Chronic kidney disease in type 2 diabetes in UK primary care: Testing frequency, coding accuracy and clinical inertia
Authors' conclusion
The study emphasises the need for increased uACR testing and CKD coding in type 2 diabetes mellitus patients to ensure accurate monitoring and management. Fluctuating eGFR/ACR levels and process issues may contribute to clinical inertia. These findings specifically highlight gaps in CKD monitoring and diagnosis, particularly in younger patients and rural settings. We recommend healthcare professionals review coding practices and follow CKD guidelines to improve patient outcomes.
Study context
- Population
- People with T2D with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² on two occasions, two UK primary care settings (urban and rural)
- Outcome
- CKD testing within the past 12 months
- Follow-up
- Past 12 months
Methodological detailstwo primary care settings, SystmOne and the PARM Diabetes tool; Chronic kidney disease (CKD) coding accuracy evaluated per NICE guidelines
- Two primary care settings
- SystmOne and the PARM Diabetes tool; CKD coding accuracy evaluated per NICE guidelines
Main finding
As reported in the abstract
eGFR testing (overall)
77.3%
Urine albumin-creatinine ratio (uACR) testing (overall)
37.6%
Both tests
35%
Both tests, patients under 60 years
28%
Observational data: associations, not effects.
Further findings
Uncoded for CKD among patients with ≥2 eGFR readings <60 mL/min/1.73 m²
- Uncoded, exactly two readings
- 61%
- Uncoded, more than two readings
- 15%
- Coding rates increased with age; did not differ significantly between settings
Original publication
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