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Published on: January 30, 2020
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United Kingdom guidelines for chronic kidney disease
1Department of Clinical Biochemistry, East Kent Hospitals NHS Trust, Canterbury, Kent, UK. edmund.lamb@ekht.nhs.uk
Summary
Early identification and management of chronic kidney disease (CKD) are crucial for improving patient outcomes and reducing healthcare costs. Proactive CKD strategies in the UK aim to detect the condition earlier, benefiting patients and the National Health Service (NHS).
Area of Science:
- Nephrology
- Public Health Policy
- Healthcare Management
Background:
- Most patients initiating renal replacement therapy (RRT) have advanced chronic kidney disease (CKD), suggesting missed opportunities for earlier detection and intervention.
- End-stage renal disease (ESRD) treatments are costly, representing over 2% of the UK National Health Service (NHS) budget, highlighting the economic imperative for early CKD management.
- Improving early CKD identification and management is a public health priority in the United Kingdom.
Purpose of the Study:
- To review the UK's strategies for enhancing the early identification and management of chronic kidney disease (CKD).
- To assess the impact of national initiatives on CKD detection and referral practices.
- To inform future clinical guidelines for CKD care.
Main Methods:
- Review of UK national policies and guidelines for renal services, including the National Service Framework (NSF) for Renal Services.
- Analysis of initiatives promoting estimated glomerular filtration rate (eGFR) reporting and primary care physician incentives (Quality and Outcomes Framework - QOF).
- Examination of quality assurance processes, such as the UK National External Quality Assessment Scheme (UKNEQAS) for eGFR harmonization.
Main Results:
- National strategies have been implemented to improve CKD identification, including standardized eGFR reporting and financial incentives for primary care.
- Efforts have been made to harmonize eGFR reporting across the UK to ensure consistent data.
- New clinical guidelines from the National Institute for Health and Clinical Excellence (NICE) are anticipated to further guide CKD management.
Conclusions:
- The UK has actively pursued policy and practical changes to improve early detection and management of chronic kidney disease (CKD).
- These initiatives aim to optimize patient outcomes and reduce the significant economic burden associated with advanced kidney disease.
- Continued focus on guideline implementation and quality assurance is essential for sustained improvements in CKD care.
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