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Current chronic kidney disease practice patterns in the UK: a national survey

Current chronic kidney disease practice patterns in the UK: a national survey
Current chronic kidney disease practice patterns in the UK: a national survey
Background: There is an increasing focus on improving the detection and management of patients with chronic kidney disease (CKD). Data on CKD prevalence based on population sampling are now available, but there are few data about CKD patients attending nephrology services or how such services are organized.
Aim: To survey services for CKD patients nationally.
Methods: A pre-piloted questionnaire was sent to all 72 renal units in the UK, referring to the situation in June 2004.
Results: Seventy units (97%) responded. The median ratio of prevalent CKD patients/prevalent renal replacement therapy (RRT) patients in the 25 units with data was 3.7 (IQR 2.7–5.7) and the median ratio of CKD stage 4 and 5 patients/prevalent RRT patients was 0.6 (IQR 0.4–1.1). This gives an estimated 140 000 CKD patients under the care of UK nephrologists, with 23 000 at CKD stage 4 or 5 (excluding those on RRT). Very few units had a full complement of the recommended multi-skilled renal team. Counsellors and psychologist were the most common perceived shortages. Of 70 responding units, 50 (74%) were using low clearance clinics for management of advanced CKD patients. Elective dialysis access services often had long delays, with median waiting time for vascular access ranging between 1 and 36 weeks, and for Tenchkoff catheter, between 0 and 12 weeks.
Discussion: CKD patients are a significant workload for UK nephrologists. Current provision of service is variable, and services need to be re-designed to cope with the expected future increase of referral of CKD patients.
1460-2725
245-251
Ahmad, A.
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Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Ward, M.
a199bc96-75b6-415c-bffe-e68e8a00b468
Steenkamp, R.
2747774c-cb75-4ea4-bf5f-fb10a6978ce6
Burden, R.
a0fd4c5a-9df3-4658-8bf8-072e9e0af44b
O'donoghue, D.
d188e25a-314f-41b0-9243-c51e6345a4d9
Ansell, D.
4849c1d3-9ff9-46ac-91e5-b4c6d7a6b52f
Feest, T.
35e86351-7682-448a-817c-759561797c80
Ahmad, A.
2c47be8e-9351-4335-a3e8-148aba31d1a8
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Ward, M.
a199bc96-75b6-415c-bffe-e68e8a00b468
Steenkamp, R.
2747774c-cb75-4ea4-bf5f-fb10a6978ce6
Burden, R.
a0fd4c5a-9df3-4658-8bf8-072e9e0af44b
O'donoghue, D.
d188e25a-314f-41b0-9243-c51e6345a4d9
Ansell, D.
4849c1d3-9ff9-46ac-91e5-b4c6d7a6b52f
Feest, T.
35e86351-7682-448a-817c-759561797c80

Ahmad, A., Roderick, P., Ward, M., Steenkamp, R., Burden, R., O'donoghue, D., Ansell, D. and Feest, T. (2006) Current chronic kidney disease practice patterns in the UK: a national survey. QJM: An International Journal of Medicine, 99 (4), 245-251. (doi:10.1093/qjmed/hcl029).

Record type: Article

Abstract

Background: There is an increasing focus on improving the detection and management of patients with chronic kidney disease (CKD). Data on CKD prevalence based on population sampling are now available, but there are few data about CKD patients attending nephrology services or how such services are organized.
Aim: To survey services for CKD patients nationally.
Methods: A pre-piloted questionnaire was sent to all 72 renal units in the UK, referring to the situation in June 2004.
Results: Seventy units (97%) responded. The median ratio of prevalent CKD patients/prevalent renal replacement therapy (RRT) patients in the 25 units with data was 3.7 (IQR 2.7–5.7) and the median ratio of CKD stage 4 and 5 patients/prevalent RRT patients was 0.6 (IQR 0.4–1.1). This gives an estimated 140 000 CKD patients under the care of UK nephrologists, with 23 000 at CKD stage 4 or 5 (excluding those on RRT). Very few units had a full complement of the recommended multi-skilled renal team. Counsellors and psychologist were the most common perceived shortages. Of 70 responding units, 50 (74%) were using low clearance clinics for management of advanced CKD patients. Elective dialysis access services often had long delays, with median waiting time for vascular access ranging between 1 and 36 weeks, and for Tenchkoff catheter, between 0 and 12 weeks.
Discussion: CKD patients are a significant workload for UK nephrologists. Current provision of service is variable, and services need to be re-designed to cope with the expected future increase of referral of CKD patients.

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More information

Published date: 23 February 2006
Additional Information: QJM Advance Access originally published online on February 23, 2006
Organisations: Community Clinical Sciences, Dev Origins of Health & Disease, Medicine

Identifiers

Local EPrints ID: 24268
URI: https://eprints.soton.ac.uk/id/eprint/24268
ISSN: 1460-2725
PURE UUID: 6e2109ea-18ea-47eb-a365-884203748e96
ORCID for P. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 30 Mar 2006
Last modified: 06 Jun 2018 13:05

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Contributors

Author: A. Ahmad
Author: P. Roderick ORCID iD
Author: M. Ward
Author: R. Steenkamp
Author: R. Burden
Author: D. O'donoghue
Author: D. Ansell
Author: T. Feest

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