The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Chronic Conditions have published a guideline which will help save lives of people with chronic kidney disease (CKD).
The guidelines recommend that health professionals should offer people testing for CKD if they have any of the following risk factors: diabetes; high blood pressure; cardiovascular disease; disease in the renal tract, kidney stones or an enlarged prostate; systemic diseases which may affect the kidneys; a family history of kidney failure; blood or protein in the urine discovered opportunistically. In the absence of the above risk factors, age, gender or ethnicity should not be used as markers to test people for CKD.
The report also recommends preferential use of the ACR1 test to identify low levels of protein in the urine indicative of chronic kidney disease, and use of ACR for people with diabetes. Patients should be offered an ultrasound scan in specified circumstances including worsening kidney function; blood in the urine; and family history of polycystic kidney disease.
In addition, health professionals should work with people who are more likely to have progressive kidney disease to maintain the best possible health, and check their kidney function regularly. This includes people who: have cardiovascular disease; diabetes; are of African- Caribbean or Asian ethnicity; smoke; take longterm non-steroidal anti-inflammatory medicines (NSAIDs) which are often used for arthritis and other causes of chronic pain.
People with CKD should be offered referral to a specialist in specified circumstances including renal failure or severe decrease in kidney function; high blood pressure despite using at least four medicines to control it; and urinary tract obstruction.
