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21-03-2012 | Article

GPs urged to inform patients of CKD


Br J Gen Pr 2012; Advance online publication

GPs should be more open to informing patients that they have chronic kidney disease (CKD), in order to optimise their management and avoid missed opportunities to prevent disease progression, say experts.

In a forthcoming CKD-themed issue of the British Journal of General Practice, researchers report that of 1741 patients on a CKD register, 41% were unaware they had it.

Dr Maarten Taal (Royal Derby Hospital) and colleagues found the rate of awareness also varied considerably, from 7-65% across the 32 general practices involved.

Furthermore, a review of the patients' test results indicated that two-thirds needed adjustment to their treatment, with a third requiring improved control of high blood pressure.

Exploring potential reasons for not disclosing a CKD diagnosis, Dr Tom Blakeman and colleagues (University of Manchester) found that concerns about 'medicalisation' and raising anxiety were key barriers to GPs and nurses telling patients about their diagnosis.

Authors of a related editorial comment that, while a reluctance to disclose a diagnosis may be understandable in some circumstances, this diverges from a 'patient-centred' approach.

Led by National clinical director for kidney care Dr Donal O'Donoghue, they argue that in the case of CKD, disclosure provides a platform to discuss lifestyle choices and address vascular risk factors and comorbidities "within a model of collaborative self-management".

"The medico-legal implications of putting patients on a disease register without their knowledge should also be borne in mind," they add.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price