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Our research tries to find out which patients are at risk of chronic kidney disease, how their cardiovascular health is affected by this and how screening and monitoring can help.

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Over the last decade we have realised the increasing importance of CKD. Even mild reductions in renal filtering function, expressed as estimated glomerular filtration rate (eGFR), substantially increase the risk of cardiovascular events, hospitalisation and death and a small proportion will go on to develop end stage renal failure and require dialysis or renal transplant. Yet patients with CKD are often asymptomatic until later in the disease and currently there is no established screening strategy.

NICE recommends using estimates of GFR to stage CKD, and management of CKD in primary care (such as monitoring of blood pressure, eGFR, proteinuria and prescribing to reduce cardiovascular risk) is dependent on CKD stage. However, there are still many important questions for primary care research to answer to improve clinical outcomes in our patients.

  1. How should we best detect CKD in the population?
  2. Which patients will go on to have vascular events or decline in renal function and how can we reduce these risks?
  3. What are the optimal monitoring intervals between blood tests in CKD and what is the right blood test for renal function?

At the Department of Primary Care Health Sciences, we have developed the Monitoring Of Renal Specific Endpoints (MORSE) programme to address the key issues of CKD management in primary care There are three large studies with different streams of NIHR funding and all take place in general practices with patients that GPs are likely to see on a daily basis.