What is the programme and its aims?
The number of patients starting renal replacement therapy in England is increasing by 1 per cent  per year, and improvements in the management of chronic kidney disease to reverse this trend are a public health priority. Therefore we are keen to support the adoption of the eGFR surveillance system implemented by Heart of England Foundation Trust and other providers nationally. eGFR surveillance supports the population wide management of chronic kidney disease patients by helping primary care to identify early those patients with declining renal function.

Having demonstrated positive change in one location, the Health Foundation and Kidney Research UK is supporting a national ASSIST-CKD programme to extend and explore the benefits of this system in a wider population. We are a partner to this programme and will be leading work in East Midlands to support implementation.

Why is the programme required?
Late presentation for renal replacement therapy remains an important cause of avoidable harm and premature death. Late presentation for renal replacement therapy is a powerful and modifiable predictor of poor outcome. Consequences of late referral include anaemia and bone disease, low prevalence of permanent access, delayed referral for transplantation, reduced choice of renal replacement modality, worse psychological adjustment to end stage renal disease, longer initial hospitalisation and increased mortality.

Patients with declining kidney but still within stage 3 may not be recognised in primary care and so miss an opportunity to have early specialist care.

Earlier identification of patients with progressive CKD and so at risk of needing dialysis or a kidney transplant allows more time for intervention to preserve kidney function and reduce the rate of decline which delays and for some, avoids altogether the need for dialysis or a kidney transplant.

Who are the partners?
  • Clinical commissioning groups
  • Acute trusts
  • Renal labs
  • Path labs
  • National ASSIST-CKD team

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