware of their CKD diagnosis. This was despite two-thirds of patients needing at least one intervention.

The authors said CKD education must improve: ‘High-risk groups, older people and the less well educated should be the focus of these efforts.’

In another study, a research team led by Leeds GP Dr Tom Blakeman of the University of Manchester found GPs and practice nurses were uncertain about the merits of disclosing a CKD diagnosis to the patient. This occurred where vascular risk was low and there were concerns about causing patients excessive worry and ‘medicalisation’.

In a related editorial, Dr Donal O’Donoghue, national clinical director for kidney care in England, and colleagues, said: ‘Some practitioners will have concerns over the stigmatising and anxiety-provoking impact of a CKD label and the greater consultation time required for a complex explanation of the diagnosis.’

But he insisted: ‘We should not forget that physicians have a duty, morally and legally, to disclose truths that patients could reasonably be expected to be told in a sensitive way that they will understand.’

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