Understanding and improving the management of chronic kidney disease in primary care

We aim to find out how patients and primary and specialist care clinicians understand experience and manage the early stages of chronic kidney disease (CKD) through face-to-face interviews. The early stages of CKD have no symptoms but may be associated with risk of kidney damage and development of more serious conditions. As there are no symptoms, there is under-diagnosis and recording of the problem.  This has led to new policy aiming to encourage doctors to look for early CKD in their patients. There is concern that as early CKD is a risk factor for other problems such as heart disease, rather than a sign of potentially progressive kidney disease, that early diagnosis may be creating a new and unnecessary medical condition.

There is little current guidance for how best to tell people they have the early stages of kidney disease with its associated risks. The terminology has caused professional concern and patient anxiety. Therefore disclosure and early management are issues that need to be addressed.  We plan to interview a range of health professionals to explore how this condition is managed and thought of in primary care. We will also interview a range of patients, including those who may not be aware of their kidney risk, to explore issues around disclosure, anxiety, views on taking medication and understanding of diagnosis and risks. We will develop an online website resource for patients through video-recording a proportion of the patient interviews. We will conduct interviews with health professionals to develop guidance for the management of early CKD in primary care.