The Early Impact of the United Kingdom Chronic Kidney Disease (CKD) Guidelines on the Number of New Attendances at Renal Clinics

Abstract

Introduction In April 2006 the United Kingdom (UK) Chronic Kidney Disease (CKD) guidelines and laboratory estimated glomerular filtration rate (eGFR) reporting were introduced to encourage identification and appropriate management of patients with CKD. The aim of this study was to assess the early impact of the implementation of the UK CKD guidelines on new patient attendances at nephrology clinics in our unit. Methods The number of adult new patients, sex, mean age and number in each CKD stage were analysed in consecutive 6 month blocks from 2000 to 2006. Results The number of new attendances gradually rose 2000 to 2006 until an abrupt 48% rise from 333 to 492 patients in the 6 months before and after June 2006. Between the second 6 months of 2005 and second 6 months of 2006 the proportion of females (43.4% to 56.3%; p<0.0001) and mean age (61.3 v 66.4 years; p<0.0001) rose abruptly. The increase was mainly in patients with stage 3B (eGFR 30-44.9ml/min/1.73m2) and stage 4 CKD (15- 29.9ml/min/1.73m2). Discussion The data demonstrate that substantial changes in practice can be implemented rapidly within both primary and secondary care. Further studies will determine if this is going to improve outcome in patients with CKD.