Electronic records suggest suboptimal management of chronic kidney disease in general practice

Objective: To examine electronic records of GP management of chronic kidney disease.
Design: Cross‐sectional study.
Setting: Thirteen general practices.
Participants: Fifteen thousand four hundred and fiftteen active patients aged 50 years and over.
Main outcome measure: Recorded estimated glomerular filtration rate (eGFR) and diabetes, and rate of prescribing of angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers (ACE/ARBs).
Results: Six thousand and fifty‐nine (39%) patients had hypertension and 1859 (12%), diabetes. Two thousand six hundred and eighty‐nine (17%) patients were recorded with eGFR < 60 mL min^–1 (1.73 m²)^–1, while 3344 (22%) did not have an eGFR result recorded. Hypertension, diabetes and eGFR <60 mL min–1 (1.73 m²)^–1 were shown to be significantly related to prescribing of ACE/ARBs; however, 31% of known diabetics and 23% of diabetics with an eGFR < 60 mL min–1 (1.73 m²)^–1 are not recorded as receiving ACE or ARB therapy. Forty‐two per cent of patients with eGFR < 60 mL min^–1 (1.73 m²)^–1, are also not recorded as receiving ACE or ARB therapy. There was a 23% variation in the rates of prescribing of ACE/ARBs by practice for patients with diabetes and eGFR < 60 mL min^–1 (1.73 m²)^–1.
Conclusion: The overall recording of eGFR and the recorded prescribing of ACE or ARB therapy in known diabetics and patients with eGFR < 60 mL min^–1 (1.73 m²)^–1 appear suboptimal. Also, the variations in prescribing between practices require further investigation.