• A new UK-wide survey found that a urine test, which identifies early markers of kidney damage, is not routinely carried out by GPs and nurses in annual reviews

• This is mainly because many patients are reluctant to provide a urine sample

A new survey has found that over half of GPs and nurses who treat patients with type 2 diabetes (T2D) do not carry out a vital routine test annually, which is used to identify early markers of kidney damage.

The Urine Albumin-to-Creatinine Ratio (UACR) test is used to detect protein in the urine, signalling kidney damage, which can lead to fatal complications.

According to survey respondents, the UACR test, which is recommended by UK guidelines for diabetes management, is not being administered annually to all patients as it should be because many patients are unwilling to provide a urine sample.

A urine test can help diagnose kidney problems early

Dr Aisling McMahon, Executive Director for Research, Innovation & Policy at Kidney Research UK said: “These survey results are sadly unsurprising, indeed they bear out findings from our own research among people with diabetes. Large numbers of people within this patient group are unaware that they are at increased risk of developing kidney problems, and how life-limiting those kidney problems can become. Having a simple urine test can help diagnose kidney problems early, and treatment and adjustments to lifestyle can make an enormous difference.”

Kidney function declines quicker for those with Type 2 Diabetes

Chronic kidney disease (CKD), the progressive and irreversible destruction of the kidneys, has far reaching effects on the body, particularly the heart. Kidney function naturally declines with age, however this decline is accelerated in 1.9 million patients who also live with T2D in the UK.

In these patients, any kidney damage results in a 23 per cent increased likelihood of death over 10 years, compared to only 12 per cent for T2D alone. Early identification of kidney damage, as identified through the vital UACR test, can help provide a ‘window of opportunity’, where rate of damage can be slowed or even halted with the right treatment and lifestyle changes.

Routine kidney function testing is vital

Diabetes is estimated to cost the NHS £14 billion per year, and over 80 per cent of those costs are the result of managing complications of the disease, including those associated with the kidney and the heart. Routine kidney function testing is an important way of identifying those people who are at risk of disease progression.

Despite 79 per cent of healthcare professionals surveyed stating that they knew the UACR test should be used as best practice, 75 per cent underestimated the impact of kidney disease on cardiovascular mortality. Once they were told the level of risk, 85 per cent responded that their colleagues would be more likely to conduct kidney function testing if they were aware of the true increase in risk of death.

The survey, commissioned by Napp Pharmaceuticals, was conducted online via the physician network, SERMO during October and November 2019. Only UK Practice nurses and GPs who confirmed they were actively involved in the management of patients with T2D were able to participate. Read the full press release about the survey and its findings.