Could community finger-prick testing improve access to kidney protection in underserved high-risk groups?
Dr Rouvick Gama from King’s College London has received a clinical training fellowship award of £200,000, in partnership with the Stoneygate Trust, to investigate the most accurate way to measure kidney function in people from different ethnicities, and whether community finger-prick kidney function testing can improve early diagnosis and monitoring.
What is the problem with kidney function diagnosis?
Approximately one in ten people in the UK have kidney disease and many are undiagnosed. It is vital that we have a way to test kidney function quickly and accurately, both to help with early diagnosis, and for monitoring of disease.
Currently, healthcare providers will measure a substance in the blood called creatinine, which increases with worsening kidney disease. They then calculate overall kidney function with an estimated glomerular filtration rate (eGFR) equation using creatinine, age and sex. However, the accuracy of eGFR measurements may vary among different ethnic groups.
New kidney function equations have been developed in North America, but these may not be accurate in the UK. If kidney function is measured incorrectly it can result in delayed diagnosis of kidney disease (and therefore delayed treatment), or it could mean that a patient is given the wrong treatments.
What is a solution for early diagnosis?
Rouvick will compare formerly measured kidney function tests from across the UK with new and old equations to work out which ones work best across all ethnicities. He will then use a new data system to look at data from over 180,000 patients to see how different eGFR equations can affect prescribing.
Point-of-care or finger-prick kidney function testing provides quicker and cheaper results than laboratory testing. Rouvick will assess how accurate the new finger prick kidney function tests are compared to standard blood tests in people of different backgrounds. He will also work with local GP practices to train nurses and pharmacists to use the finger-prick tests.
What this might mean for patients
Rouvick will work with patients to develop materials to tell people about their kidney function, how accurately it is measured, and the limitations of the current testing methods. This work will also show whether finger prick tests are safe and effective to use in community settings and will hopefully provide a fast, accurate way of diagnosing and monitoring kidney disease in all patients.
"I am very grateful to Kidney Research UK for funding this important and exciting work, which I hope will improve chronic kidney disease management in underserved populations, through point-of-care testing in local community settings and also improve the way we measure kidney function and raise awareness of these tests and their limitations for people living with kidney disease from diverse backgrounds." Dr Rouvick Gama
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