Monday 20 December 2010

Health Survey England confirms CKD is common and shines a light on proteinuria

Health Survey England, commissioned by NHS Kidney Care, included kidney disease as a special topic for the first time this year. It recognises CKD as a global health problem and the link with stroke and heart attack. On the face of it, the headline figure of 5% of men and 7% of women having stage 3-5 chronic kidney disease (Fig 3C) might not seem that interesting. These levels are what we might expect from previous epidemiological work. But Health Survey England is the first large community based study of CKD in the English general population and also provides the first comprehensive study of proteinuria which we now know affects 10% of men and 8% of women (Fig 3D). Overall, 14% of men and 13% of women were found to have reduced kidney function or proteinuria (Fig 3E).

Looking at the data from primary care we know that 4.3% of the adult population are on CKD registers. So the Health Survey England report that only 1.5% of men and 1.3% of women have been told by their doctor that they have kidney CKD means that only one third of those on CKD registers have been counselled or involved in their own CKD care.

Elsewhere in Health Survey England report, personal care plans have been enquired about. Overall, about 16% of those with long term conditions have a care plan. The majority of those have received their care plans in the last 12 months. Two thirds of those with a care plan participate actively in the management of their condition. Less then one third of those without a care plan are actively involved in self care.

Other worrying information from Health Survey England shows that hypertension affects 32% of men and 29% of women of whom 46% and 57% respectively are on treatment but only 26% of men and 32% of women with hypertension have controlled blood pressure!

It was however reassuring to find that all those with stage 4 and 5 CKD identified in Health Survey England were already diagnosed.