Disparities in testing for renal function in UK primary care: cross-sectional study.

Area of Science:

• Nephrology
• Public Health
• Health Services Research

Background:

• Chronic kidney disease (CKD) affects 5.4% of the UK population and is linked to increased mortality, particularly in individuals with diabetes and proteinuria.
• National Service Frameworks and pay-for-performance indicators set quality standards for chronic disease management, including diabetes and CKD.
• CKD is often asymptomatic, necessitating renal function testing for early detection.

Purpose of the Study:

• To investigate the patterns of renal function testing in a large primary care population.
• To examine associations between renal function testing and patient demographics including age, sex, ethnicity, and diabetes status.

Main Methods:

• A cross-sectional survey utilizing routine data from a primary care research network in south-west London (n=220,721).
• Data extracted included serum creatinine, diabetes diagnosis, proteinuria recording, age, gender, and ethnicity.
• Logistic regression analysis was employed to identify factors associated with CKD testing.

Main Results:

• 82.1% of patients with diabetes received renal function and proteinuria testing, compared to less than 0.5% of those without diabetes.
• Women were more likely to have creatinine tests than men, but this varied by age, ethnicity, and diabetes status.
• Older adults (over 75) with diabetes were most likely to be tested. Black and South Asian patients showed higher odds of testing compared to white patients, while ethnicity not stated was the only group not tested more than whites.

Conclusions:

• Significant disparities exist in renal function testing rates for chronic kidney disease (CKD).
• Quality improvement initiatives and equity audits for CKD management must consider these demographic and ethnic variations.
• Ensuring equitable access to CKD testing is crucial for improving patient outcomes and reducing health inequalities.