Chronic kidney disease: early identification and management of chronic kidney disease in adults in primary and secondary care [CG182]

Measuring the use of this guidance

Recommendation: 1.6.1

In people with CKD aim to keep the systolic blood pressure below 140 mmHg (target range 120–139 mmHg) and the diastolic blood pressure below 90 mmHg[6].

What was measured: Patients who achieved the NICE BP control target

Data collection end: March 2010

58.1%

Number that met the criteria: 829 / 1426

Area covered:	Regional
Source:	Fraser SDS et al. (2013) Suboptimal blood pressure control in chronic kidney disease stage 3: baseline data from a cohort study in primary care. BMC Family Practice, Vol 14 p88

What was measured: Proportion of people with CKD stage 3 to 5 without diabetes who had a below target blood pressure reading recorded

Data collection end: June 2016

53.1%

Area covered:	England and Wales
Source:	National Chronic Kidney Disease Audit National Report (Part 1)

Recommendation: 1.6.2

In people with CKD and diabetes, and also in people with an ACR of 70 mg/mmol or more, aim to keep the systolic blood pressure below 130 mmHg (target range 120–129 mmHg) and the diastolic blood pressure below 80 mmHg

What was measured: Proportion of people with CKD stage 3 to 5 with diabetes who had a below target blood pressure reading recorded

Data collection end: June 2016

29.2%

Area covered:	England and Wales
Source:	National Chronic Kidney Disease Audit National Report (Part 1)

Recommendation: 1.6.3

Offer a low‑cost renin–angiotensin system antagonist to people with CKD and: - diabetes and an ACR of 3 mg/mmol or more (ACR category A2 or A3) - hypertension and an ACR of 30 mg/mmol or more (ACR category A3) - an ACR of 70 mg/mmol or more (irrespective of hypertension or cardiovascular disease)[4]. [new 2014]

What was measured: Proportion of patients on the CKD register with hypertension and proteinuria who are currently treated with an ACE-I or ARB.

Data collection end: July 2015

76.4%

Area covered:	England
Source:	Health and Social Care Information Centre. Quality Outcomes Framework.

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