NICE Launches New Quality Standard On Chronic Kidney Disease On World Kidney Day
April 20, 2017
NICE has launched its new quality standard for chronic kidney disease (CKD) in adults. The launch coincides with World Kidney Day[1].
CKD is a common condition encompassing problems such as abnormal kidney function or structure, with around 1 in 10 adults in the UK having mild to severe CKD[2]. Although less common in younger adults under 45 years (affecting around 1 in 50 people), kidney problems increase with age, affecting half of people aged over 75 years[3],[4]. If CKD remains undetected, it can progress to established kidney failure requiring dialysis or transplantation, very poor health and in some cases early death.
Aimed at patients and the public, health and social care professionals, commissioners and service providers, NICE quality standards are markers of excellence in patient care. They are developed in collaboration with the NHS and social care professionals, along with their partners and service users and are the only health and social care standards that apply nationally in England.
Based on the best available evidence, usually NICE guidance or other sources that have been accredited by NHS Evidence, NICE quality standards will form a cornerstone of the new NHS Outcomes Framework[5], which sets out the aims and objectives towards improving outcomes in the NHS, and what this means for patients and healthcare professionals.
The quality standard on CKD defines high quality patient care, and includes such statements as: people with CKD are assessed for disease progression; people with CKD are assessed for cardiovascular risk; people with established renal failure have access to psychosocial support (which may include support with personal, family, financial, employment and/or social needs) appropriate to their circumstances; and, people with CKD are supported to receive a pre-emptive kidney transplant before they need dialysis, if they are medically suitable.
Dr Fergus Macbeth, Director of the Centre for Clinical Practiceat NICE said: "CKD is a potentially serious condition affecting a significant proportion of the population. If it is not managed properly, people with the condition may have up to 35 times higher risk of premature death[6]. These standards will act as a tool for local healthcare professionals to help deliver the best available care for their patients. The NICE quality standard on CKD has been developed from a range of evidence sources such as published NICE guidance, and the UK Renal Association Clinical Practice Guidelines."
Dr Paul Stevens, Consultant Nephrologist and Associate Medical Director from Kent and Canterbury Hospital, and Topic Expert Group Chair said: "I was very pleased to be involved in the development of these standards, which show the best care pathways for those with this condition. Robust, clear and evidence-based, I have every expectation they will be welcomed by both patients and healthcare professionals alike."
Fiona Loud, Chair of the Kidney Alliance said: "Kidney disease is more common than people might think, and as someone who has personally experienced the devastating effects of kidney failure, I am delighted that the Kidney Alliance was involved with NICE in the development of this new quality standard. I am confident it will improve outcomes for patients with CKD, and aid healthcare professionals involved in care and treatment."
Kate Shipton, chronic kidney disease patient said: "After two years on dialysis, my wonderful son gave me one of his kidneys last year, and so far things are going well. My experience of having chronic kidney disease has made me acutely aware of how important it is to have clear standards in place that will help people like me. I am very pleased that NICE has produced these, and I am sure they will make a significant contribution in the battle against this disease."
The quality standard on CKD is available on the NICE website from Thursday 10 March.
Notes
1. The quality standard on CKD in adults has been developed from the following evidence sources:
- Anaemia management in people with chronic kidney disease. NICE clinical guideline 114 (2011; NHS Evidence accredited). Available here.
- Chronic kidney disease: early identification and management of chronic kidney disease in adults in primary and secondary care. NICE clinical guideline 73 (2008; NHS Evidence accredited). Available here.
- Anaemia management in people with chronic kidney disease. NICE clinical guideline 39 (2006; NHS Evidence accredited) (now replaced by NICE clinical guideline 114). Available from www.nice/CG39
- Guidance on home compared with hospital haemodialysis for patients with end-stage renal failure. NICE technology appraisal 48 (2002; NHS Evidence accredited). Available here.
- The Renal Association (2011) Clinical practice guideline: acute kidney injury.
- The Renal Association (2011) Clinical practice guideline: vascular access for haemodialysis.
- The Renal Association (2010) Clinical practice guideline: assessment of the potential kidney transplant recipient.
- The Renal Association (2010) Clinical practice guideline: cardiovascular disease in CKD.
- The Renal Association (2010) Clinical practice guideline: peritoneal dialysis.
- The Renal Association (2009) Clinical practice guideline: haemodialysis.
- The Renal Association (2009) Clinical practice guideline: peritoneal access.
- The Renal Association (2009) Clinical practice guideline: Planning, initiating and withdrawal of renal replacement therapy.
2. Related policy documents:
- Department of Health (2009) Achieving excellence in kidney care: Delivering the National Service Framework for Renal Services.
- Department of Health (2007) Second Progress Report on the Renal NSF.
- Department of Health (2004) National Service Framework for Renal Services: Part One - Dialysis and transplantation.
- Department of Health (2005) National Service Framework for Renal Services - Part Two: Chronic kidney disease, acute renal failure and end of life care.
3. The NHS Outcomes Framework can be found here.
4. Quality standard topics are referred to NICE by ministers on the advice of the National Quality Board, a group of representatives from health and social care, committed to improving quality in the NHS and overseeing the reforms aimed at improving care. Further information on the National Quality Board can be found here.
[1] World Kidney day is a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF). The UK Celebration of World Kidney Day is led by the Kidney Alliance.
[2] UK National Kidney Federation
[3] Many elderly people with CKD may not have 'diseased' kidneys, but have normal ageing of their kidneys. Although severe kidney failure will not occur with normal ageing of the kidneys, there is an increased chance of high blood pressure and heart disease or stroke.
[4] UK National Kidney Federation
[5] The recently announced Transparency in Outcomes framework for the NHS proposes using quality standards to produce more detailed commissioning guidance to meet the suggested outcome goals.
[6] NHS Kidney Care
Source:
NICE