Kidney health

Attitudes towards monitoring kidney health

We asked the people we spoke to what they thought were the positive and negative aspects of having regular monitoring of their kidney health. People commonly said they gained a sense of reassurance from knowing that health professionals were keeping an eye on them, that their test results were fine and that if problems were to be discovered as a result of routine testing then they would be dealt with promptly.
On the negative side, organising and attending regular check-ups could be a nuisance and inconvenient especially if people had mobility problems or had to travel some distance, or if they had to wait a long time after arriving at the GP’s surgery or hospital renal clinic before being seen. Anne said she needed a lift to her appointments because of mobility problems but this was not usually a problem to arrange.
Waiting for tests to be done once they had made the appointment, and then for the results to come back, could be a worrying time.
A fear of needles was a problem for some people who therefore didn’t like having blood samples taken (see ‘Tests used to monitor kidney health’).

Most people we asked were happy with how often they had their check-ups done. A few would prefer them more or less often, some saying they would not be happy if the frequency of their testing was reduced. Pat was currently having blood tests every month because of an infection and was looking forward to a time when she would have tests further apart. Bill would like to have a home testing kit for his blood sugar so he could measure it between formal check-ups, as many other diabetics do, but his GP would not supply it on prescription. Some people whose check-ups didn’t appear to be organised at particular time intervals wanted them more regularly. Gordon said that if his check-ups were done more frequently than every six months he might worry that there was something wrong.
We also asked people how they would feel if their doctor wanted to make changes to the way they were monitored other than how often the tests were done. A common response was that they trusted their doctor and would go along with whatever they suggested without questioning it. Others said they would want to discuss it with their doctor so they could understand the reasons for any change. Jim and Joanne expected the format of their check-ups to remain as they were for the foreseeable future.
When asked about which professionals they would like to see for particular aspects of their care, having blood taken by a nurse or phlebotomist (a specially trained healthcare assistant not usually trained in nursing) was a popular choice because they were more expert at it than doctors. Some people were happy for a practice receptionist to tell them about test results as long as they were normal, but would prefer to speak to a doctor or nurse about abnormal results because they were better qualified to discuss medical matters and should be able to answer any questions.
Home testing kits that enable patients to carry out their own blood tests at home and know the results immediately are an example of Point Of Care Testing (POCT), also known as Near Patient Testing (NPT) or Extra-laboratory testing. Another kind of Point of Care Testing is where samples that have traditionally been sent to a hospital pathology laboratory for analysis are instead analysed with equipment in the GP’s surgery or hospital outpatient clinic, cutting down on waiting times for results to reach the patient. Some people who were having blood tests to measure their INR (International Normalised Ratio) because they were taking warfarin said this kind of testing was already available in their practice or hospital clinic using a finger prick blood sample rather than one taken with a needle.
The prospect of Point of Care Testing for other types of tests in future was popular among some of the people we spoke to because they wouldn’t have to remember to phone up for their results, and receiving results straight away would prevent the worry associated with waiting. But some felt that if they still had to wait a short while at the GP surgery or clinic for the results there would be no advantage over how they got their results now, and not everyone said that obtaining test results straight away was important.
Monitoring of kidney performance in general was felt to be a good thing by several people because they recognised that the kidneys are vital to life and they believed in the value of preventative medicine. There was uncertainty about why some things are monitored while others are not, and suggestions for other aspects of health that people would like to have monitored.

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