Criteria/rules for diagnosis of CKD 2

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I'd be interested to hear from anyone who has found out about the condition by accident or who had a diagnosis based solely on a blood test which showed a GFR below 90 without evidence from further tests. .  I have just found out by accident that a hospital has given me a diagnosis of CKD stage  2 no proteinuria  based solely on my  blood test codes which have shown a GFR between 60 and 90 since 2011. My GP didn’t mention it to me at all. I  have just queried it with the GP and have been told  that the current GFR of 61  is normal for my age (53) and isn’t a problem because my tests for creatinine, potassium (all wastage functions)  etc. are normal. The GFR has fluctuated but has never been  below 60.  They don’t have a diagnosis of CKD on my records because of this.

Is it common for a diagnosis of CKD  to be made just on a blood test by a different department? I  don’t know whether to be angry with the GP for not telling me or the hospital for diagnosing without actual evidence of damage to the kidney. I was told that the 'diagnosis' will remain on my hospital records due to blood test codes.

I have been told that most people over  50  have a GFR under 90 so, without further tests, this would give a lot more people a diagnosis of CKD 1/2

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  • Posted

    Hi, yes you're spot on, there is no treatment for a GFR in the 60 range and a lot of doctors will not recognize kidney disease until it drops below that threshold, strictly speaking you are obviously in stage 2 but for your age a GFR that is slightly reduced is quite normal, some people don't actually get symptoms until it drops to 30 or below, whereas others can be borderline stage 3 and feel unwell, each individual is different i guess.

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    • Posted

      Thanks! So why does a hospital record that someone has CKD without an interpretation from an experienced doctor ? It is irresponsible to shock a patient who has no symptoms.
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    • Posted

      If your urine shows blood and or protein with a GFR below 90, CKD will be diagnosed but there is no treatment until it drops below 60, the symptoms of anaemia and waste build up  often doesn't show until stage 3 or lower, in fact some people have been close to failure yet have dismissed symptoms as they were still quite well in general. Nephrologists tend not to offer treatment unless the GFR drops to 30 or below

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    • Posted

      It sounds dangerous to wait until it is below 30! I wonder whether some patients with a GFR between 30 and 60 aren't told about it. As I said to Helen, this could be risky. i bet an insurer wouldn't pay out even if the doctor hadn't told the patient. I wish my GP practice allowed me to view test results online. i only have the latest one.

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  • Posted

    Hi,

    A GFR is only a best guess that is why creatinine levels are more accurate.  A GFR can flucuate depening on medication, what you have been doing before the test and lots of other factors.  Your kidney function also drops with age.  CKD can be diagnosed off a blood test all they have done is looked at your GFR and matched it against the CKD stages table which runs from 1 to 5 (which is end stage).  You are lucky enough to have got results for the rest of your tests.  I would suggest having the bloods repeated in a year and see where things stand.  At the moment though I would not worry I know this is easier said than done.  Take care.

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    • Posted

      Hi Helen  

      I am actually seeing a nephrologist in January following haematuria after 2 UTI's in september. No protenuria. It's not at the same hospital which  gave the CKD label.   I know that kidney function drops with age but that suggests that relying on the blood tests would label virtually all over 50's with CKD!  Surely a GFR of 61 in someone under about 40-45 would be considered more serious?  I just wonder how many older people have CKD and their doctors aren't telling them. If someone went on holiday and failed to declare this to an insurer (because the GP hadn't told them), they could lose money if taken ill on holiday. I brought this up with the GP who said that I currently don't have a diagnosis of CKD in their records.

      Are you  a doctor or a patient with CKD?  

       

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