Diabetes and renal disease: who does what?
Editor – Jones et al criticise the current guidelines for referral of patients with -diabetes (DM) and chronic kidney disease (CKD) to nephrology clinics (Clin Med October 2013 pp 460–4). They have provided their evidence on 26,759 patients aged between 68 and 81 years with declining renal function that was based on estimated glomerular filtration rate (eGFR). However, it must be understood that eGFR of <60ml/min is very commonly seen in healthy older people1 and this is erroneously categorised as having CKD. It is well recognised that about 25% of the population aged over 70 years do have an eGFR consistent with stage 3 CKD or worse.2 In the geriatric age group, and without evidence of proteinuria/haematuria, an eGFR around 60ml/min should be considered as normal. In such patients a diagnosis of CKD should not be offered.
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- © 2014 Royal College of Physicians
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