QJM Advance Access published online on February 23, 2006
QJM, doi:10.1093/qjmed/hcl029
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1 From the UK Renal Registry, Southmead Hospital, Bristol, UK
* To whom correspondence should be addressed. 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.
Received October 8, 2005
Revised January 2, 2006
Original paper
Current chronic kidney disease practice patterns in the UK: a national survey
A. Ahmad 1 *,
P. Roderick 2,
M. Ward 3,
R. Steenkamp 1,
R. Burden 4,
D. O’Donoghue 5,
D. Ansell 1,
and
T. Feest 1
2 From the Public Health Sciences and Medical Statistics, University of Southampton, Southampton General Hospital, Southampton, UK
3 From the Renal Unit, Freeman Hospital, Newcastle Upon Tyne, UK
4 From the Renal Unit, Nottingham City Hospital, Nottingham, UK
5 From the Department of Renal Medicine, Salford Royal Hospital NHS Trust, Salford, UK
A. Ahmad, E-mail: azhar.ahmad{at}btinternet.com
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