Monday, 23 January 2017

UK National Chronic Kidney Disease Audit Results

The first ever National CKD audit produced worrying results for the UK. With 1 in 20 adults having CKD and often no symptoms until it is too late, those at higher risk eg patients with diabetes and high blood pressure, regular blood and and urine tests should be done, and at least annually if not more often. But the recently released National CKD audit found that on average only 54% of people with diabetes have the relevant urine tests, compared to 86% that have blood tests. In some other groups, including those with high blood pressure, it’s less than 30%.

This makes the chance of identifying patients with problems a bit variable to put it mildly. Further findings showed that whilst over 80% of those who have CKD had had a blood test in the previous year, only 31% had a repeat urine test. For people without diabetes, urine testing rates dropped to less than 15%. This is despite recommendations that effort should be focused on regular review. The report authors also urged GPs to review how they record the fact a patient has CKD on their systems as almost a third of confirmed CKD cases were not given the right coding and 1 in 10 people who were coded as having CKD did not have it.

You can read the full report at the Healthcare Quality Improvement Partnership.

For our American readers, GP is short for General Practitioner, the free medical providers available to all UK residents. The vast majority of UK medical care is provided free by the state's National Health Service.

Saturday, 21 January 2017

Kidney dialysis treatment negatively impacts heart function says MRI study

The world’s first MRI study of the effect of kidney disease on heart function shows that the necessary dialysis treatments for those with kidney failure can cause heart damage.

Recent research conducted by the University of Nottingham used magnetic resonance imaging to study the stress placed on patients’ hearts while they underwent kidney dialysis. The study compared the effects of two different types of dialysis on the heart—hemodialysis and hemodiafiltration.

They noted the amount of blood pumped per minute by the left ventricle, as well as how efficiently the muscle could contract, as well as blood flow into the coronary artery, and found that cardiac function suffered while the patient underwent both forms of dialysis, with some recovery after the treatment.

Professor of Nephrology at the University of Nottingham, Maarten Taal, summarized their findings, noting that “All patients showed some degree of left ventricular dysfunction and blood flow to the small capillaries in the heart muscle decreased significantly during both types of treatment.” While the sample size tested was small, 100% of patients’ cardiac function was negatively impacted by the dialysis treatments, raising concern.

But for many patients, dialysis is not something they can casually say no thanks to. That causes even greater problems. More research is required so that doctors can treat chronic kidney disease by dialysis without causing heart problems.

A summary of this report can be read here