NICE Releases New Guideline on Early Identification of Chronic Kidney Disease

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Title: NICE Releases New Guideline on Early Identification of Chronic Kidney Disease
URL: http://www.pslgroup.com/dg/22D736.htm
Doctor's Guide
September 24, 2008

LONDON -- September 24, 2008 -- The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Chronic Conditions today published a guideline on the early identification of people with chronic kidney disease (CKD). The guideline sets out how best to identify who has CKD; who is at risk of progression and at risk of serious complications, and how to manage their care.

The guideline recommends offering simple blood and urine tests to individuals at risk of CKD to identify who has the disease as early as possible. This targeted, early identification of CKD will enable prompt advice and treatment, allowing most people to stay healthy. There are specific conditions which the guideline highlights as indicating a risk of CKD. For example, diabetes can damage the kidneys and therefore increases the risk of developing CKD.

The guideline also recommends that physicians provide individuals with high-quality information about the condition, and advises when to refer people already diagnosed with CKD to a specialist. Key recommendations from the guideline include:

• Health professionals should offer people testing for CKD if they have any of the following risk factors: diabetes; hypertension; 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

• Preferential use of the ACR test to identify low levels of protein in the urine indicative of chronic kidney disease, and use of ACR for people with diabetes

• People should be offered an ultrasound scan in specified circumstances including worsening kidney function; blood in the urine; and family history of polycystic kidney disease

• 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. Where any of the following apply, this includes people who: have cardiovascular disease; diabetes; are of African-Caribbean or Asian ethnicity; smoke; take long-term non-steroidal anti-inflammatory drugs (NSAIDs)

• People with CKD should be offered referral to a specialist in specified circumstances including renal failure or severe decrease in kidney function; hypertension despite using at least 4 medicines to control it; and urinary tract obstruction.

"Chronic kidney disease is a potentially dangerous condition, affecting more than 1 in 10 people. People with kidney disease have few or no symptoms until the kidney function is severely impaired, and if it's not recognised, people with the condition may have up to 35 times higher risk of premature death," said Dr. Donal O'Donoghue, National Director of Kidney Care. "It's very easy to detect kidney disease in the early stages with a simple blood test and a urine test for albumin/protein. This NICE guideline on kidney disease will help healthcare professionals identify people in the early stages who can then be treated -- it thus has the potential to delay progression of disease and extend the lives of thousands of people."

Source: National Institute for Health and Clinical Excellence

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