With an ageing population, heart failure is an increasing problem within the community. The treatment of heart failure has improved, resulting in fewer deaths and consequently patients can remain on potent drugs for many years. This has its own problems - our hospital admission study showed that kidney damage caused by drugs used to remove fluids was the second most common adverse reaction (ADR) causing hospital admission. Potentially this is preventable through regular monitoring of how the patients’ kidneys are working. However there are no clear clinical guidelines on how or where (with the patients’ GP or in specialist clinics) this checking should be carried out. Even if population-based guidelines were available, this is likely to be wasteful in terms of unnecessary testing for patients, increasing the economic burden and also impairing the quality of life of patients.
To develop personalised kidney function monitoring guidelines based on the characteristics of individual patients (for example: severity of heart failure, drugs being taken and other diseases that they might have). The availability of such monitoring protocols would change clinical care pathways, and potentially reduce hospital admissions, reduce cost and improve patient quality of life.