INFORMATION RESOURCES ON KIDNEY DISEASE AND SERVICES
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National policy and guidelines
The government has set out its strategy for kidney care in The National Service Framework (NSF) for Renal Services:
NSF part one: Dialysis and Transplantation (January 2004)
This focuses on patients with end stage renal disease (ESRD) and the subsequent renal replacement therapy (RRT) that they need. This treatment can either augment kidney function (dialysis) or replace it (transplantation). It is anticipated that in England treatment rates for renal failure will increase by at least 50%; this is largely due to the ageing population structure but increases are also expected amongst black and minority ethnic groups.
Part one outlines five standards that the NHS will need to be delivering by 2014 (10 years after the report was published).
NSF part two: Chronic Kidney Disease, Acute Renal Failure and End of Life Care (February 2005).
This looks at how renal failure can be prevented, primarily by the efficient identification and management of both chronic kidney disease (CKD) and acute renal failure. End of life care for people with renal failure is also considered. People with diabetes and/or hypertension have a greater risk of developing CKD. Because of this, people of South Asian, African or African Caribbean origin are at high risk of CKD; the former due to higher levels of diabetes in their community, whilst the latter two experience higher levels of hypertension. The close relatives of someone with ESRD have a higher risk of developing CKD.
Part two details four quality requirements that are designed to improve the general health experience of people with renal disease:
NICE guidelines on the “Early identification and management of chronic kidney disease in adults in primary and secondary care”
The National Institute for Health and Clinical Excellence (NICE), working with the National Collaborating Centre for Chronic Conditions, has produced guidance on how best to achieve early identification of both individuals with CKD and also those who are at the greatest risk of progression. Advice on managing their care is also provided.
The Renal Association Clinical Guidelines
The Clinical Practice Guidelines Committee prepares guidelines for the renal community in the UK. The guidelines provide a template for the management of patients with kidney disease in the UK including guidance for CKD, RRT and management of cardiovascular disease in CKD.
SIGN guidelines on ‘Diagnosis and management of chronic kidney disease; A national clinical guideline.’
Produced by the Scottish Intercollegiate Guidelines Network (SIGN). This guideline covers three main CKD areas;
- Risk factors e.g. diabetes, smoking and hypertension
- Diagnostic measures e.g. urine and blood test and imaging
- Treatment methods for preventing progression e.g. managing high blood pressure drug therapy and behaviour change
Quality and Outcomes Framework (QOF)
Introduced in April 2004, QOF is a voluntary system that rewards general practices for providing ‘quality care’; it has a very high participation. Practices are required to produce disease registers for various chronic conditions. In April 2006 CKD stages 3-5 was included in QOF, along with targets for measuring blood pressure and treating hypertension (if applicable) amongst patients with CKD stages 3-5.
Saving lives, valuing donors: A transplant framework for England
As well as its two-part National Service Framework for Renal Services, the government has also published Saving lives, valuing donors: A transplant framework for England (July 2003).
“This document sets out key aims for organ and tissue transplantation over the next 10 years. It describes good practice based on national and international evidence which the Government believes the NHS and society can use together to save lives and maximise the benefits of organ and tissue transplantation”.
The more recent 2008 Organ Donation Taskforce document ‘Organs for Transplants’ sets out some recommendations on how a rise in organ donation could be achieved in the UK.
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PAGE CREATED: 28 November 2008 | PAGE REVISED: 3 November 2010